Hi geric,
The pancreas lies in what some call the ?arm? of the stomach. This arm
is actually a loop of small intestine, behind the stomach. The wider
right end of the pancreas is called the ?head?, the middle section is
known as the ?body? and the narrower left end is called the ?tail? .
The islet cells make several hormones, the most well known being
insulin, along with somatostatin, gastrin, and glucagon. When islet
cells are invaded by a cancerous tumor, the production of hormones is
increased, and the tumor is called a functioning tumor. Not all tumors
however, increase hormone production. Endocrine tumors of the pancreas
account for only 5% of all pancreatic cancers. The majority of
endocrine pancreatic tumors are functional adeno-carcinomas that
overproduce a specific hormone. Insulinomas are the most prevalent
type of endocrine tumors.
EndocrineWeb
http://www.endocrineweb.com/pancreas.html
Health AtoZ
http://www.healthatoz.com/healthatoz/Atoz/ency/pancreatic_cancer_endocrine.html
As with many things medical, the choice of treatment depends on a
number of variables, such as the age and general health of the
patient, the type of cancer/tumor, the stage (How advanced) of the
cancer, as well as the doctor?s experience and preference. I have
listed the most common current treatments, along with an emerging
therapy, immunotherapeutics, followed by some experimental drugs on
the horizon.
Current Treatment:
According to the US Government site, Cancer.gov, these are the current
treatment options, with surgery being the most common treatment:
·Surgery (taking out the cancer).
·Chemotherapy (using drugs to kill cancer cells).
·Hormone therapy (using hormones to stop cancer cells from growing).
With surgery, the cancerous section of the pancreas, along with some
surrounding tissue is removed. A procedure known as a Whipple
procedure removes the head of the pancreas, part of the small
intestine and some of the surrounding tissues. Surgeons try to remove
the cancer, yet leave an adequate amount or the pancreas to continue
producing insulin and other digestive juices.
?If the cancer has spread so extensively that it cannot be removed,
the doctor may perform surgery to relieve the painful symptoms. If the
cancer is blocking the small intestine and bile builds up in the
gallbladder, the doctor may do surgery to bypass the obstruction.
During this surgery the doctor will cut the gallbladder or bile duct
and attach it to the small intestine. This is called biliary bypass.
Surgery or X-ray procedures may also be done to insert a catheter
(small tube) to drain bile that has built up in the area. The bile may
drain from the catheter to outside of the body or the catheter may
bypass the blocked area and drain the bile into the small intestine.
If the cancer is blocking the flow of food from the stomach, the
stomach may be sewn directly to the small intestine so the patient can
continue to eat normally.?
http://www.cchs.net/health/health-info/docs/1800/1811.asp?index=8094
?Surgery is the only curative method for islet cell cancers, and
studies have shown that an aggressive surgical approach can improve
survival and alleviate symptoms of the disease. As with most forms of
cancer, the earlier it is diagnosed, the greater the chance for
survival. With the exception of insulinoma, the majority of islet cell
tumors are malignant at the time of diagnosis, and more than half are
metastatic. However, surgery and chemotherapy have been shown to
improve the outcome of patients even if they have metastatic disease.
Surgery may include partial or total removal of the pancreas, and in
patients with gastrinoma, the stomach may be removed as well.?
Health AtoZ
http://www.healthatoz.com/healthatoz/Atoz/ency/pancreatic_cancer_endocrine.html
Sometimes the stomach is removed (gastrectomy) if the cancer has
invaded the area, or if ulcers have developed. Surrounding lymph nodes
may also be removed, if suspected of being infiltrated with cancerous
cells.
Chemotherapy is a treatment of very strong drugs, intended to kill
cancer cells, delivered by IV or orally, in a pill form.
