Doctors at NYU Langone’s Perlmutter Cancer Center may use radiation therapy, in which energy beams are used to kill cancer cells, to manage pancreatic cancer. Radiation therapy is often used in combination with chemotherapy, an approach called chemoradiation.
Doctors may give radiation therapy or chemoradiation before surgery to shrink a tumor, so a surgeon can more easily remove it, or after surgery to destroy any remaining tumor cells.
Radiation therapy or chemoradiation is also prescribed for people who cannot have surgery due to poor health or whose cancer can’t be surgically removed based on its size or location.
Our doctors also use these approaches to control symptoms of pancreatic cancer, such as pain and difficulty eating. Radiation therapy or chemoradiation can help shrink tumors, relieving discomfort and improving the ability to digest food if a tumor is interfering with nearby organs, such as the stomach or intestines.
Our radiation oncologists use special CT scans of the tumor and the surrounding tissue and organs, in conjunction with computer-based treatment planning software, to customize a treatment plan. The result is a three-dimensional image of the tumor and the surrounding organs. This information helps your doctors determine how best to target the cancer and spare healthy tissue.
Image-Guided Radiation Therapy
Our doctors may use CT scans during your treatment sessions to ensure that the radiation therapy precisely targets the cancer, while avoiding other important organs, such as the stomach, intestines, kidneys, and liver.
This approach, called image-guided radiation therapy, helps compensate for the natural moving and shifting of organs during treatment, which can happen as you breathe.
Types of Radiation Therapy
Our doctors may use one of several types of external beam radiation therapy, which is delivered from a machine called a linear accelerator. This machine rotates around you during therapy to treat the entire tumor.
Radiation oncologists determine which type of therapy may be right for you.
Intensity-Modulated Radiation Therapy
With intensity-modulated radiation therapy, doctors break up the radiation into many small beams of different adjustable strengths, which closely conform to the size, shape, and location of the pancreatic tumor. Doctors can adjust the radiation beam within millimeters to spare surrounding healthy tissue.
Treatment is delivered in small doses called fractions. Typically, intensity-modulated radiation therapy sessions take place once daily, five days a week, for several weeks. Our radiation oncologists can recommend the best schedule for you.
Volumetric Modulated Arc Radiation Therapy
Volumetric modulated arc radiation therapy allows the linear accelerator to move around you in one or several 360-degree rotations as the therapy is delivered. This means radiation therapy can be given from almost any angle to closely target the tumor, while avoiding healthy tissue.
Doctors are also able to continuously adjust the radiation beams as they are delivered, whereas more traditional forms of radiation therapy require that the treatments start and stop for adjustments. Because this type of radiation therapy is given without interruption, treatment sessions may be shorter than with other approaches.
Sessions are typically once daily, five days a week, for several weeks.
Stereotactic Body Radiation Therapy
In stereotactic body radiation therapy, a few high doses of carefully targeted radiation beams are delivered to the tumor over several days.
A gastroenterologist can assist the radiation oncologist with treatment planning by placing small pieces of gold, called fiducials, near pancreatic tumors during an endoscopic ultrasound or endoscopic retrograde cholangiopancreatography. Fiducials appear on imaging scans to help the radiologist better target radiation therapy.
Treatment is usually completed within a week. Your doctor may use this approach to shrink pancreatic tumors before surgery. People who cannot have surgery because of poor health may be good candidates for this treatment.
Managing Side Effects
Nausea, heartburn, diarrhea, fatigue, skin irritation, and decreased appetite are common side effects of radiation therapy. They usually go away after treatment is complete.
Perlmutter Cancer Center doctors can minimize these side effects by carefully avoiding healthy organs and tissues during therapy and adjusting the radiation dose. They also recommend dietary changes to help ease digestive system side effects, and supportive and integrative therapies.
Our researchers are conducting clinical trials that test new approaches to chemoradiation for pancreatic cancer.
Perlmutter Cancer Center researchers are involved in clinical trials of new approaches to chemoradiation for pancreatic cancer. You and your doctor can discuss whether a clinical trial might be right for you.
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