Pancreatic cancer treatments

The choice of treatment is decided at the end of the extension assessment, which makes it possible to determine the extent of the tumor and to evaluate if it can be removed immediately by resection, i.e. surgically removed. Other patients must first undergo chemotherapy before surgery. These patients will not be operated on, but treated with chemotherapy alone in order to postpone and control the progression of the disease.

Pancreatic cancer surgery

Before any surgical intervention, the patient undergoes an MRI of the liver to verify that there are no metastases at this stage. Upon discovery of the disease, half of those affected by it will have metastases. Even when the cancer has remained localized, tumor cells are often already circulating in the body and are invisible to the scanner. This is the reason why it is usually decided to perform chemotherapy sessions prior to surgery.

Pancreatic cancer surgery is a major operation with risks of postoperative complications. Patients therefore have every interest in being cared for by expert surgeons at a referral center, such as Institut Curie, which offers the prospect of improving the survival prognosis.

The surgery varies depending on the location of the tumor. If the cancer is in the head of the pancreas, the surgeon removes the head and the small intestine. This is called a cephalic duodeno-pancreatectomy. If it is at the level of the body or the tail of the pancreas, the surgeon performs an intervention called left spleno-pancreatectomy.

Chemotherapy for pancreatic cancer

Chemotherapy can follow surgery or precede the procedure, if the size of the tumor needs to be reduced beforehand. As a rule, Folfirinox administered for a period of six months after the resection or four months before the operation supplemented by two months afterwards is the standard protocol. It is composed of three different medications.

When the tumor is not operable, the patient must undergo lifelong chemotherapy, depending on their general condition. The treatment starts with Folfirinox, and then it is reduced.

Radiotherapy for pancreatic cancer

If necessary, radiotherapy can also be performed prior to pancreatic cancer surgery in order to reduce the tumor size as much as possible. However, radiotherapy treatment remains controversial and is usually discussed as an option. Radiotherapy may also be indicated to reduce cancer-related pain.

Targeted therapy of pancreatic cancer

Immunotherapy does not work against pancreatic cancer. On the other hand, in rare cases, targeted therapy based on PARP inhibitors can be effective.