Pancreatic Cancer (cont.)
Treatment for pancreatic cancer
Staging
When pancreatic cancer is diagnosed, the doctor needs to know the stage, or
extent, of the disease to plan the best treatment. Staging is a careful attempt
to find out the size of the tumor in the pancreas, whether the cancer has
spread, and if so, to what parts of the body.
The doctor may determine the stage of pancreatic cancer at the time of
diagnosis, or the patient may need to have more tests. Such tests may include
blood tests, a CT scan, ultrasonography, laparoscopy, or angiography. The test
results will help the doctor decide which treatment is appropriate.
Treatment
Many people with pancreatic cancer want to take an active part in making
decisions about their medical care. They want to learn all they can about their
disease and their treatment choices. However, the shock and stress that people
may feel after a diagnosis of cancer can make it hard for them to think of
everything they want to ask the doctor. Often it helps to make a list of
questions before an appointment. To help remember what the doctor says, patients
may take notes or ask whether they may use a tape recorder. Some patients also
want to have a family member or friend with them when they talk to the doctor-to
take part in the discussion, to take notes, or just to listen.
Cancer of the pancreas is very hard to control with current treatments. For
that reason, many doctors encourage patients with this disease to consider
taking part in a clinical trial. Clinical trials are an important option for
people with all stages of pancreatic cancer. The section on "The Promise of
Cancer Research" has more information about clinical trials.
At this time, pancreatic cancer can be cured only when it is found at an
early stage, before it has spread. However, other treatments may be able to
control the disease and help patients live longer and feel better. When a cure
or control of the disease is not possible, some patients and their doctors
choose palliative therapy. Palliative therapy aims to improve quality of life by
controlling pain and other problems caused by this disease.
The doctor may refer patients to an oncologist, a doctor who specializes in
treating cancer, or patients may ask for a referral. Specialists who treat
pancreatic cancer include surgeons, medical oncologists, and radiation
oncologists. Treatment generally begins within a few weeks after the diagnosis.
There will be time for patients to talk with the doctor about treatment choices,
get a second opinion, and learn more about the disease.
Getting a second opinion
Before starting treatment, a patient may want a second opinion about the
diagnosis and the treatment plan. Some insurance companies require a second
opinion; others may cover a second opinion if the patient requests it. Gathering
medical records and arranging to see another doctor may take a little time. In
most cases, a brief delay to get another opinion will not make therapy less
helpful.
There are a number of ways to find a doctor for a second opinion:
- The doctor may refer patients to one or more specialists. At cancer centers,
several specialists often work together as a team.
- The Cancer Information Service (1-800-4-CANCER) can tell callers about
treatment facilities, including cancer centers and other programs supported by
the National Cancer Institute, and can send printed information about finding a
doctor.
- A local medical society, a nearby hospital, or a medical school can usually
provide the name of specialists.
- The American Board of Medical Specialties (ABMS) has a list of doctors who
have met certain education and training requirements and have passed specialty
examinations. The Official ABMS Directory of Board Certified Medical Specialists
lists doctors' names along with their specialty and their educational
background. The directory is available in most public libraries. Also, ABMS
offers this information on the Internet at http://www.abms.org. (Click on "Who's
Certified.")
Preparing for treatment
The doctor can describe treatment choices and discuss the results expected
with each treatment option. The doctor and patient can work together to develop
a treatment plan that fits the patient's needs.
Treatment depends on where in the pancreas the tumor started and whether the
disease has spread. When planning treatment, the doctor also considers other
factors, including the patient's age and general health.
These are some questions a person may want to ask the doctor before treatment
begins:
- What is the diagnosis?
- Where in the pancreas did the cancer start?
- Is there any evidence the cancer has spread? What is the stage of the
disease?
- Do I need any more tests to check whether the disease has spread?
- What are my treatment choices? Which do you recommend for me? Why?
- What are the expected benefits of each kind of treatment?
- What are the risks and possible side effects of each treatment?
- What is the treatment likely to cost? Is this treatment covered by my
insurance plan?
- How will treatment affect my normal activities?
- Would a clinical trial (research study) be appropriate for me?
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People do not need to ask all of their questions or understand all of the
answers at one time. They will have other chances to ask the doctor to explain
things that are not clear and to ask for more information.
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