Standard Treatment Surgical bypass procedures can be carried out as a palliative measure ( see "Palliation" section ) and neurosurgical procedures such as blocking the nerves from the stomach and pancreas (celiac ganglion nerve blocks) may relieve much of the pain.
Combined radiation and chemotherapy may be helpful. Radiation therapy alone may relieve symptoms, but clinical trials should be considered, since survival is not significantly increased with radiotherapy alone.
If the patient is jaundiced, the bile ducts can be drained through the skin (transhepatic percutaneous biliary bypass). Alternatively, a drainage tube can be placed inside the small bowel by means of a gastroscope (endoscopic stent placement).
Investigational
• Radiation therapy with radiosensitizers.
• Intraoperative radiotherapy (IORT) and implantation of radioactive seeds (brachytherapy) are sometimes
combined, with and without chemotherapy, for resectable or unresectable tumors.
• Postoperative radiation therapy plus 5-FU in resected patients.
