Proton Therapy for Pancreatic Cancer

Pancreatic cancer is one of the most difficult forms of cancer to treat because it is so difficult to find.

However, advanced treatments like Penn Medicine’s proton therapy for pancreatic cancer offers new hope and may someday change the statistics, despite the challenges pancreatic cancer poses for both researchers and clinicians.

Why is Pancreatic Cancer So Difficult?

There are currently no detection tools to diagnose pancreatic cancer in its early stages when treatment would be most effective, and the symptoms (abdominal pain, weight loss, jaundice) mimic those of several other ailments. Therefore, pancreatic cancer has the highest mortality rate of all major forms of cancer. Ninety-four percent of those diagnosed with pancreatic cancer die within five years. If the cancer has metastasized, life expectancy is less than six months. Unlike so many other types of cancer, these statistics have not improved substantially in nearly 40 years.

Stephen Hahn, MD (l) and James Metz, MD

Given the typical late detection of the disease, pancreatic cancer has limited treatment options. As symptoms usually arise in the late stages, only 20 percent of patients are still eligible for surgery at the time of detection. For those eligible for surgery, adjuvant chemotherapy and radiation therapy has been shown to increase the five-year survival rate from 10 to 20 percent.

Radiation Therapy for Pancreatic Cancer

As surgery is often not an option, chemotherapy and radiation are the primary forms of treatment for pancreatic cancer. The FDA currently approves only three drugs for chemotherapy treatment. That’s why physicians at Penn Medicine recommend clinical trials for pancreatic cancer when available.

“Most clinical trials are using the best available therapies plus something else,” said Jeffrey Drebin, MD, PhD, chairman of surgery at Penn Medicine. “We hit a lot of singles with our standard therapies; we don’t hit a lot of home runs. Clinical trials offer that chance to be in the group of patients who are first treated with a really new and innovative therapy.”

With radiation treatment, the amount of radiation that can be given with conventional doses is limited due to the proximity of the pancreas to critical organs such as the liver and kidneys, as well as the spinal cord. That is why Penn offers proton therapy for pancreatic cancer treatment at the Roberts Proton Therapy Center.

“It’s all about depositing the dose where you want it,” said James Metz, MD, vice chair clinical division, department of radiation oncology and professor of radiation oncology at Penn Medicine.

“Proton therapy allows us to pinpoint exactly where we want to put that radiation dose while missing the normal tissues,” says Dr. Metz.

This is a key benefit of proton therapy for pancreatic cancer, as exposing normal tissue to radiation causes significant side effects.

“They get nauseous, they get diarrhea, they feel lousy, their quality of life is not as good,” says Dr. Metz of patients undergoing conventional radiation treatment. “Many of the patients that get protons have a tendency to really go through treatment easier, and I think that’s really important from a quality of life perspective.”

Who Can Get Proton Therapy for Pancreatic Cancer?

Not all patients are eligible for proton therapy for pancreatic cancer. Where the tumor is and how it moves inside the pancreas, along with several other technical reasons, helps the cancer team at Penn Medicine to determine the correct course of treatment. The team includes specialists in surgery, medical oncology, and radiation oncology, along with several other disciplines, all collaborating on the patient’s behalf.

“We have to analyze what’s been done before, where you are now, and figure out if that’s the right thing for you,” says Dr. Metz. “It’s not right for everyone. That is something the physician needs to decide when you come in.”

The Roberts Proton Therapy Center is the only place that offers proton therapy for pancreatic cancer in the Philadelphia region.

To set up an appointment to learn if proton therapy is right for you, call 800-789-PENN.