} Pancreatic cancer is deadly if not diagnosed in its early stages. FOIA These patients are well recognized to suffer a high risk of local and regional failure after surgery - a risk that is only marginally reduced with postoperative X-ray-based radiotherapy. The Whipple procedure (pancreaticoduodenectomy) is an operation to remove the head of the pancreas, the first part of the small intestine (duodenum), the gallbladder and the bile duct. Stage IV cancer is defined differently for each type of cancer. Hall WA, Kamgar M, Erickson BA, Ponce SB, Tsai S, Nevalainen MT, Christians KK, George B, Dua KS, Khan AH, Evans DB, Azmi AS. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. More specifically, proton therapy may help in the following situations: If you have pancreatic cancer, talk with a doctor about the most viable treatment options for your stage of cancer, age, and overall health. International Journal of Radiation Oncology. ErrorSelect But ultimately if you have a pancreas, there's always a risk of developing pancreatic cancer. 2022 May 30;12:890587. doi: 10.3389/fonc.2022.890587. The site is secure. Pancreatic cancer - Care at Mayo Clinic - Mayo Clinic Neoptolemos JP, Stocken DD, Friess H, Bassi C, Dunn JA, Hickey H, Beger H, Fernandez-Cruz L, Dervenis C, Lacaine F, et al. Loncle C, et al. What clinical trials are available for pancreatic cancer? Survival after resection of pancreatic adenocarcinoma: results from a single institution over three decades. As stated earlier, the main resistance to the use of preoperative radiotherapy involves concerns about radiotherapy toxicity and its potential to complicate what is already a complicated operation. People with cancer frequently experience distress. (2018). How proton therapy works for pancreatic cancer, Advantages and disadvantages of proton therapy, some symptoms associated with radiation therapy. Distress management. In theory, proton therapy may be more effective and produce fewer side effects than photon radiation therapy, but theres still not enough data to support this hypothesis. All patients received gemcitabine at 800 mg/m weekly for 3 wk concurrent with proton therapy. clip-path: url(#SVGID_2_); Recurrent Pancreatic Cancer. Truty MJ (expert opinion). Stage 4 pancreatic cancer: Symptoms, treatment, and survival rates There are a few, but I would recommend asking your doctor about those. Sometimes it is used after surgery to reduce the risk that pancreatic cancer may recur. A phase I/II study of gemcitabine-concurrent proton radiotherapy for locally advanced pancreatic cancer without distant metastasis. A Mayo Clinic expert explains, Mayo Clinic to lead new radiotracer trial for detecting pancreatic cancer, Helpful guidelines if you test positive or negative for COVID-19, Identifying inherited gene mutations in pancreatic cancer can lead to targeted therapies, better survival, Mayo Clinic Q and A: Pancreatic cancer risk, symptoms and treatment, Advances in treating pancreatic cancer mean options and hope--2022, Mayo Clinic Researchers ID Potential Gene Marker for Treating Pancreatic Cancer, AI applied to prediagnostic CTs may help diagnose pancreatic cancer at earlier, more treatable stage, Mayo Clinic Minute: Pancreatic cancer is the most lethal, Assortment of Pill Aids from Mayo Clinic Store, Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter Digital Edition, A doctor who diagnoses and treats digestive conditions (gastroenterologist), A doctor who uses radiation to treat cancer (radiation oncologist), A surgeon who specializes in operations involving the pancreas. While valid criticisms of the ESPAC-1 study have been published[4], chemotherapy alone, without radiotherapy, has been adopted as a standard postoperative approach for resected patients in many centers. While the results of proton therapy for patients with unresectable pancreatic cancer are encouraging, it is unlikely that this therapy, without meaningful improvements in systemic therapy, can be viewed as a potentially curative intervention. There are three kinds of surgery that may be done for stage 4 pancreatic cancer: Bile duct bypass surgery Bypass surgery is an option if the tumor is blocking the common bile duct. See this image and copyright information in PMC. Dahlin C, ed. 5th ed. While generally shown to be feasible, proton irradiation, particularly when an ablative dose is planned, remains a challenge, especially due to tumor motion and the proximity to organs at risk, like the stomach, duodenum, and bowel. The site is secure. Doctors and scientists around the world are actively investigating immunotherapy