Standard Treatment Removal of the pancreatic tumor is the basic approach, depending on the size and the site (in the head of the pancreas versus the body or tail). Most of these tumors can be enucleated and formal pancreatic resection is not required. Occasionally, patients benefit from surgical removal of metastases to help reduce symptoms of increased insulin and low blood sugar.
For pancreatic tumors that can't be removed or for widespread metastatic tumors, combination chemotherapy (5-FU + streptozocin) or diazoxide or somatostatin/octreotide (Sandostatin) can be given.
Palliation Dietary changes, including frequent small meals and increased carbohydrates,
may help reduce low blood sugar (hypoglycemia). Insulin-inhibiting drugs such as diazoxide may also help. Radiation therapy is not effective. Octreotide may be used to block insulin release from the tumor.
Five-Year Survival 80 percent
Glucagonomas
These tumors are often very large by the time they are discovered.
Standard Treatment The tumor should be removed, if possible. If not, palliation of symptoms usually is possible with octreotide.