?Total gastrectomy is no longer considered the immediate treatment of
choice and is selectively used depending on effectiveness of other
treatment programs?
http://www.cancer.gov/cancerinfo/pdq/treatment/isletcell/healthprofessional/#Section_27
Newer Therapies:
Immunotherapeutics
Immunotherapy is intended to stimulate the body?s own defense system.
Immunotherapy used to be thought of only in conjunction with
infectious diseases, or allergies. ?Interferon alfa-2a (Roferon-A)
and alfa-2b (Intron A) -- Protein product manufactured by using
recombinant DNA technology. Pancreatic endocrine tumor patients
treated with human leukocyte interferon have objective response rates
of 77%, with effects lasting >1 year in some cases.
Responses represent primarily decreased hormone production rather than
objective reduction in tumor bulk (Oberg, 1989). Mechanisms of hormone
reduction and antitumor activity are not clearly understood; however,
direct antiproliferative effects against malignant cells and
modulation of host immune response likely have important roles.?
EMedicine
http://www.emedicine.com/med/topic272.htm
?Biological therapy tries to get your own body to fight cancer. It
uses materials made by your own body or made in a laboratory to boost,
direct, or restore your body's natural defenses against disease.
Biological therapy is sometimes called biological response modifier
(BRM) therapy or immunotherapy. Biological therapy is being tested in
clinical trials.?
http://www.cancer-info.com/pancreas.htm
?The body's ability to develop an immune reaction to tumors may help
determine which patients are cured of cancer using conventional
therapies, including surgery, radiation and drugs?
Cancer Supportive Care Programs
http://www.cancersupportivecare.com/immunotherapy.html
?The newest treatment in the fight against pancreatic cancer is
biological therapy, which is the use of the body's immune system to
fight cancer. Biological therapy uses materials made by the body,
animals or in a laboratory to boost, direct and restore the body's
natural defenses against disease. Biological therapy is sometimes
called biological response modifier (BRM) therapy or immunotherapy.?
http://www.cchs.net/health/health-info/docs/1800/1811.asp?index=8094
?With immunotherapy, for instance, we've seen initial promise,
particularly targeting early stage pancreas tumors after surgery. In
locally advanced inoperable pancreas cancer, the traditional way to
reduce tumor size is chemotherapy, or combination chemotherapy and
radiation therapy. Increasingly, people are looking at adding a
targeted therapy or a vaccine approach to those traditional
treatments. I don't think these new treatments will be used in lieu of
standard chemotherapy and radiation therapy, but they give us new
weapons to add to our arsenal. ?Eileen O'Reilly, Medical Oncologist
Memorial Sloan-Kettering Hospital
http://www.mskcc.org/mskcc/html/19296.cfm
From CancerCenter.com
Biotherapy may be used to:
Stop, control, or suppress processes that permit cancer growth;
Make cancer cells more recognizable, and therefore more susceptible,
to destruction by your immune system;
Boost the killing power of your immune system cells, such as T-cells,
NK-cells, and macrophages;
Alter cancer cells' growth patterns to promote behavior like that of
healthy cells;
Block or reverse the process that changes a normal cell or a
pre-cancerous cell into a cancerous cell;
Enhance your body?s ability to repair or replace normal cells damaged
or destroyed by other forms of cancer treatment, such as chemotherapy
or radiation; and
Prevent pancreatic cancer cells from spreading to other parts of your body.
http://www.cancercenter.com/pancreatic-cancer/biotherapy-immunotherapy.cfm
These centers (In the US) offer Immunotherapy:
Midwestern Regional Medical Center
http://www.cancercenter.com/midwestern-hospital.cfm
Southwestern Regional Medical Center
http://www.cancercenter.com/southwestern-hospital.cfm
Seattle Cancer Treatment and Wellness Center
http://www.cancercenter.com/seattle-clinic.cfm
New and/or experimental drugs
COX-2 Inhibitors
?Based on promising research, in 1997 The Life Extension Foundation
began to recommend the European COX-2 inhibiting drug nimesulide to
cancer patients. Since then a wealth of clinical research has
confirmed that COX-2 is elevated in many cancers, including pancreatic
cancer, and that COX-2 inhibitors are useful in treating cancer.