for treating a variety of cancers, including pancreatic cancer. Distinguishing pancreatic cancer from autoimmune pancreatitis. In most cases, surgery is the first method of treatment of pancreatic cancer to be considered. In fact, published studies on patients receiving postoperative radiation therapy after surgery indicate local-regional failure rates ranging from 25%-36%[24,25]. Thiels CA, et al. Immunotherapy in pancreatic cancer treatment: A new frontier. Stage IV Pancreatic Cancer | Texas Oncology - txo A comprehensive dosimetric study of pancreatic cancer treatment using three-dimensional conformal radiation therapy (3DCRT), intensity-modulated radiation therapy (IMRT), volumetric-modulated radiation therapy (VMAT), and passive-scattering and modulated-scanning proton therapy (PT). Depending on your individual pancreatic cancer treatment plan, a doctor may prescribe chemotherapy medications for you to take after proton therapy. 8600 Rockville Pike Narita Y, Kato T, Takemasa K, Sato H, Ikeda T, Harada T, Oyama S, Murakami M. J Appl Clin Med Phys. 2016;7:32295. http://www.nature.com/cddis/journal/v7/n7/full/cddis2016202a.html. Palliative care is provided by teams of doctors, nurses, social workers and other specially trained professionals. Analysis of surgical failure and implications for radiation therapy. When did you first begin experiencing symptoms? Pancreatic cancer is the seventh leading cause of death from cancer globally. Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. .st0 { The initial report suggested tolerability of this regimen[15]; however, a subsequent publication in the gastroenterology literature reported a high rate of upper gastrointestinal complications[16]. Detailed Description: Chemotherapy:Capecitabine on radiation days Proton radiation over 7 weeks Consolidation Chemotherapy:Gemcitabine Study Design Go to Both the double-scattered and pencil-beam plans decreased gastric, duodenal, and small bowel dose in the low-dose regions compared to IMRT; however, protons were associated with increased dose in the mid- to high-dose regions. None of the operating surgeons described fibrosis, anastomotic leaks, or perception that the proton therapy complicated the operation. A passively scattered proton plan is shown on the left and an intensity-modulated X-ray therapy plan is shown on the right for a typical patient receiving postoperative radiotherapy for pancreatic cancer. Because of this, protons appear to represent a superior modality for radiotherapy delivery to patients with unresectable tumors and those receiving postoperative radiotherapy. When a person has stage 4 pancreatic cancer, it means that the cells that grew into a tumor in the pancreas have spread in the bloodstream. These drugs can be injected into a vein or taken orally. Pancreatic cancer: Associations of inflammatory potential of diet, cigarette smoking and long-standing diabetes. You can be the best partner to your medical team by staying healthy, staying informed, ask a lot of questions and bring somebody with you to your appointments so they can be an additional set of eyes and ears. The series published by investigators at Johns Hopkins Medicine (Baltimore, MD) on 905 patients undergoing pancreaticoduodenectomy between 1995 and 2005 indicated a 41% margin positivity rate and a 79% node positivity rate[26]. Is proton therapy safer than traditional radiation? Is there one treatment you think is best for me? The cells start to make tumors in other parts of the body, such as the bones or lungs. MD Anderson Proton Therapy Center Houston, TX - MD Anderson Cancer Center 2013. http://www.nationalconsensusproject.org/guidelines_download2.aspx. Proton Therapy | Penn Medicine Unfortunately, the cure rate for these patients is only approximately 20%[21]. Efficacy and feasibility of proton beam radiotherapy using the simultaneous integrated boost technique for locally advanced pancreatic cancer. information highlighted below and resubmit the form. What websites do you recommend? Talk to your doctor about what clinical trials might be appropriate for you. What Are the Early Warning Signs of Pancreatic Cancer. