For some people with pancreatic cancer, treatment may remove or destroy the cancer. Completing treatment can be both stressful and exciting. You will be relieved to finish treatment, yet it is hard not to worry about cancer coming back. (When cancer returns, it is called recurrence.) This is a very common concern among those who have had cancer.
It may take a while before your fears lessen. But it may help to know that many cancer survivors have learned to live with this uncertainty and are living full lives. Our document, Living With Uncertainty: The Fear of Cancer Recurrence, gives more detailed information on this.
For most people with pancreatic exocrine cancer (and some patients with pancreatic neuroendocrine tumors), the cancer never goes away completely. These people may get regular treatments with chemotherapy, radiation therapy, or other therapies to try to help keep the cancer in check. Learning to live with cancer that does not go away can be difficult and very stressful. It has its own type of uncertainty. Our document, When Cancer Doesn't Go Away, talks more about this.
Follow-up care
When treatment ends, your doctors will still want to watch you closely. It is very important to go to all of your follow-up appointments. During these visits, your doctors will ask questions about any problems you may have and may do exams and lab tests or x-rays and scans to look for signs of cancer or treatment side effects. Almost any cancer treatment can have side effects. Some may last for a few weeks to months, but others can last the rest of your life. This is the time for you to talk to your cancer care team about any changes or problems you notice and any questions or concerns you have.
After your cancer treatment is finished, you will probably need to still see your cancer doctor for many years. So, ask what kind of follow-up schedule you can expect.
It is important to keep health insurance. Tests and doctor visits cost a lot, and even though no one wants to think of their cancer coming back, this could happen.
Should your cancer come back, our document, When Your Cancer Comes Back: Cancer Recurrence can give you information on how to manage and cope with this phase of your treatment.
Nutrition
People with exocrine pancreatic cancer often lose their appetite and suffer weight loss and weakness. These symptoms may be caused by treatment or by the cancer itself. When possible, people are often advised to try to eat high-energy foods as well as supplements. Many patients need to take pancreatic enzymes in pill form in order to help digest food so that it can be absorbed. A nutritionist may be able to help with this. In some cases the doctors may put a feeding tube into the stomach to improve nutrition and energy levels. This is usually temporary.
Pain
Pain in the abdomen or back can be a major problem for people with exocrine pancreatic cancer. Treatment is available to help relieve this pain. If you are having any pain, please be sure to tell your doctor or nurse right away. Pain is easier to treat if the treatment is started when you first have it. You and your doctor or nurse can talk about the best ways to treat your pain. A pain specialist can also help develop a treatment plan.
There are proven ways to relieve pain from pancreatic cancer. This can be done with a combination of medicines or in some cases, endoscopy or surgery. For example, cutting some of the nerves that carry pain sensations or injecting alcohol into these nerves can provide relief. Often, if the cancer is being removed, these nerves will be cut or treated during the same operation. For most patients, treatment with morphine or other similar medicines (opioid agents) will reduce the pain considerably. Pain medicines work best when they are given regularly on a schedule. They do not work as well if they are only used when the pain becomes severe. Several long-acting forms of morphine and other opioid agents need only be given once or twice a day. Chemotherapy and/or radiation therapy to the pancreas can also sometimes relieve pain by shrinking the size of the cancer.
For more detailed information on pain and what can be done about it, see our document, Pain Control: A Guide for Those With Cancer and Their Loved Ones.
Seeing a new doctor
At some point after your cancer diagnosis and treatment, you may find yourself seeing a new doctor who does not know anything about your medical history. It is important that you be able to give your new doctor the details of your diagnosis and treatment. Make sure you have this information handy:
- A copy of your pathology report(s) from any biopsy or surgery
- If you had surgery, a copy of your operative report(s)
- If you were hospitalized, a copy of the discharge summary that every doctor prepares when patients are sent home from the hospital
- If you had chemotherapy (or were given other drugs such as targeted therapy), a list of the drugs, drug doses, and when you took them
It is also helpful if you have copies of your lab results and imaging tests (these can often be put on a DVD).
The doctor may want copies of this information for his records, but always keep copies for yourself.
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