An article in the journal Cancer Research reported that COX-2 levels
in pancreatic cancer cells are 60 times greater than in adjacent
normal tissue (Tucker et al. 1999).
A study in the journal Cancer Research found COX-2 expression in 14 of
21 (67%) pancreatic carcinomas. Two NSAIDs, sulindac sulfide and
NS398, produced a dose-dependent inhibition of cell proliferation in
all pancreatic cell lines tested (Molina et al. 1999).?
Life Extension
http://cancer.lef.org/pancreatic-2.html#cox
?Virulizin is the latest medication being researched for pancreatic
cancer patients.Virulizin is made from cow bile and works by boosting
macrophages, the cells that fight cancer and aid the immune system.
Researchers claim that the medication has fewer side effects than
current therapies and may offer an viable alternative for pancreatic
cancer patients.
In research trials, researchers gave Virulizin to 26 patients with
pancreatic cancer who had not responded to the drug Gemzar
(gemcitabine). Virulizin appeared to increase the survival rate by an
average of six months. Researchers reported one patient in the study
survived for 22 months.?
http://www.cchs.net/health/health-info/docs/1800/1811.asp?index=8094
Orathecin by SuperGen, is a new chemotherapy drug, that is indicated
for use in patients who have had a failed prior chemotherapy.
SuperGen?s Phace III cinical trial is thought to be the largest
clinical development program in pancreatic cancer ever undertaken.
MyCancerCompass
http://www.mycancercompass.com/public.cfm/6629/6670
SuperGen
http://www.supergen.com/home/main.asp
Just two weeks ago, an experimental drug CX-3543, was announced.
CX-3543 suppresses the cancer gene, as well as the growth factor VEGF
that promotes formation of blood vessels that feed tumors. ?"Also, in
a very-difficult-to-treat pancreatic cancer model, we saw anywhere
from 50 percent to 90 percent reductions in tumor growth depending on
the dose of CX-3543," he added. All of these tumors are largely driven
by high levels of c-Myc.
Dr. Geoff M. Wahl, from The Salk Institute in La Jolla, California,
who organized the program for this year's AACR meeting, said CX-3543
represents "one exciting advance in taking cancer-specific gene
alterations and targeting them. This is a new direction in which
cancer therapy must go in the future."
Reuters Health Information
http://www.nlm.nih.gov/medlineplus/news/fullstory_16874.html
For Stages I-IIII ?Platinol, Gemzar, and 5-FU which appears to be
well-tolerated in patients with advanced pancreatic cancer. The
results of this trial were published in the March 2004 issue of the
Annals of Oncology.?
Cancer Consultants
http://www.cancerconsultants.com/professional_new/education_news.php?article=pancreatic_march04m&type=pron&style=news.css&navType=0&target=_self&otherParams=
If you are interested in finding a clinical trial, visit this
Pancreatica site. You will need to enter the information to find
trials in your location.
Suggested Keywords:
CX-3543
Virulizin
TNP-470
COX-2 Inhibitors
http://www.pancreatica.org/Search.cfm
See an illustration of the pancreas, and how a tumor is excised:
http://www.cpmc.org/advanced/liver/patients/topics/PP-hepatobiliary.html#Diseases%20of%20the%20Pancreas%20-%20Surgical%20Options
Pancreatic Cancer Vaccine Clinical Trials, From Duke University
http://cancer.duke.edu/Vaccine/trials/pancreas.asp
Hope this helps! If any part of my answer is unclear, please request
an Answer Clarification, before rating. This will allow me to assist
you further, if possible.
Regards,
crabcakes
Search Terms
Islet Cell cancer
New therapies islet cell cancer
Islet cell carcinoma experimantal treatment |
