Treating and Coping With Pancreatic Cancer

Although significant progress has been made in diagnosis and treating many types of cancers, one type of cancer that remains highly intractable to treatment is pancreatic cancer. In fact, pancreatic cancer is difficult to detect because symptoms may not occur until the condition is well advanced, and even when it is diagnosed early, patient prognoses are poor. Although pancreatic cancer represents just around 3% of all types of cancers in the United States, the condition is responsible for approximately 7% of all cancer deaths (Key statistics, 2015). This paper provides a description of the diagnosis and staging of pancreatic cancer followed by a discussion concerning the complications and side effects that are associated with the disease. Finally, a description of the methods that are used to lessen the physical and psychological effects of treatment for pancreatic cancer is followed by a summary of the research and important findings concerning this disease in the conclusion.

Review and Discussion

Description of the diagnosis and staging of pancreatic cancer

Pancreatic cancer originates in pancreatic tissues, but individuals who develop this type of cancer are faced with poor prognoses even when the condition is diagnosed early on (Pancreatic cancer causes, 2015). According to the Mayo Clinic, “Pancreatic cancer typically spreads rapidly and is seldom detected in its early stages, which is a major reason why it is a leading cause of cancer death” (Pancreatic cancer causes, 2015, para. 2). Moreover, in many cases, there will not be any discernible symptoms or signs of pancreatic cancer until the condition is well and advanced, preventing the use of surgical intervention (Pancreatic cancer causes, 2015). In this regard, Shah (2008) emphasizes that, “Due to its late onset of symptoms, pancreatic cancer often goes undetected until it’s too late” (p. 29).

The American Cancer Society‘s 2015 estimates for pancreatic cancer in the United States indicate that approximately 48,960 individuals (24,840 men and 24,120 women) will be diagnosed with pancreatic cancer each year, and the vast majority (approximately 40,560 individuals, 20,710 men and 19,850 women) will die each year as a result of pancreatic cancer (Key statistics, 2015). These rates have remained fairly stable in recent years (Key statistics, 2015). Although no major professional groups recommend screening tests for pancreatic cancer at present because there are no screening tests available that have been demonstrated effective at reducing mortality rates, tumor markers can help diagnosis the condition, but in most cases, the condition is too advanced by the time tumor markers are generated (Key statistics, 2015).

Complications and Side Effects Associated with Pancreatic Cancer Treatments

The four main methods that are currently used to treat pancreatic cancer and their associated side effects are as follows:

1. Surgery: This is the only intervention that has a reasonable chance of curing some types of pancreatic cancer, but it is only effective in a small percentage of patients and can result in severe side effects and complications. The complications that are associated with surgical interventions include: (a) leaking from the various connections among organs made by the surgeon; (b) infections; (c) bleeding; and (d) problems with emptying the stomach after meals.

2. Ablative techniques: These interventions attempt to destroy the pancreatic cancer using various methods such as microwaves rather than removing them surgically, but these techniques are unlikely to cure the condition in isolation from other treatments. Some of the complications that are associated with ablative techniques include fever, nausea, infection, abdominal pain, and blood clots in blood vessels that are in close proximity to the treated area.

3. Radiation therapy: High-energy X-rays are used in radiation therapy to destroy pancreatic cancer cells, but some types of pancreatic cancer are unresponsive to this intervention. This method may be used prior to surgical interventions or chemotherapy (discussed below) to improve their effectiveness. Some of the side effects that are commonly associated with radiation therapy include: (a) skin changes similar to sunburn in radiated areas; (b) nausea and vomiting; (c) diarrhea; (d) fatigue; (e) poor appetite; (f) weight loss; (g) diminished blood counts; and (h) increased risk of infection.

4. Chemotherapy and other drugs: These interventions use orally administered or injected anti-cancer drugs such as Gemcitabine and 5-fluorouracil which spread through the entire body, making their use especially appropriate in cases where the pancreatic cancer has spread to other regions of the body. This approach is frequently used in combination with radiation therapy to improve its efficacy. There are numerous side effects that are associated with these interventions, including: (a) nausea and vomiting; (b) loss of appetite; (c) hair loss; (d) mouth sores; (e) diarrhea or constipation; (f) increased risk of infection; (g) fatigue; and (h) bleeding and bruising following minor cuts due to reduced platelets (Pancreatic cancer treatments, 2015).

