Treating and Coping With Pancreatic Cancer

Introduction

Although significant progress has been made in diagnosing and treating many types of cancer, pancreatic cancer remains highly intractable to treatment. It is difficult to detect because symptoms may not occur until the condition is well advanced, and even when it is diagnosed early, patient prognoses are poor. Although pancreatic cancer represents just around 3% of all cancers in the United States, it is responsible for approximately 7% of all cancer deaths (Key statistics, 2015). This paper provides a description of the diagnosis and staging of pancreatic cancer, followed by a discussion of the complications and side effects associated with the disease. Finally, it describes the methods used to lessen the physical and psychological effects of pancreatic cancer treatment before summarizing the key research findings in the conclusion.

Diagnosis and Staging of Pancreatic Cancer

Pancreatic cancer originates in pancreatic tissues, but individuals who develop this type of cancer face poor prognoses even when the condition is diagnosed early (Pancreatic cancer causes, 2015). According to the Mayo Clinic, "Pancreatic cancer typically spreads rapidly and is seldom detected in its early stages, which is a major reason why it is a leading cause of cancer death" (Pancreatic cancer causes, 2015, para. 2). Moreover, in many cases there will not be any discernible symptoms or signs of pancreatic cancer until the condition is well advanced, preventing the use of surgical intervention (Pancreatic cancer causes, 2015). In this regard, Shah (2008) emphasizes that "due to its late onset of symptoms, pancreatic cancer often goes undetected until it's too late" (p. 29).

The American Cancer Society's 2015 estimates for pancreatic cancer in the United States indicate that approximately 48,960 individuals (24,840 men and 24,120 women) will be diagnosed with pancreatic cancer each year, and the vast majority — approximately 40,560 individuals (20,710 men and 19,850 women) — will die each year as a result (Key statistics, 2015). These rates have remained fairly stable in recent years (Key statistics, 2015). Although no major professional groups currently recommend screening tests for pancreatic cancer, because no screening tests have been demonstrated to reduce mortality rates, tumor markers can assist with diagnosis in some cases. However, in most instances the condition is too advanced by the time tumor markers are generated (Key statistics, 2015).

Complications and Side Effects Associated with Pancreatic Cancer Treatments

The four main methods currently used to treat pancreatic cancer, along with their associated side effects, are as follows:

1. Surgery: This is the only intervention with a reasonable chance of curing some types of pancreatic cancer, but it is effective in only a small percentage of patients and can result in severe side effects and complications. These complications include: (a) leaking from the various connections among organs made by the surgeon; (b) infections; (c) bleeding; and (d) problems with emptying the stomach after meals.

2. Ablative techniques: These interventions attempt to destroy pancreatic cancer using methods such as microwaves rather than removing tumors surgically, but they are unlikely to cure the condition in isolation from other treatments. Complications associated with ablative techniques include fever, nausea, infection, abdominal pain, and blood clots in blood vessels near the treated area.

3. Radiation therapy: High-energy X-rays are used in radiation therapy to destroy pancreatic cancer cells, though some types of pancreatic cancer are unresponsive to this intervention. This method may be used prior to surgery or chemotherapy to improve their effectiveness. Common side effects include: (a) skin changes similar to sunburn in radiated areas; (b) nausea and vomiting; (c) diarrhea; (d) fatigue; (e) poor appetite; (f) weight loss; (g) diminished blood counts; and (h) increased risk of infection.

4. Chemotherapy and other drugs: These interventions use orally administered or injected anti-cancer drugs — such as Gemcitabine and 5-fluorouracil — that spread throughout the entire body, making them especially appropriate in cases where the cancer has spread to other regions. This approach is frequently combined with radiation therapy to improve its efficacy. Numerous side effects are associated with these interventions, including: (a) nausea and vomiting; (b) loss of appetite; (c) hair loss; (d) mouth sores; (e) diarrhea or constipation; (f) increased risk of infection; (g) fatigue; and (h) bleeding and bruising following minor cuts due to reduced platelet counts (Pancreatic cancer treatments, 2015).

Conclusion

The research showed that pancreatic cancer is diagnosed in nearly 50,000 people in the United States each year, and most of these individuals will die as a result. Unfortunately, the research also showed that pancreatic cancer is an especially insidious type of cancer due to the inability to detect the condition early — stemming from a lack of identifiable symptoms — and that even when the disease is diagnosed early, patient prognoses are generally very poor. Several types of treatments are available for pancreatic cancer, including surgery, ablative techniques, radiation therapy, and chemotherapy and other drugs, and these interventions are frequently used in combination to enhance their effectiveness. Each of these techniques was also shown to carry a number of serious side effects that require individualized management, while the overarching need to help all pancreatic cancer patients manage their pain remains paramount. Finally, because as many as half of all pancreatic patients experience a major depressive disorder as a result of the condition, it is important to treat depression using pharmacological interventions as well as patient education, behavioral therapy, and individual and group psychotherapy.

References

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Pancreatic cancer causes. (2015). Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/pancreatic-cancer/basics/definition/con-20028153

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Shah, M. (2008, September 15). Emerging therapies aim to battle pancreatic cancer. Drug Topics, 152(10), 28–31.