Learn about inoperable pancreatic cancer

Posted by Master, Doctor Mai Vien Phuong - Department of Examination & Internal Medicine - Vinmec Central Park International General Hospital

Pancreatic cancer is cancer that begins in the pancreas, an organ located behind the stomach. The pancreas helps the body digest food and regulate blood sugar levels. If the cancer has spread to other areas, then pancreatic cancer will not be operable.

As cancer grows, it usually forms in one area or organ of the body. This area is called the main site. Unlike other cells in the body, cancer cells can break away from their primary site and travel to other parts of the body and cannot be removed surgically.
Pancreatic cancer often metastasizes to the liver or to other organs such as the lungs, bones, brain,... Cancer that has spread to other organs is called stage 4 cancer.

Locally advanced cancer is a tumor that has not spread to other organs but cannot be removed surgically because of its location near major blood vessels.

If your cancer recurs during or after treatment, it is called recurrent cancer. Sometimes the cancer that has recurred is inoperable because it has spread to other organs. For example, when pancreatic cancer recurs, it usually develops in the liver first.

Pancreatic cancer is often diagnosed when the disease is more advanced because it does not cause early symptoms. Some of the tests that can detect pancreatic cancer include:
Imaging tests: Help your doctor see your internal organs, including the pancreas. Some of the techniques used to diagnose pancreatic cancer include ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET); Endoscopic ultrasound: With this procedure, your doctor inserts a thin endoscope down your esophagus and into your stomach to take pictures of your pancreas. Biopsy: A procedure to remove a small sample of tissue and examine it under a microscope. Most tissues were collected during endoscopic ultrasound (EUS). Sometimes pancreatic tissue samples are also obtained by fine-needle aspiration through the skin and into the pancreas; Blood test: Helps find specific proteins (tumor markers) secreted by pancreatic cancer cells. The tumor marker used in pancreatic cancer is CA19-9, which helps to understand response to treatment. However, there are cases where people with pancreatic cancer do not have elevated CA19-9 levels, then this test will not be possible. These tests can help your doctor determine if you can have surgery. In some cases, tests won't show if the cancer has spread, and doctors find the cancer has spread at the start of surgery.

Although patients with pancreatic cancer cannot have surgery, there are a number of other treatments that can help control symptoms.
Chemotherapy
Chemotherapy uses special drugs to kill cancer cells and it can be delivered as an injection or orally.
In people with inoperable pancreatic cancer, chemotherapy is often used to control the growth of the cancer and improve their chances of survival.

Radiation
Radiation is sometimes combined with chemotherapy, which uses high-energy beams to kill cancer cells.
Targeted therapies
These therapies interfere with cancer cell growth by targeting specific abnormalities within the cancer cells.
People with advanced pancreatic cancer may be prescribed erlotinib in combination with gemcitabine (Gemzar, Infugem).
Immunotherapy
Immunotherapy is given to boost your immune system to fight cancer in your body. Immunotherapy is also known as biological therapy.
The targeted therapy drug pembrolizumab (Keytruda) is also an immunotherapy.
Cancer inherently does not spare anyone, it is estimated that every year in the world, a very large proportion of people die from cancer. In fact, if cancer can be detected at an early stage, the prognosis for treatment is very high, even if it is completely cured and not recurred. Therefore, screening for cancer is essential, especially for high-risk patients.
Currently, Vinmec International General Hospital has been implementing cancer screening packages. At Vinmec, there are fully modern diagnostic facilities such as: PET/CT, SPECT/CT, MRI..., blood marrow test, histopathology, immunohistochemistry test, gene test, lab test molecular biology, as well as a full range of targeted drugs, the most advanced immunotherapy drugs in cancer treatment. Multimodal cancer treatment from surgery, radiation therapy, chemotherapy, hematopoietic stem cell transplantation, targeted therapy, immunotherapy in cancer treatment, new treatments such as autoimmunotherapy body, heat therapy...
After having an accurate diagnosis of the disease and stage, the patient will be consulted to choose the most appropriate and effective treatment methods. The treatment process is always closely coordinated with many specialties: Diagnostic Imaging, Biochemistry, Immunology, Cardiology, Stem Cell and Gene Technology; Department of Obstetrics and Gynecology, Department of Endocrinology, Department of Rehabilitation, Department of Psychology, Department of Nutrition... to bring the highest efficiency and comfort to patients. After undergoing the treatment phase, the patient will also be monitored and re-examined to determine whether the cancer treatment is effective or not.
Thanks to modern facilities, a team of qualified doctors, perfect medical services, have brought confidence, health and good quality of life to patients who come to visit and treat diseases at the hospital. Vinmec.

References:
The American Cancer Society medical and editorial content team. (2019). Can pancreatic cancer be found early cancer.org/cancer/pancreatic-cancer/detection-diagnosis-staging/detection.html Cancer stat facts: Pancreas cancer. (n.d.). seer.cancer.gov/statfacts/html/pancreas.html