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29

NCCN Guidelines for Patients

®

:

Pancreatic Cancer, Version 1.2017

4

Supportive care

Blocked bile duct | Blocked stomach

As pancreatic cancer grows, it can

cause serious health problems such as

pain, blockage, and difficulty eating. It

is important to know about these health

issues and talk to your treatment team

to get the support you need. This section

explains some of the main challenges

you may face and the recommended

supportive care for each.

Supportive care is treatment given to relieve

symptoms caused by pancreatic cancer or cancer

treatment. It is also referred to as palliative care.

Supportive care is an important part of care for

pancreatic cancer. Pancreatic cancer not only affects

your body, it can also cause distress. Some patients

have depression, anxiety, and sleeping problems.

Because of this, it is helpful to talk to your doctor and

with those whom you feel most comfortable about

how you are feeling. Let them know how they can

help or guide you when it comes to supportive care.

Ask questions and seek information about supportive

care options. Other members of your treatment

team may also include a social worker, psychologist,

registered dietitian, or specialist who treats pain.

Blocked bile duct

A tumor in the pancreas may grow large enough

to block your bile duct. A bile duct is a small tube

that drains digestive fluid (bile) from the liver. The

common bile duct carries bile from the liver through

the pancreas and to the first part of the small

intestine (duodenum). A blocked duct causes bile to

build up in the liver. As a result, you may have pain,

itching, discomfort, and jaundice. This blockage can

cause an infection of the bile duct called cholangitis.

A blocked bile duct may also be treated by placing a

biliary stent or doing a biliary bypass. A biliary stent is

a tiny tube that is placed in the bile duct to unblock it

or keep it open. Before the stent can be placed, bile

may need to be drained through an opening in the

side of the body. However, you may need a new or

second stent during or after cancer treatment if the

tumor grows larger. A bypass is a surgery to re-route

the flow of fluids in the body. A biliary bypass is a

surgery to re-route the flow of bile from the common

bile duct into the small intestine. The result is that the

bile flow avoids (bypasses) the blocked part of the

duct.

Blocked stomach

A tumor in the pancreas may also grow large

enough to block eaten food from passing out of your

stomach through the first part of the small intestine

(duodenum). This blockage can cause pain, vomiting,

and other problems. Treatments for a blocked

stomach include a stent, a PEG (

p

ercutaneous

e

ndoscopic

g

astrostomy) tube, or a duodenal bypass

(gastrojejunostomy).

A stent is an expandable tube that is placed in the

duodenum to unblock it and keep it open. A PEG

tube is a tube that is inserted through a cut in the

abdomen and placed in the stomach to give food.

A duodenal bypass is a surgery to re-route the

path eaten food takes from the stomach into the

small intestine. The result is that the path out of the

stomach avoids (bypasses) the blocked part of the

duodenum. This surgery may also be done as a

preventive measure if there is a high risk that your

stomach may become blocked.