Manual Pancreatic Cancer - Clinical Management

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Recent breakthroughs including new systemic therapies and the emergence of stereotactic radiation have driven significant changes in pancreatic cancer treatment, which led ASTRO to develop its first guideline on this topic. In the past several years, newer systemic therapies are proving to be more effective at controlling this cancer when it spreads, and fewer people are dying from distant disease.

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This makes treatments like radiation to manage local disease more meaningful," explained Manisha Palta, MD, co-chair of the guideline task force and a radiation oncologist at Duke University. The guideline first presents indications for radiation therapy in the adjuvant, neoadjuvant and definitive settings. It delineates between conventionally fractionated and stereotactic radiation therapy, providing the first clinical guidance on the newer, shorter-course approach.

The guideline also addresses ways to mitigate side effects related to pancreatic radiation, whether given alone or with chemotherapy. The guideline strongly recommends that patients who undergo radiation treatments for pancreatic cancer be given prophylactic anti-nausea medicines. It also conditionally recommends the use of antacid or acid-reducing medications.

Palta explained how these medications are used preventatively with radiation: "If we know that certain side effects tend to occur with a relatively modest or high frequency -- such as nausea and stomach pain -- there are medications we can give to patients prior to treatment to help mitigate those side effects. The guideline comments on emerging and upcoming trial reports that will add to the evidence on stereotactic radiation and other aspects of pancreatic cancer treatment, and which subsequently will shape future clinical practice and guideline updates.

It's also essential that any patient who might be an appropriate candidate for radiation have access to a radiation oncologist who can provide perspective on the pros and cons of treatment, so that the patient can make an informed decision," said Dr. The guideline was based on a systematic literature review of articles published from May through January The member task force included a multidisciplinary team of radiation oncologists from a variety of practice settings, a medical physicist, a medical oncologist, a surgical oncologist, a radiation oncology resident and a patient representative.

ASTRO's clinical guidelines are intended as a tool to promote appropriately individualized, shared decision-making between physicians and patients. APA Leonard, J. MNT is the registered trade mark of Healthline Media. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.

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Send securely. Message sent successfully The details of this article have been emailed on your behalf. By Jayne Leonard. Table of contents What is stage 4 pancreatic cancer? Symptoms Treatments Survival rates Takeaway. A doctor will aim to manage pain and prolong lifespan when treating stage 4 pancreatic cancer. Chemotherapy is available in either oral or intravenous form. Emotional support from loved ones can help when dealing with a cancer diagnosis. How can you cope with a cancer diagnosis?

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New guideline clarifies role of radiation therapy in pancreatic cancer treatment

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Clinical Management of Pancreatic Cancer

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