Chemotherapy
During chemotherapy, the patient is administered various drugs (cytostatics) that inhibit cell growth in a variety of ways. Particularly fast-growing tissues, including tumor tissue, are inhibited in their growth and partially killed. The combination of cytostatic drugs with different side effect profiles has proven to be advantageous in order to be able to reduce the dosage of the individual substances.
Chemotherapy can be administered prior to surgery in order to reduce the size of the tumor and thus make it operable (neoadjuvant chemotherapy). If, on the other hand, chemotherapy is carried out after the surgical removal of the tumor, this is called adjuvant chemotherapy. Which form of chemotherapy is carried out must be decided in each individual case. Finally, chemotherapeutic agents can also be administered when there is no longer any prospect of a cure (palliative chemotherapy) in order to reduce the tumor-related side effects of chemotherapy and improve the quality of life.
Radiotherapy
Radiotherapy can be used neoadjuvant, adjuvant and palliative, like chemotherapy. A combination of chemotherapy and radiotherapy is also popular. Since the pancreas is located deep inside the abdomen and surrounded by radiation-sensitive organs, the radiation dose must be adjusted so that there are no radiation side effects on neighboring organs.
Immunotherapy
Immunotherapy is a relatively new therapeutic option in the treatment of various types of cancer. Here, antibodies and other substances are used which are directed against different structures of the cancer cell, which are characteristically found in cancer cells and are essential for the metabolism of the cancer cell. These drugs are administered in combination with drugs (cytostatics) but also as monotherapy. Various such drugs are still undergoing clinical trials.
Palliative therapy
In some patients an inoperable and therefore incurable condition has developed at the time of diagnosis. In this phase of the disease, however, there are still many options available to extend the patient’s survival time and to maintain the quality of life as well as possible (palliative therapy). Many cancer patients suffer from severe pain in the final stage, which must be treated consistently.This therapy requires a lot of experience from the attending physician, since even the strongest painkillers (opiates) should not be spared in order to achieve sufficient freedom from pain.
A further palliative measure is the preservation of the bile and food passage. This is because the tumor can constrict the bile duct, the stomach outlet or the duodenum due to its uncontrolled growth. These constrictions can be removed in a minimally invasive operation (endoscopic surgery) by inserting a plastic tube (stent).
The bile duct (ductus choledochus) is most frequently affected by such a procedure. As mentioned above, chemo- and radiotherapy with a palliative approach are used because they can prevent the tumor from growing or even achieve partial remissions (regressions). An important accompanying measure for all tumor patients should be psychosocial therapy, e.g. in the form of psychological support or participation in self-help groups.