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2014. http://www.clinicalkey.com. Psycho-Oncology. It's often used while undergoing aggressive treatments, such as surgery, chemotherapy and radiation therapy. Everything You Need to Know About Endoscopic Ultrasound. The vast majority of pancreatic cysts will not become cancerous. Epub 2021 Oct 2. This suggests that the two types of radiation therapies have similar efficacy. government site. With conventional radiotherapy (A) using X-rays (photons), the highest dose is near the point of beam entry into the patient. With protons, however, because the dose distribution can be modulated along the beam path, significant sparing of sensitive gastrointestinal structures (small bowel and stomach) can be achieved. You will also Thompson RF, Mayekar SU, Zhai H, Both S, Apisarnthanarax S, Metz JM, Plastaras JP, Ben-Josef E. Med Phys. No dose-limiting toxicities were observed. and transmitted securely. government site. Pancreatic Cancer Treatment Program - Massachusetts General Hospital National Library of Medicine Advertising revenue supports our not-for-profit mission. 8th ed. When that isn't an option, the focus may be on improving your quality of life and limiting the cancer from growing or causing more harm. Be sure to discuss the potential benefits and risks of proton therapy with a doctor before undergoing proton therapy for pancreatic cancer. Pancreatic Cancer Treatment (PDQ): Prognosis and Survival. Hong TS, Ryan DP, Blaszkowsky LS, Mamon HJ, Kwak EL, Mino-Kenudson M, Adams J, Yeap B, Winrich B, DeLaney TF, et al. In: Goldman-Cecil Medicine. Learn about the warning signs and screening options. The 2-year overall survival rate was 31%, the median survival rate was 18.4 mo, and the 2-year freedom from local progression rate was 69% (Figure (Figure4).4). Winter JM, Brennan MF, Tang LH, DAngelica MI, Dematteo RP, Fong Y, Klimstra DS, Jarnagin WR, Allen PJ. Accessed June 3, 2016. Proton radiotherapy can be used to create dose distributions that conform to tumor targets with significant normal-tissue sparing. Clinically, standard doses of proton radiation treatment have not been shown to be . Do you have any brochures or other printed material that I can take with me? eCollection 2021. Kozak KR, Kachnic LA, Adams J, Crowley EM, Alexander BM, Mamon HJ, Fernandez-Del Castillo C, Ryan DP, DeLaney TF, Hong TS. Proton Radiation Therapy for Pancreatic Cancer } Comparison of chemoradiotherapy (CRT) and chemotherapy (CT) in patients with a locally advanced pancreatic cancer (LAPC) controlled after 4 months of gemcitabine with or without erlotinib: Final results of the international phase III LAP 07 study [abstract]. In certain situations, proton therapy can be used to treat pancreatic cancer and it may offer fewer side effects compared with standard radiation therapy. Stage 4 Pancreatic Cancer Prognosis Treatment - Envita Medical Centers Protons are positively charged particles within an atom. Your in-depth coping with cancer guide will be in your inbox shortly. the contents by NLM or the National Institutes of Health. Psychological distress in patients with pancreatic cancer An understudied group. Accessibility The median follow-up for surviving patients was 23 mo. Proton beam therapy for gastrointestinal cancers: past, present, and Proton Therapy and Concomitant Capecitabine for Non-Metastatic Unresectable Pancreatic Adenocarcinoma. The https:// ensures that you are connecting to the Charged particles such as protons travel a finite distance into tissue, determined by their energy, and then release most of that energy in a tightly defined region called the Bragg peak. Pittsburgh, Pa.: National Consensus Project for Quality Palliative Care. By delivering a range of energies directed toward the tumor target, a summation of these Bragg peaks allow for the creation of a spread-out Bragg peak, which conforms to the depth and position of the tumor target (Figure (Figure1).1). 2016;160:1080. Accessibility official website and that any information you provide is encrypted Results and patterns of failure in patients treated with adjuvant combined chemoradiation therapy for resected pancreatic adenocarcinoma. 2007 Aug 1;68(5):1557-66. doi: 10.1016/j.ijrobp.2007.02.056. A particularly exciting opportunity for protons also exists for patients with resectable and marginally resectable disease. Every day doctors learn more about how new treatments, such as immunotherapies, could help treat pancreatic cancer more effectively. Journal of Clinical Oncology. The Cancer Center is a leading provider of clinical trials in New England for pancreatic cancer, making clinical trial evaluation of new therapies a key treatment option. Accessed June 3, 2016. Pancreatic cancer treatment options depend on disease stage and include surgery, radiation, chemotherapy, chemoradiation, and palliative therapy. Overall survival is increased among stage III pancreatic adenocarcinoma patients receiving neoadjuvant chemotherapy compared to surgery first and adjuvant chemotherapy: An intention to