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Wednesday, May 14, 2008

Treatment for pancreatic cancer

Types of treatment

The type of treatment you will be offered depends on the particular type of cancer of the pancreas you have, the stage of the cancer, its size, and your general health.

Cancer of the pancreas can be very difficult to treat. Early-stage cancer can sometimes be cured with surgery, but many pancreatic cancers are not diagnosed until the cancer is quite advanced and then it may not be possible to cure it.

The most effective treatment for early-stage cancer of the pancreas is surgery to remove part, or all, of the pancreas. This is a major operation and is only suitable for people whose cancers are small and have not spread, and who are fit. If the cancer is too large, or has already spread beyond the pancreas when it is diagnosed, this kind of surgery is not possible. Learning that your cancer has spread, and therefore that certain treatments are not suitable for you, is distressing news to cope with. Your doctor will advise you about the treatments that are most likely to help in your situation.

If the cancer has spread and is causing a blockage of the bile duct or the bowel, surgery can be used to relieve the blockage and ease the symptoms.

Chemotherapy can be used in a number of different ways. It may be used after surgery for early-stage pancreatic cancer to try to reduce the chances of the cancer coming back. It can also be used to shrink cancers that have spread into the area around the pancreas (locally advanced), or to treat cancers that have spread to other parts of the body, such as the liver. For cancers that have not spread beyond the pancreas but cannot be removed by surgery, chemotherapy and radiotherapy may be given separately or together. Sometimes you may be asked to take part in a clinical trial of a new drug or treatment.

Chemotherapy may also be given to reduce some of the symptoms of the cancer. Radiotherapy can be helpful in controlling pain.

Cancer of the pancreas is often difficult to treat and control effectively. You may be told that the risks or side effects of some treatments may outweigh the benefits, and this can often be hard to understand and accept. However, uncomfortable symptoms can nearly always be treated to help you to feel better. The section on other treatments discusses ways in which certain symptoms can be managed.

Benefits and disadvantages

Many people are frightened at the idea of having cancer treatments, because of the side effects that can occur. Some people ask what would happen if they did not have any treatment.

Although many of the treatments can cause side effects, these can usually be effectively controlled with medicines.

Treatment can be given for different reasons, and the potential benefits will vary depending upon each person's situation. In people with early-stage pancreatic cancer, surgery is often done with the aim of curing the cancer. Additional treatments such as chemotherapy may also be given to reduce the risks of it coming back.

If the cancer is at a more advanced stage, the treatment may only be able to control it, leading to an improvement in symptoms and a better quality of life. However, for some people, the treatment will have no effect upon the cancer and they will get the side effects without any of the benefit.

If you have been offered treatment with the aim of curing your cancer, deciding whether to accept the treatment may not be difficult. However, if a cure is not possible and the treatment is being given to control the cancer for a period of time, it may be more difficult to decide whether to go ahead with treatment.

Making decisions about treatment in these circumstances is always difficult, and you may need to discuss in detail with your cancer specialist whether you wish to have treatment. If you choose not to, you can still be given supportive (palliative) care, with medicines to control any symptoms.

Giving your consent

Before you have any treatment, your doctor will explain the aims of the treatment to you. They will usually ask you to sign a form saying that you give your permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent, and before you are asked to sign the form you should have been given full information about:

  • the type and extent of the treatment you are advised to have
  • the advantages and disadvantages of the treatment
  • any other possible treatments that may be available
  • any significant risks or side effects of the treatment.

If you do not understand what you have been told, let the staff know straight away so that they can explain again. Some cancer treatments are complex, so it is not unusual for people to need repeated explanations.

It is often a good idea to have a friend or relative with you when the treatment is explained, to help you remember the discussion more fully. You may also find it useful to write down a list of questions before you go to your appointment.

Patients often feel that the hospital staff are too busy to answer their questions, but it is important for you to be aware of how the treatment is likely to affect you. The staff should be willing to make time for you to ask questions.

You can always ask for more time to decide about the treatment, if you feel that you can’t make a decision when it is first explained to you.

You are also free to choose not to have the treatment. The staff can explain what may happen if you do not have it. It is important to tell a doctor, or the nurse in charge, so that they can record your decision in your medical notes. You do not have to give a reason for not wanting to have treatment, but it can be helpful to let the staff know your concerns so that they can give you the best advice.

Second opinion

A number of cancer specialists work together as a team to decide the most suitable treatment for a patient, and they follow national cancer treatment guidelines. Even so, you may want to have another medical opinion. Most doctors (your GP or specialist) will be willing to refer you to another specialist for a second opinion, if you feel that it will be helpful. As the second opinion may cause a delay in the start of your treatment, you and your doctor need to be confident that it will give useful information.

If you decide to get a second opinion, again it may be a good idea to take a friend or relative with you, and to have a list of questions ready, so that you can make sure your concerns are covered during the discussion.

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

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