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Wednesday, May 14, 2008

Treating pancreatic cancer with chemotherapy

Why chemotherapy is given

Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells.

If a pancreatic cancer has been removed with surgery, chemotherapy may be given afterwards to try to reduce the chance of the cancer coming back. This is known as adjuvant chemotherapy. Occasionally, chemotherapy may be given before surgery, to try to shrink the cancer down and make it easier to remove. This is known as neoadjuvant chemotherapy.

If the cancer cannot be removed, but has not spread beyond the pancreas, chemotherapy cannot cure the cancer but may shrink the cancer down and control it for a time. Chemotherapy may be given together with radiotherapy to increase its effectiveness. This is known as chemoradiation.

If the cancer has spread, chemotherapy may be used to try and shrink the cancer and relieve symptoms.

How chemotherapy is given

Chemotherapy drugs are usually given by injection into a vein (intravenously) either in your arm or through a plastic tube (a central line), into your chest.

The chemotherapy drugs used to treat pancreatic cancer include gemcitabine (Gemzar®), 5-flourouracil, cisplatin, and mitomycin C. Sometimes a tablet form of 5FU, called capecitabine (Xeloda®), may be used. The length of time that chemotherapy is given for will depend on how well the treatment is working and controlling symptoms. This will be monitored by your doctor at regular appointments, and you will have regular blood tests and occasional scans. Any decision to use chemotherapy will be reached after a discussion between you and your doctor.

After you have had your chemotherapy there is usually a rest period of a few weeks, which allows your body to recover from the side effects of the treatment. Chemotherapy is normally given to you as an outpatient, but sometimes it will mean spending a few days in hospital.

Our separate section on chemotherapy gives detailed information about the treatment and its side effects. Information about individual drugs you may have as part of your treatment, and their particular side effects, are also available

Sometimes chemotherapy can be given to you through a small portable pump, which is attached to your central line. A controlled amount of the drugs can be given continuously into the bloodstream over a period of time. This means that you can go home with the pump and so spend less time in hospital.

A number of research trials are being carried out to try to improve the results of treatment for pancreatic cancer. You may be asked to take part in a trial.

Side effects

Chemotherapy can sometimes cause unpleasant side effects, but it can also make you feel better by relieving the symptoms of the cancer. Most people have some side effects, but these can often be well controlled with medicines. The possible side effects are described here, along with some of the ways in which they can be reduced.

Reduced resistance to infection

While the drugs are acting on the cancer cells in your body, they also temporarily reduce the number of normal cells in your blood. When these cells are reduced you are more likely to get an infection. During chemotherapy, your blood will be tested regularly and, if necessary, you will be given antibiotics to treat any infection.

Sore mouth

Some chemotherapy drugs can make your mouth sore and cause small ulcers. Regular mouthwashes are important and your nurses will show you how to do these properly. If you don’t feel like eating during treatment, you could try replacing some meals with nutritious drinks or a soft diet. Our section on eating well has some useful tips on coping with eating problems.

Diarrhoea

Some drugs used to treat cancer of the pancreas can irritate the lining of the digestive system and cause diarrhoea for a few days. Your doctor can give you medicine to slow down the bowel, and reduce the diarrhoea. You may also be able to help to control it by eating a low-fibre diet, avoiding wholemeal bread and pasta, raw fruit, cereals and vegetables for a few days after each treatment.

Feeling sick

Some of the drugs may make you feel sick (nauseated) and you may be sick. There are now very effective anti-sickness drugs (anti-emetics) to prevent or greatly reduce nausea and vomiting. Your doctor can prescribe these for you. Let your doctor or nurse know if your anti-sickness drugs are not helping you, as different types can be used. We have a factsheet about controlling nausea and vomiting.

Tiredness

You are likely to find that you become very tired and have to take things much more slowly. Just do as much as you feel like and try not to overdo it.

Hair loss

Ask your doctor whether the drugs you are taking are likely to make your hair fall out. Not all drugs cause hair loss and certain drugs are more likely to make your hair thin. If your hair does fall out, it will start to grow back once your treatment is over.

Skin

Chemotherapy can affect the skin and nails, causing dryness and flaking. Some drugs make your skin more sensitive to the sun, so it is important to cover up and use a high-factor suncream.

Although these side effects may be hard to bear at the time, they will gradually disappear over a few weeks once your treatment has finished.

Via: http://www.cancerbackup.org.uk

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