treat analysis of the National Cancer Database. The series from Memorial Sloan-Kettering Cancer Center (New York, NY) on 625 resections between 2000 and 2009 indicated a 16% margin positivity rate and a 70% node positivity rate[27]. Proton radiotherapy can be used to create dose distributions that conform to tumor targets with significant normal tissue sparing. For example, postoperative convalescence generally necessitates a 10- to 12-wk window between surgery and initiation of postoperative radiation therapy. Some integrative and alternative medicine approaches may help with signs and symptoms you experience due to your cancer or cancer treatments. Front Radiat Ther Oncol. Shubert CR, et al. Epub 2007 Jun 4. Learn about the most common surgical options for pancreatic cancer including when they're used, the procedure, recovery, and outlook. with cancer, plus helpful information on how to get a second opinion. But it might help you live longer and relieve symptoms. The pancreas produces enzymes that contribute to proper digestion. You'll spend several days in the hospital and then recover for several weeks at home. Healthline Media does not provide medical advice, diagnosis, or treatment. Possible side effects Some of the more common side effects of radiation therapy include: Skin changes in areas getting radiation, ranging from redness to blistering and peeling Nausea and vomiting Diarrhea Fatigue Loss of appetite Weight loss Radiation can also lower blood counts, which can increase the risk of serious infection. Three patients experienced grade 2 gastrointestinal toxicity; all 3 of these patients were treated early in the series with fields that included anterior and left lateral components. Antwi SO, et al. Potential New Therapies Help Outsmart Pancreatic Cancer Romaine C Nichols, Soon Huh, Zuofeng Li, Michael Rutenberg, Department of Radiation Oncology, University of Florida, Jacksonville, FL 32206, United States. ncbi.nlm.nih.gov/pmc/articles/PMC6990870/, cancer.gov/news-events/cancer-currents-blog/2020/proton-therapy-safety-versus-traditional-radiation, cancer.gov/types/pancreatic/patient/pancreatic-treatment-pdq, cancer.gov/about-cancer/treatment/types/radiation-therapy/side-effects, cancer.gov/about-cancer/treatment/types/radiation-therapy, ncbi.nlm.nih.gov/pmc/articles/PMC6396775/, ncbi.nlm.nih.gov/pmc/articles/PMC7052755/, mskcc.org/cancer-care/diagnosis-treatment/cancer-treatments/radiation-therapy/what-proton-therapy. Journal of Gastrointestinal Surgery. Pancreatic Cancer Treatment - MD Anderson Cancer Center 2021 Sep;40(3):879-889. doi: 10.1007/s10555-021-09993-z. What Type of Endoscopy Detects Pancreatic Cancer? While proton therapy could mean fewer side effects, theres not enough evidence to definitively show that the treatment can extend lifespan. 2011;43:465-485. doi: 10.1159/000322511. sharing sensitive information, make sure youre on a federal Palliative care and end-of-life hospice. Palliative care is not the same as hospice care or end-of-life care. Pancreatic neuroendocrine tumors. My Support Stage IV Pancreatic Cancer Pancreatic cancer is considered stage IV if it has spread to distant locations in the body, such as the liver, lungs, or adjacent organs including the stomach, spleen, and/or the bowel. Du Y, Duan Y, Zhang L, Gu Z, Zheng X, Li Z, Wang C. Front Oncol. While many surgeons are hesitant to perform major pancreatic operations on patients who have received preoperative X-ray-based radiotherapy, it is possible that the normal tissue-sparing characteristics of protons will allow for more wide-spread adoption of preoperative radiotherapy in the setting of resectable potentially curable disease. The .gov means its official. The short answer is no. Kozak et al[7] demonstrated the dosimetric feasibility of hypo-fractionated proton therapy for neoadjuvant pancreatic cancer treatment using anatomical data from 9 patients. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Once you have pancreatitis, though, weight loss is the bigger issue. gro.notorpadirolf@slohcinr, Telephone: +1-904-5881800 Fax: +1-904-5881300. You may receive one chemotherapy drug or a combination of them. Also, an exit dose is delivered beyond the tumor target. