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Chemotherapy for Pancreatic Cancer by Rosalyn Carson-DeWitt, MD

Cancer chemotherapy is the use of drugs to kill cancer cells. Unlike radiation and surgery, which are localized treatments, chemotherapy is a systemic treatment, meaning the drugs travel throughout the whole body. This means chemotherapy can reach cancer cells that may have spread, or metastasized, to other areas.

Chemotherapy is usually combined with other types of treatment (surgery, radiation therapy) in an attempt to do the following:

Cure smaller, early-stage pancreatic cancer
Increase survival time in more advanced pancreatic cancer (Although, this usually means only by a matter of months.)
Provide some symptom relief

Chemotherapy Drugs Used for Pancreatic Cancer

Fluorouracil (5-FU)
Gemcitabine (the first line treatment)
Gemcitabine plus erlotinib (Tarceva)—first line treatment
Cisplatin (Blastolem RU, Tecnoplatin)
Investigational agents (experimental treatments)
Streptozotocin (for endocrine tumors)

Effectiveness

Gemcitabine, used alone or in combination with other chemotherapy agents, seems to improve the quality of life for patients with pancreatic cancer. Chemotherapy with gemcitabine improves symptoms, including pain, nausea, and vomiting in about 25% of patients. It also provides a modest increase in survival (usually only a few months).

Fluorouracil is not associated with a survival benefit. Cisplatin and some other drugs have been used in combination with gemcitabine, but are associated with more side effects.

These drugs should be used with caution in the elderly and those with liver or kidney disease . Elderly patients are at an increased risk of side effects.

References:

Detailed guide: pancreatic cancer. American Cancer Society website. Available at: http://www.cancer.org/ . Accessed April 8, 2009.
DiMagno E. Pancreatic carcinoma. In: Cecil RL, Goldman L, Bennett J. Cecil Textbook of Medicine. 21st ed. Philadelphia, PA: WB Saunders Company; 2000: 750-752.
Freelove R, Walling AD. Pancreatic cancer: diagnosis and management. Am Fam Physician. 2006;73:485-492.
Lohr JM. Medical treatment of pancreatic cancer. Expert Rev Anticancer Ther. 2007;7:533-544.
What you need to know about cancer of the pancreas. National Cancer Institute website. Available at: http://www.cancer.gov/cancerinfo/wyntk/pancreas#2 . Accessed April 8, 2009.
Yip D, Karapetis C, Strickland A, et al. Chemotherapy and radiotherapy for inoperable advanced pancreatic cancer. Cochrane Database Syst Rev. 2006;3:CD002093.

Last reviewed September 2012 by Igor Puzanov, MD

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Chemotherapy for Pancreatic Cancer by Rosalyn Carson-DeWitt, MD

Chemotherapy Drugs Used for Pancreatic Cancer

Effectiveness

References:

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