Radiation

Radiation therapy can be used as part of a treatment plan for pancreatic cancer. Radiation treatments are designed to lower the risk of local growth of the cancer, thereby minimizing the symptoms that local progression causes (back or belly pain, nausea, loss of appetite, intestinal blockage, jaundice).

Radiation treatments are typically given Monday through Friday for about five weeks. Chemotherapy given at the same time may improve the effectiveness of the radiation and may lower the risk for cancer spread outside the area where the radiation is delivered. When the radiation is completed and the patient has recovered, more chemotherapy is often recommended. Recently, newer forms of radiation delivery (stereotactic radiosurgery, gamma knife radiation, cyberknife radiation) have been utilized in locally advanced pancreatic cancer with varying degrees of success, but these treatments are largely experimental.

Exciting New Research Studies are investigating the effectiveness of using Cyberknife Radiosurgery

CyberKnife is radiosurgery that is used to treat pancreatic cancer in patients who are not candidates for surgery or for whom surgery or other treatments have failed. Two clinical studies from Stanford University have shown the growth of pancreatic tumors in patients with advanced disease has been controlled by CyberKnife radiosurgery. One study estimated the six-month survival at 80 percent and the estimated one-year survival at 15 percent. In another preliminary study, CyberKnife treatment was shown to provide pain control in 85 percent of the treated patients.

Treating tumors in and near the pancreas with radiation is challenging because those tumors move as you breathe, making it difficult to target them accurately with radiation. As a result, the tumor may not receive enough radiation and healthy tissue near the tumor may be damaged. With other kinds of radiation therapy – often referred to as conventional, external-beam, or intensity-modulated radiotherapy – the total radiation dose is divided up into smaller doses delivered over 25 to 40 sessions in order to minimize damage to surrounding healthy tissue. CyberKnife radiosurgery is intended to destroy, or ablate, the tumor tissue with high doses delivered in one to five sessions. To do that safely requires a highly accurate system that detects the movement of the tumor throughout treatment sessions and delivers the radiation with pinpoint precision.

With the CyberKnife , doctors can zero in on a moving target – the pancreatic tumor – and irradicate it without harming the healthy surrounding tissue. As a result, the CyberKnife treatment is more comfortable for patients, radiation is delivered more accurately and treatments can be completed in one to five sessions.

The Cyberknife is only offered at three cancer centres in Canada and is currently under investigation for pancreatic cancer:

• The Ottawa Hospital
• Juravinski Cancer Centre - Hamilton
• Centre Hospitalier de l'Universite de Montreal (CHUM)