Pancreatic Cancer

Treatment for pancreatic cancer depends on the stage and location of the cancer as well as your overall health and personal preferences. For localised pancreatic cancer the first goal of treatment may be to try and eliminate the cancer where possible. When that isn’t an option, the focus may be on improving quality of life and limiting the cancer from growing or causing more harm.

The primary treatment options for pancreatic cancer may include surgery, chemotherapy, radiation or a combination of these. When the cancer is advanced, the primary treatment option is chemotherapy. New treatments are regularly being developed in clinical trials and there may be an option to participate in a clinical trial for your cancer.

This page aims to give you a comprehensive overview of how pancreatic cancer treatment works in the private health system.

For advanced neuroendocrine tumours (NETs) with many somatostatin receptors, somatostatin analogue and radiation can be used to destroy and damage the cancer cells in a treatment known as peptide receptor radionuclide therapy (PRRT). This technique typically requires the expertise of a medical oncologist and nuclear medicine specialist.

Somatostatin is a hormone that allows the pancreas to release other hormones. Somatostatin analogues (SSAs) are drugs which have a similar molecular structure to the somatostatin hormone which are used to treat NETs. They help to slow down somatostatin hormone production for neuroendocrine tumours (NETs), slowing the tumours’ growth and relieving symptoms such as diarrhoea. They are delivered through monthly injections into the muscle (intramuscular injections) or deep into the skin (deep subcutaneous injections).

Somatostatin analogue drugs used to treat NETs include octreotide and lanreotide.

Ablation delivers extreme heat (through radiowaves and microwaves) and cold (via cold gases) into cancerous tissue to destroy pancreatic cancer. This is achieved through inserting a thin needle-like probe into the pancreatic cancer, guided by CT scans. Ablation is a short 15-minute procedure and is often delivered when pancreatic cancer has spread to other organs in the body.

Pancreatic cancer cells are made up of multiple building blocks, such as genes or proteins. Targeted therapy focuses on targeting specific parts of these building blocks, known as modular targets, to stop pancreatic cancer cells from growing and spreading.

Targeted therapy drugs called tyrosine kinase inhibitors may be used to shrink, slow and prevent the growth of pancreatic cancer. Sunitinib or everolimus may also be effective for people with neuroendocrine tumours (NETs) to stop the cancer from growing and spreading. Targeted therapies are only effective for certain pancreatic cancers which have these modular targets. Your care team will examine the make-up of your cancer cells to determine if targeted therapies are suitable for you.

Immunotherapy trains the immune system to recognise and fight pancreatic cancer cells, which may hide behind proteins known as ‘checkpoints’. Checkpoint inhibitors such as PD-1 block these checkpoints, allowing the immune system to target the pancreatic cancer. While there are no immunotherapy drugs currently approved for use for pancreatic cancer in Indonesia, there may be immunotherapy treatments being investigated through clinical trials.