Methods to Lessen the Physical and Psychological Effects of Treatment

Given the wide range of side effects that are associated with the various types of interventions that are currently used to treat pancreatic cancer, it is important to ensure that patients receive individualized care in minimizing their effects (MacNeil, 2008). In addition, many pancreatic patients (about 33%-50%) experience a major depressive disorder, including clinical depression, as a result of the disease, an outcome that is not surprising given its intractability to treatment (MacNeil, 2009). Moreover, major depressive disorders are even more common among pancreatic patients undergoing chemotherapy (MacNeil, 2009). These findings underscore the need for treating depression among pancreatic cancer patients throughout their course of treatment. For instance, according to Marks and Heinrich (2013):

Left untreated, depression in seriously ill patients can be associated with increased physical symptoms, suicidal thoughts, worsened quality of life, and emotional distress. Moreover, depression can impair the patient’s interaction with family during a pivotal time in which patients may be saying goodbye, thank you, or planning for their death. (p. 36)

Further, the depressive symptoms that are associated with pancreatic cancer can interfere with patients’ abilities to make informed decisions concerning their care (Marks & Heinrich, 2013). Although there has been a lack of research in this area, the studies to date indicate consistently positive results from the use of antidepressants for pancreatic cancer patients (MacNeil, 2009). Even though most people who are diagnosed with pancreatic cancer will die as a result of the disease, timely treatments for physical and psychological side effects can help improve their quality of life while they undergo treatment (Marks & Heinrich, 2013).

A growing number of clinicians are recommending medical marijuana to help pancreatic cancer patients improve their appetites and manage their pain (Cohen, 2006). Other methods that can be used to lessen the physical and psychological effects of treatment include patient education, behavioral therapy, and individual and group psychotherapy (MacNeil, 2009). Finally, irrespective of what type of intervention is used, pancreatic patient sufferers should receive careful pain management because of the severe pain that is associated with the condition and the potential for unmanaged pain to contribute to the onset of major depressive disorders and even suicidal ideations and acts (Shah, 2008).

Conclusion

The research showed that pancreatic cancer is diagnosed in nearly 50,000 people in the United States each year, and most of these individuals will die as a result. Unfortunately, the research also showed that pancreatic cancer is an especially insidious type of cancer due to the inability to diagnosis the condition early as a result of a lack of identifiable symptoms, but even when the disease is diagnosed early, patient prognoses are generally very poor. There are several types of treatments available for pancreatic cancer, including surgery, ablative techniques, radiation therapy and chemotherapy and other drugs, and these interventions are frequently used in combination to enhance their effectiveness. Each of these techniques was also shown to have a number of serious side effects that require individual management but there is an overarching need to help all pancreatic cancer patients manage their pain. Finally, because as many as half of all pancreatic patients experience a major depressive disorder as a result of the condition, it is important to treat depression using pharmacological interventions as well as patient education, behavioral therapy, and individual and group psychotherapy.

References

Cohen, P. J. (2006, May-June). Medical marijuana, compassionate use, and public policy: Expert opinion or vox populi? The Hastings Center Report, 36(3), 19-23.

Key statistics. (2015). American Cancer Society. Retrieved from http://www.cancer.org/cancer/pancreaticcancer/detailedguide/pancreatic-cancer-key-statistics.

MacNeil, N. S. (2009, November). Treat depression in cancer patients. Clinical Psychiatry News, 33(11), 64.

Marks. S. & Heinrich, T. (2013, August). Assessing and treating depression in palliative care patients: Antidepressants, psychotherapy can improve dying patients’ quality of life. Current Psychiatry, 12(8), 35-41.

Pancreatic cancer causes. (2015). Mayo Clinic. Retrieved from http://www.mayoclinic.org / diseases-conditions/pancreatic-cancer/basics/definition/con-20028153.

Pancreatic cancer treatments. (2015). American Cancer Society. Retrieved from http://www. cancer.org/cancer/pancreaticcancer/detailedguide/pancreatic-cancer-treating-general-info.

Shah, M. (2008, September 15). Emerging therapies aim to battle pancreatic cancer. Drug Topics, 152(10), 28-31.

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