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). You may opt-out of email communications at any time by clicking on Current research shows a higher treatment efficacy with combined chemotherapy and radiotherapy/proton therapy. Stage IV Pancreatic Cancer - Pancreatic Cancer Action Network Image borrowed from the University of Florida Health Proton Therapy Institute. Its not widely available yet, but proton therapy may be able to treat pancreatic cancer without causing as many of the side effects associated with other therapies. https://www.merckmanuals.com/professional/gastrointestinal-disorders/tumors-of-the-gi-tract/pancreatic-cancer. It often . The Whipple procedure is a technically difficult operation to remove the head of the pancreas, the first part of the small intestine (duodenum), the gallbladder, part of the bile duct and nearby lymph nodes. Cancer Metastasis Rev. Dosimetric feasibility of hypofractionated proton radiotherapy for neoadjuvant pancreatic cancer treatment. 2012 May 1;83(1):158-63. doi: 10.1016/j.ijrobp.2011.05.045. Generally, the main treatment is . Clipboard, Search History, and several other advanced features are temporarily unavailable. Neoptolemos JP, Dunn JA, Stocken DD, Almond J, Link K, Beger H, Bassi C, Falconi M, Pederzoli P, Dervenis C, et al. 2023 Healthline Media LLC. Cigarette smoking is one of the major risk factors for pancreatic cancer. [19]. I'm Dr. Chee-Chee Stucky, a surgical oncologist at Mayo Clinic, and I'm here to answer some of the important questions you might have about pancreatic cancer. National Cancer Institute. A dosimetric comparison of proton and photon therapy in unresectable cancers of the head of pancreas. other information we have about you. } Proton therapy may be used as the only treatment for your condition. In many cases, surgeons at Mayo Clinic can now perform complex pancreatic cancer operations using either small incisions (laparoscopy) or robotic techniques, which have been shown to allow for a faster recovery. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015. Studies of intraoperative radiotherapy in carcinoma of the pancreas. The tumor dose is significantly less than the entry dose. Doctors usually recommend proton therapy for advanced pancreatic cancer or in situations when surgery alone cant remove all the cancerous tissue usually stage 2B to stage 4. While generally shown to be feasible, proton irradiation, particularly when an ablative dose is planned . 2021 Nov;22(11):90-98. doi: 10.1002/acm2.13429. This process stands in contrast to X-rays for which the highest dose is near the point of beam entry into the patient. Pancreatic cancer is a fast-growing cancer that occurs when normal cells in the pancreas mutate (change) and start to grow uncontrollably. Radiation therapy plays a central role in the treatment of pancreatic cancer. 2016;20:891. Post-treatment endoscopic examinations in 45 of 91 patients revealed radiation-induced ulcers in the stomach and duodenum. Sai S, Kim EH, Koom WS, Vares G, Suzuki M, Yamada S, Hayashi M. Onco Targets Ther. Proton therapy may result in fewer side effects, but you may still experience some symptoms associated with radiation therapy, such as: Another downside to proton therapy is the lack of accessibility. Careers. You can definitely live without a pancreas. official website and that any information you provide is encrypted Int J Radiat Oncol Biol Phys. Thind K et al. An official website of the United States government. All rights reserved. This type of cancer can spread before any symptoms appear, which may influence what treatments a doctor or specialist recommends. After surgery some people experience nausea and vomiting if the stomach has difficulty emptying (delayed gastric emptying). The ESPAC-1 trial, using a complicated randomization scheme[2,3], concluded that postoperative radiotherapy was associated with a nominal, but statistically insignificant, survival decrement as irradiated patients demonstrated a 15.5-mo median survival vs 16.1 mo for patients receiving chemotherapy alone. In some cases, doctors may perform proton therapy before, during, or after surgery, and they may combine it with chemotherapy. Clinical trials for pancreatic cancer might give you a chance to try new targeted therapy, chemotherapy drugs, immunotherapy treatments or vaccines. Moris M, et al. In reality, many patients are unable to receive postoperative radiation therapy within a clinically meaningful time frame. Because of this, protons appear to represent a superior modality for radiotherapy delivery to patients with unresectable tumors and those receiving postoperative radiotherapy. If the treatment being studied proves to be safer and more effective than current treatments, it can become the new standard of care. Learn why these tests may detect cancer, A combined kidney and pancreas transplant is a procedure where you receive two organ transplantations at the same time. Cancer at this stage may also be called metastatic or