by Carson-DeWitt R

Medications for Pancreatic Cancer

Chemotherapy and targeted therapy are used to treat pancreatic cancer. Chemotherapy uses drugs to destroy pancreatic cancer cells. The drugs enter the bloodstream and travel through the body to the cancer cells. Targeted therapy uses medications to attack or block specific factors that help cancer cells grow.

Chemotherapy

Chemotherapy may be used:
  • Before surgery—to shrink the tumor and decrease the amount of tissue that needs to be removed
  • After surgery—to kill any remaining cancer cells and decrease risk of return
  • To help relieve symptoms of metastatic cancer and extend survival time
For pancreatic cancer, radiation therapy is most often used in combination with chemotherapy.

Chemotherapy Drugs and Delivery

There are a variety of chemotherapy drugs. Chemotherapy regimens for pancreatic cancer have been found to work better when drugs are combined. The choice and combination of drugs will be based on your particular cancer and reaction to drugs. Chemotherapy drugs for pancreatic cancer may include:
  • Gemcitabine
  • Fluorouracil (5-FU)
  • Oxaliplatin
  • Cisplatin
  • Capecitabine
  • Irinotecan
  • Paclitaxel
  • Carboplatin
  • Docetaxel
Chemotherapy is most often given through an IV, but some forms can be given by mouth. It is delivered in cycles over a set period of time. A medical oncologist will determine how many cycles of chemotherapy are needed and what combination of drugs will work best.

Side Effects

Though the drugs are designed to target cancer cells, they can affect healthy cells as well. The death of cancer cells and impact on healthy cells can cause a range of side effects. A medical oncologist will work to find the best drug combination and dosage to have the most impact on the cancer cells and minimal side effects on healthy tissue. Side effects or complications from chemotherapy may include:
  • Numbness, pain, or burning sensation in the the hands and feet—peripheral neuropathy (oxaliplatin, cisplatin, paclitaxel )
  • Nausea and vomiting
  • Diarrhea or constipation
  • Low blood cell counts (white cells or platelets) that can lead to infection or bleeding
  • Fatigue due to anemia
  • Confusion, forgetfulness
  • Kidney damage (cisplatin)

Targeted Therapy

Unlike chemotherapy, targeted therapy drugs attack cancer cells without harming healthy cells. Presently, erlotinib is the only targeted therapy drug used on pancreatic cancer. It is designed to block a specific protein that makes the tumor grow. Erlotinib is given in combination with the chemotherapy drug gemcitabine.
Common side effects include:
  • Rash, mainly on the face and neck
  • Diarrhea
  • Fatigue
  • Loss of appetite

Managing Side Effects

A variety of treatments are available to help manage side effects including medication, lifestyle changes, and alternative treatments. In some cases, the chemo- and/or targeted therapy regimens may be adjusted to reduce severe side effects. The earlier the side effects are addressed, the more likely they will be controlled with a minimum of discomfort.

References

Chemotherapy and other drugs for pancreatic cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/pancreatic-cancer/treating/chemotherapy.html. Updated May 31, 2017. Accessed March 23, 2017.
De La Cruz MD, Young AP, Ruffin MT. Diagnosis and management of pancreatic cancer. Am Fam Physician. 2014;89(8):626-632.
Pancreatic cancer. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114527/Pancreatic-cancer. Updated July 6, 2016. Accessed March 23, 2017.
Pancreatic cancer. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/gastrointestinal-disorders/tumors-of-the-gi-tract/pancreatic-cancer. Updated January 2017. Accessed March 23, 2017.
Treatment option overview. National Cancer Institute website. Available at: https://www.cancer.gov/types/pancreatic/patient/pancreatic-treatment-pdq#section/%5F162. Updaed December 23, 2016. Accessed March 23, 2017.

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