Treatment of Pancreatic Cancer: Chemotherapy

Chemotherapy is the use of medications to fight cancer. It is considered a systemic treatment which means the medication travels through the blood stream and throughout the body to reach the cancerous cells. Chemotherapy works by attacking rapidly dividing cells in the body, interfering with their ability to grow or multiply. Since cancer cells are marked by uncontrolled growth, they are often susceptible to these drugs. However, since chemotherapy is a systemic treatment and affects all rapidly dividing cells in the body, these drugs may also damage some normal cells. The most susceptible normal cells are the blood cells, hair follicles, and the cells lining the mouth and intestines.

Chemotherapy may be administered alone, or in combination with other treatments such as surgery or radiation therapy. Chemotherapy can be administered before surgery, after surgery, or both. When it is given before surgery, it is called neoadjuvant chemotherapy. When it is used after surgery, it is called adjuvant chemotherapy. It can be administered orally, by injection, or intravenously depending on the regimen and the drug. The best course of therapy is selected depending upon the specific characteristics of the patient's cancer to maximize the results of the treatment and increase survival.

The most commonly used drugs used for treating pancreatic cancer, are gemcitabine (Gemzar®), docetaxel (Taxotere®), cis-platinum (Platinol®), 5-fluorouracil (5-FU), and mitomycin C. These drugs are sometimes used alone or in combination.

Currently, there are clinical trials examining other new drug combinations, as well as targeted therapies that kill only cancer cells and not normal cells, such as erlotinib (Tarceva®), for their effectiveness against pancreatic cancer.

The side effects of chemotherapy vary on the type and dose of drugs given, as well as the length of treatment. Some of the more common side effects associated with chemotherapy are hair loss, fatigue, mouth sores, nausea and vomiting. These side effects typically go away when treatment is stopped.