Pancreatic Cancer Chemotherapy
Cancer within the ducts of the pancreas, called adenocarcinoma, is one of the more dangerous cancer types. In the US alone, it kills over 30,000 people each year. But research has shown some advances in treating the disease. Pancreatic cancer chemotherapy is one such treatment. It is usually used after doctors perform surgery to remove the pancreatic tumor to destroy any remaining cancer cells. However, it is also used to shrink the growth's size to facilitate surgery. There many chemotherapy drugs for pancreatic cancer, but two of the most commonly used are 5-fluorouracil and gemcitabine.
In the recent past, chemotherapy (so named for its use of chemical agents to destroy cancerous cells) showed little benefit when used on pancreatic cancer patients. The only drug available to pancreas cancer sufferers in the past was 5-fluorouracil, abbreviated 5-FU. It was given after pancreas resection surgery. Doctors usually prescribed a vitamin called folinic acid to improve 5-FU's effects. 5-FU was first given in unit doses instead of extended intravenous infusions. Yet recent data proposes that such a dose had no benefits. Trial results from bolus (doses injected into the vein rather than infused) doses of 5-FU show an average survival rate 5 months at best. But when given over prolonged infusion rates, the average survival rate rose to 6 to 8 months.
Radiation and 5-FU were usually used together. In people with inoperable tumors, the combination seemed to slow tumor growth. But in the long run the chemotherapy and radiation did little but ease cancer symptoms and pain before death. In fact, it showed very little benefit for people with end stage pancreatic cancer. Side effects of 5-FU therapy are much like those of other chemotherapeutic drugs: diarrhea, hair thinning or loss, mouth ulcers, and an increased risk of infection.
Recently, a new chemotherapy drug recently approved by the FDA for pancreatic cancer treatment has replaced 5-FU as the leading agent. This drug is called gemcitabine or Gemzar. It works in a way completely different from 5-FU's method. Studies found that it improved the leading pancreatic cancer symptoms, namely weight loss and tumor-related pain. It also demonstrated a slightly improved increase in patient survival rates than did 5-FU. But it is still given intravenously. The previous practice was to give in it 30 minute infusions every week, but research has shown that three-hour infusion every three weeks may be more effective. As with 5-FU, gemcitabine is combined with radiation. This seems to be effective in shrinking tumors. The side effects of gemcitabine are like those of 5-FU and other chemo medications: being or feeling sick, swelling of the lower extremities (feet or legs), weight gain from fluid retention, flu-like symptoms (aches, headache, chills, fever), an increased risk for infection and low white blood cell counts, and vomiting and nausea. But these side effects are usually mild and treatable. Unfortunately, despite much research and many trials, chemotherapy agents like 5-FU, gemcitabine, and others do not have much of an impact on pancreatic cancer. Even with their use, the average survival time is little more than 6 months. This is only an improvement of 2 to 3 months over survival rates without chemotherapy. So in reality, their main effect is reducing the symptoms. More research must be done before a truly effective pancreatic cancer chemotherapy drug is discovered.
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