End Stage Pancreatic Cancer
End stage pancreatic cancer is also called advanced, Stage 4, or Metastatic cancer. It is a cancer that has spread through the body to colonize other regions and organs. The term also includes cancer that has returned after it was thought cured. Metastasis is one of cancer's defining characteristics and part of what makes it so deadly and difficult to treat. And in the case of pancreatic cancer, evidence of metastasis rules out surgery as a treatment option, further complicating the disease's treatment.
The first place cancer usually spreads to is the lymph nodes. The danger comes when the cancer reaches nodes not near the pancreas. Once in the lymph system, the cancer spreads throughout the body.
The next place it spreads to, and one that causes many problems, is the liver. Surgery is almost never an option when the cancer has reached this organ, signaling end stage pancreatic cancer. Other locations that defy surgery and most treatment are the celiac plexus, superior mesenteric vessels, portal vein, and Ligament of Treitz.
When surgery is not an option, other procedures must be tried. Still, by this time almost all treatments are aimed at reducing symptoms more than destroying cancer. One of the first treatment options is chemotherapy. This uses chemical agents to fight the cancer. A drug called 5-fluorouracil, 5-FU for short, was formerly the best drug for all stages of pancreatic cancer. The drug was given in unit doses, but research showed that infusions were more effective. When given in this way the average survival rate rose to about 6 to 8 months. Today, a new drug called gemcitabine, or Gemzar, is used. It is paired with a tablet form of 5-FU or liquid forms of other chemo drugs. Gemzar functions in a manner different from 5-FU's. This gives it an advantage over the other drug. Gemzar improves survival rates a bit over 5-FU, but its main benefit is symptoms in lesser number and severity than those of 5-FU. Side effects of 5-FU therapy are: mouth ulcers, diarrhea, hair thinning or loss, and an increased risk of infection. But unfortunately, even the strongest chemotherapy treatments show very little benefit for people with end stage pancreatic cancer. Still, chemo shows some effect in treating the advanced cancer symptoms, which is really all that can be done in most cases. A treatment often paired with chemo is radiation therapy. It uses high-energy X-rays to destroy cancer cells. Radiation treatments can be given before or after surgery, though it is used most aggressively in end stage pancreatic cancer case, where surgery is impossible. There are three types of radiation treatment. The first comes from a machine outside the body. This is the type usually used to treat pancreatic cancer. The second is called intraoperative electron beam radiation. It uses an external beam radiation during surgery that uses electrons. The third involves radioactive "seeds" that can be implanted for a time, and then removed from the affected area. The last two methods spare nearby organs. The side effects can include burns, nausea, vomiting, and fatigue. But it helps decrease cancer symptoms. End stage pancreatic cancer is typically fatal and untreatable. But by using a number of treatments, the cancer's symptoms can be controlled or at least reduced. This improves quality of life for sufferers.
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