September 7, 2020

Treatment Questions for Pancreatic Cancer

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Talking with health care providers about your pancreatic cancer can be overwhelming. Below are some questions to ask during your appointments.

After a diagnosis of pancreatic cancer, you may have several questions for your doctor. Or you may not know what to ask or why. To help you learn about the specifics of your condition and potential treatment and care options, we’ve compiled a list of questions to consider asking at your appointment.

“One thing I think is really important is to have a trusted person who can take notes for you,” said Dana Cardin, M.D., MSCI, Assistant Professor of Medicine in the Division of Hematology/Oncology at the Vanderbilt Ingram Cancer Center. “The first appointment can be very overwhelming.”

Reading up on information about pancreatic cancer from reputable sources, such as the National Cancer Institute or the Pancreatic Cancer Action Network, can be a helpful way to uncover questions you might have. But homework isn’t a requirement, Cardin said. “Some people are just ‘you tell me what to do, and I’ll do it’ kind of people,” she explained. “That’s their style. And that’s OK.”

Below, we outline three categories of questions to consider.

Understanding your condition

  • What type of pancreatic cancer do I have? Where is it?
  • Has the cancer spread? If so, where has it spread to?
  • Do I need any more tests before we decide on treatment?

Cardin said 85 to 90 percent of tumors of the pancreas are adenocarcinomas, which come from glandular tissue. A small subgroup of tumors will come from hormone-secreting cells of the pancreas and are neuroendocrine. “Part of the reason why most people get a biopsy before they meet an oncologist,” Cardin explained, “is it that we’re trying to figure out, ‘What type of cancer is this?’ The treatments are completely different for those tumor types.”

The other important consideration, Cardin said, is whether the tumor has grown outside the pancreas. “The only way we really cure these tumors is to be able to take them out surgically,” she explained. “But we only usually take them out surgically if they are confined to the pancreas. So if the tumor has spread somewhere else, generally surgery is not a part of the treatment.”

Understanding treatment options

  • What are my treatment options? 
  • What treatment do you think is best for me? Why?
  • Are there any clinical trials that are right for me?

Clinical trials can give patients access to emerging, cutting-edge treatments. As a pancreatic cancer researcher, Cardin said she always considers, for every patient she meets, whether a clinical trial is appropriate for that person. “It’s just important for patients to really know all of their options,” she explained.

Understanding treatment and care goals

  • What are the goals of treatment?
  • What does treatment involve?
  • What are the side effects of treatment?

Treatment goals are often based on whether a patient has a potentially curable or an incurable cancer and what kind of side effects the patient is willing to tolerate as part of their cancer care, Cardin said. The best outcomes for localized, removable tumors involve a combined approach of surgery and chemotherapy, she explained. “We’re really talking about an aggressive approach for some period of time with a goal of curing the cancer,” she added. But that course of action may not be appropriate for everyone. Cardin said she works with patients to determine the most reasonable treatment options, considering age and other medical conditions.

Treatment goals are different for people with incurable tumors. “There are some people who would say to me, ‘If you’re not going to cure my cancer, I’m willing to take some treatment, but it cannot cause a lot of side effects for me,’” Cardin explained. “There are other people who would say, ‘I want the most aggressive treatment you have that’s going to give me the best shot at a long-term outcome, and I’m willing to put up with a lot of side effects to make that happen.’”

Additional considerations for appointments

In addition to making a list of questions you want answers to, you may want to consider whether there is information you don’t want to know. “I’m always very careful when people ask me about prognosis and things like that to ask, ‘What sort of information do you want?’” Cardin said. “Family members sometimes ask me, but the patient doesn’t really want me to say what an average life expectancy would be.” If you are bringing someone with you to your appointment, be clear about any topics you want to make off-limits. And Cardin said it’s OK to be frank with your health care providers about what you need from them in terms of communication during this difficult time.

The experts at Vanderbilt-Ingram Cancer Center work to provide a precise diagnosis and effective treatment options for pancreatic cancer. The team  combines advanced research, technology and techniques with compassionate care to create a personalized treatment plan that is right for each patient.

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Dana Cardin, M.D.

Dana Cardin, M.D., M.S.C.I., is assistant professor in the Division of Hematology and Oncology at Vanderbilt University Medical Center. At Vanderbilt-Ingram Cancer Center, she specializes in treating patients with various gastrointestinal cancers, including pancreas cancer.