NCCN Guidelines for Patients® | Pancreatic Cancer - page 68

66
NCCN Guidelines for Patients
®
Pancreatic Cancer, Version 1.2014
5.4
Treatment guide
Locally advanced unresectable pancreatic cancer
Chart 5.4.3
shows the second-line treatment
options that are recommended for locally advanced
unresectable pancreatic cancer. Second-line
treatment is the next set of treatments given when
the first or previous treatments failed to stop cancer
growth.
Health status rating
Which treatment is recommended for you depends
on your health status rating, also called performance
status. Your health status is a rating by your doctor
based on your overall health, cancer symptoms,
and ability to do daily activities. Good health status
means that your overall health is good. You’re able to
continue doing all of your regular daily activities very
well. You also have very few or very mild symptoms
of the cancer and you’re able to eat well. Poor health
status means that your overall health is poor. You
aren’t able to do your regular daily activities well.
The number and/or severity of cancer symptoms is
increased.
Your health status rating is a very important factor
when choosing the best treatment for you. This
is because healthier patients are able to tolerate
treatments with higher risks of side effects. Certain
treatments and drug combinations have a higher risk
of severe, even lethal, side effects. Your doctor should
explain all of the risks and possible side effects of the
treatments you receive.
If you have a poor health status after first-line
treatment, then supportive care is recommended.
If you have a good health status after first-line
treatment, then you may receive second-line
treatment.
Second-line treatment
If you have a good health status after first-line
treatment,
there are four main options for second-
line treatment. The preferred option is to receive
treatment within a clinical trial. A clinical trial is a type
of research that studies the safety and effectiveness
Health status rating
Second-line treatment
Chart 5.4.3 Second-line treatment
Good health status
(Overall health is
good, able to do all
normal daily activities
well, few cancer
symptoms, good pain
control, and good
nutrition)
Clinical trial (preferred),
Fluoropyrimidine-based
chemotherapy,
Gemcitabine-based therapy, or
Chemoradiation if not
previously given
Poor health
status
Palliative
and best
supportive
care
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