Surgery
Depending on where the cancer is in your pancreas will determine the type of surgery you need.
Whipple
This surgery is the most commonly performed for pancreatic cancer. It removes cancer from the head of the pancreas. During this operation the head of the pancreas, part of the duodenum, bile duct, stomach and all of the gallbladder are removed.
Image: Organs Pre and Post Whipple
Distal Pancreatectomy and Splenectomy
This surgery removes cancer from the body and tail of the pancreas. Usually the spleen is removed at the same time because it sits beside this part of the pancreas and the artery that connects to the spleen runs along the back of the body and tail of the pancreas.
Total Pancreatectomy
This is the operation that removes all of the pancreas – head, body and tail. This type of surgery is only carried out under exceptional circumstances as it can have a big impact on your overall health and lifestyle.
Currently, surgical procedures are carried out in Cork, for patients from counties in South Munster, and St Vincent’s University Hospital Dublin for patients from the rest of the country).
National Surgical Centre for Pancreatic Cancer (NSCPC) – St. Vincent’s University Hospital
Chemotherapy
Chemotherapy is a drug treatment used to kill cancer cells. It is one of the main treatments for pancreatic cancer.
It can be used:
- after surgery, to reduce the risk of the cancer coming back.
- before surgery, to try to shrink the cancer so there is a better chance of removing it. Chemotherapy before surgery may also remove cancer cells that cannot be seen.
- to slow down the growth of cancer that can’t be removed by surgery (locally advanced pancreatic cancer or advanced pancreatic cancer).
The frequency of treatment and side-effects you may experience will depend on the type of chemotherapy you are prescribed. This will be determined by your doctor.
See below for information on the two most commonly prescribed chemotherapies for pancreatic cancer.
FOLFIRINOX (or FOLFOXIRI) | Macmillan Cancer Support
Gemcitabine and nab-paclitaxel (Abraxane®) | Macmillan Cancer Support
Radiotherapy
Radiotherapy is a treatment that uses high energy rays to kill cancer cells.
Palliative Care
Palliative care can help manage symptoms and improve quality of life. This may take place in hospital, in hospice or in your home. A palliative care team can include specially trained doctors, nurses, occupational therapists, social workers, physiotherapists, complementary therapists, counsellors and chaplains.
Complementary Treatment
These are treatments that you may have alongside your medical treatment and can include activities such as massage, reflexology, acupuncture and aromatherapy. These are not aimed at treating or curing cancer but may help in managing side effects of treatment and coping with illness. Prior to starting any complementary treatments it is important to first discuss them with your doctor. This includes taking any over the counter medications or herbal products.
Genetic Testing
Genetic testing is advised internationally for ALL pancreatic cancer patients regardless of your family cancer history. However the result will only influence treatment if the pancreatic cancer is not able to be removed.
Genetic testing looks for inherited mutations through analysis of a blood or saliva sample. If genetic testing shows a germline mutation, then their family members could consider getting tested also. People who test positive for an inherited mutation are at higher risk than most, but this does not mean that they will definitely develop pancreatic cancer.
Tumour Profiling
Tumour profiling is often recommended for patients with pancreatic cancer whose cancer has spread beyond the pancreas. Tumour profiling is not available for all patients in Ireland and access should be discussed with your oncologist.
Clinical Trials
Clinical trials aim to find new and more effective ways to prevent, diagnose, and treat cancer as well as to improve quality of life for patients.
Currently, opportunities to participate in clinical trials in Ireland are extremely limited. Talk to your healthcare provider to discuss your options for participating in a clinical trial.
Research
Update coming soon.
Nutrition
Loss of appetite and nausea are common symptoms of pancreatic cancer. These symptoms can also be a side effect of treatment and other prescribed medications.
Tips to help manage nausea or a loss of appetite:
- Eat small, frequent meals of easily digestible foods, such as crackers, dry toast.
- Avoid eating greasy, spicy, or very sweet foods.
- Sip slowly on water, clear juices or broths.
- Peppermint or ginger tea and hard candies can help lessen nausea and get rid of unpleasant tastes in your mouth.
- Wear loose, comfortable clothing and avoid rooms that are too warm or stuffy.
- Limit your exposure to odours by removing garbage right away, or have a loved one bring you meals that were cooked elsewhere. Foods that are cold or room temperature also tend to have less odours.
Note to caregivers: It can be difficult to see your loved one decline or struggle to finish food. They may also not be able to eat at typical meal times or join in on celebrations involving food. This can be especially challenging when your loved one is losing weight or appears low in energy. Remember to be patient and supportive. If helping with meal preparation, take note of food your loved one can tolerate and offer smaller portions.
Pancreatic Enzyme Replacement Therapy
The pancreas plays an important role in digestion. It does this by producing enzymes which break down food. Pancreatic cancer and surgery can affect this process which prevents you from getting all the nutrients from the food you eat.
Pancreatic enzyme replacement therapy (PERT) replaces the enzymes that your body needs to break down and digest food properly. You take PERT as capsules with your food. You should take it with most food, including meals, snacks, and milky drinks. CREON is a commonly prescribed brand in Ireland.
Type 3c Diabetes
This is a type of diabetes caused by having all or part of the pancreas removed or the pancreas being damaged. People with Type 3c diabetes produce less of all the hormones from the pancreas, including insulin and glucagon. This is typically treated with insulin or with tablets used to increase insulin production.
Sign of Type 3c Diabetes can include:
- Unintentional weight loss
- stomach pain
- feeling more tired than usual
- frequently passing wind
- diarrhoea
- fatty or oily stools
- hypoglycaemia, also called low blood sugar
Speak to your doctor if you experience any of the above symptoms.