advanced cancer. Accessed June 10, 2016. As with radiation therapy, doctors may recommend proton therapy to: Healthcare professionals also typically combine proton therapy with other cancer therapies, such as chemotherapy or surgery. Cancer of the pancreas. Patients diagnosed at an earlier stage can also develop stage IV cancer if it spreads. Ask Mayo Clinic From an accredited US hospital Show transcript Pancreatic ultrasound Enlarge image If your doctor suspects pancreatic cancer, he or she may have you undergo one or more of the following tests: Imaging tests that create pictures of your internal organs. . National Cancer Institute. The fact that surgery could be performed without significant complications after high-dose radiotherapy for patients who are initially unresectable suggests that lower doses of preoperative proton therapy in the range of 50 Gy (RBE) or even higher should not complicate surgery for patients with resectable or borderline resectable disease. But this type of therapy is still controversial due to varied results in clinical trials. (2019). at newsletters@mayoclinic.com. Tee MC, et al. Bethesda, MD 20894, Web Policies Proton Therapy for Pancreatic Cancer Most cancers of the breast, pancreas, lung, prostate, colon, esophagus and stomach are adenocarcinomas. Riggin ER. J Gastroenterol. There is a problem with What is your experience with pancreatic cancer diagnosis and treatment? Stage IV means the cancer metastasized, or spread, to another part of the body. To help pancreatic cancer patients, even those with unresectable tumors, we deliver unique targeted therapies and minimally invasive surgical options at Envita Medical Centers, a world-class Integrative center for Precision Oncology. Ding X, Dionisi F, Tang S, Ingram M, Hung CY, Prionas E, Lichtenwalner P, Butterwick I, Zhai H, Yin L, et al. What to Know About a Combined Kidney and Pancreas Transplant, Pancreatic Cancer: New AI Program Could Help With Early Detection. Niederhuber JE, et al., eds. Due to the limited data supporting its efficacy, few insurance companies are likely to cover proton therapy. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. A Female With Synchronous Multiple Primary Malignant Tumors in the Esophagogastric Junction, Duodenum and Pancreas: Case Report and Review of the Literature. Each of these surgeries carries the risk of bleeding and infection. What stage of cancer is proton therapy most useful for? FOIA Unable to load your collection due to an error, Unable to load your delegates due to an error. Get answers to the most frequently asked questions about pancreatic cancer from Mayo Clinic surgical oncologist Chee-Chee Stucky, M.D. The https:// ensures that you are connecting to the Allscripts EPSi. I'm experiencing these signs and symptoms. 2016; 94:561. http://ac.els-cdn.com/S0360301615266850/1-s2.0-S0360301615266850-main.pdf?_tid=246e86d0-dc38-11e6-94d3-00000aacb35e&acdnat=1484604617_48259687104ce7b2e3bdc7c9d165c12d. Radiotherapy is commonly offered to patients with pancreatic malignancies although its ultimate utility is compromised since the pancreas is surrounded by exquisitely radiosensitive normal tissues, such as the duodenum, stomach, jejunum, liver, and kidneys. In the proton plan, 75% of the dose is delivered via a posterior field that irradiates the tumor bed but does not exit into the small bowel. While many of these patients fail exclusively with distant metastatic disease, a substantial number experience local recurrence after surgery. And this particular study combined a variety of cancer types not just pancreatic cancer. Specialists can help you sort through your feelings and help you devise strategies for coping. health information, we will treat all of that information as protected health Click here for an email preview. In specialized medical centers, radiation therapy may be delivered during surgery (intraoperative radiation). (2019). Proton beam radiotherapy, or proton therapy, is a type of high dose radiation treatment. Image borrowed from Ref. You may also consider enrolling in a clinical trial. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Core tip: Radiotherapy is commonly offered to patients with pancreatic malignancies although its ultimate utility is compromised since the pancreas is surrounded by exquisitely radiosensitive normal tissues, such as the duodenum, stomach, jejunum, liver, and kidneys. A pancreatic cancer diagnosis should not limit your options to fight for your life. Doctors also primarily use it in more advanced cases of pancreatic cancer or those that are untreatable with surgery alone.