NCCN Guidelines for Patients® | Pancreatic Cancer - page 70

68
NCCN Guidelines for Patients
®
Pancreatic Cancer, Version 1.2014
5.5
Treatment guide
Metastatic pancreatic cancer
5.5 Metastatic pancreatic cancer
Part 5.5 describes the tests and treatments that are
recommended for cancer that has spread outside
the pancreas to far sites in the body. This is called
metastatic pancreatic cancer.
Metastasis is the spread of cancer from the first tumor
to another part of they body. Metastatic tumors are
formed by cancer cells that have spread far away
from the first tumor in the pancreas.
Chart 5.5.1
shows the first-line treatment options
for metastatic pancreatic cancer. First-line treatment
is the first treatment or set of treatments given to
control the cancer. First-line treatment options include
a clinical trial, chemotherapy, targeted therapy, and
supportive care.
Symptom control
Before beginning treatment for the cancer, your
doctor will first give treatment for symptoms such as
jaundice. Jaundice is a yellowing of the skin and eyes
caused by a buildup of bilirubin in the body. A tumor
Chart 5.5.1 First-line treatment
Symptom control
Health status rating
First-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)
Poor health status
(Overall health is poor,
unable to do normal
daily activities well, and
severe or uncontrolled
cancer symptoms)
Clinical trial (preferred),
FOLFIRINOX,
Gemcitabine + nab-paclitaxel,
Gemcitabine + erlotinib,
Gemcitabine-based combination therapy,
Gemcitabine, or
Capecitabine or continuous infusion 5-FU
Gemcitabine, or
Palliative and best supportive care
If jaundice,
place stent
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