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49

NCCN Guidelines for Patients

®

:

Pancreatic Cancer, Version 1.2017

5

Treatment guide Locally advanced unresectable pancreatic cancer

Guide 12

shows the tests and treatments that are

recommended when there is a return (recurrence) of

cancer after surgery and adjuvant treatment.

Tests and results

First, you may have a biopsy to confirm pancreatic

cancer if not done previously. A biopsy is the removal

of a sample of tissue from your body to test for

cancer cells. Additional imaging studies will allow

your doctors to know how far the cancer has spread.

Cancer that came back in or near the pancreas is

called a local recurrence. Cancer that has spread to

sites far away from the pancreas is called metastatic

cancer.

Treatment

For pancreatic cancer recurrence, joining a clinical

trial is always the preferred treatment choice above

any other option. A clinical trial is a type of research

that studies the safety and effectiveness of a test or

treatment. Best supportive care without active cancer

treatment should also be considered, especially

for patients with a poor health status. Your health

status, also called performance status, is a rating

by your doctor based on your overall health, cancer

symptoms, and ability to do daily activities.

Supportive care, also called palliative care, is

treatment to relieve the symptoms of cancer and side

effects of cancer treatment. See Part 4 for supportive

care details.

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†

For a local recurrence, there are two other

treatment options. One option is to receive

chemoradiation if you haven’t had it before.

The other option is to receive a different

chemotherapy than you had before.

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†

For metastatic cancer, the other options depend

on how long it has been since the last treatment

was completed. If the cancer recurrence is

more than 6 months after completing the last

treatment, then options include the same

chemotherapy you had before or a different

chemotherapy. If the recurrence is less than

6 months after completing the last treatment,

then the other option is to receive a different

chemotherapy than before.

Locally advanced unresectable

pancreatic cancer

This section describes the tests and treatments

recommended for cancer that has spread outside the

pancreas to nearby blood vessels or other tissues

and can’t be removed by surgery. This is called

locally advanced unresectable.

†

†

Cancer that can be removed by surgery is

called resectable.

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†

Cancer that can’t be removed by surgery is

called unresectable.