Abstract
Pancreatic cancer remains one of the most feared cancer diagnoses due to the poor prognosis associated with the majority of cases. Most patients present with distant metastases, and 5-year relative survival rates have changed very little in the past 40 years (3%–6%). Complete surgical resection remains the only potential cure, but even this modality is associated with a 5-year survival rate of only 20%. Systemic chemotherapy, and in some cases radiotherapy, is the primary treatment option for patients with unresectable disease. The multidisciplinary management of patients with pancreatic cancer requires expert hepatobiliary surgeons, a gastroenterologist who specializes in endoscopic ultrasound and biliary stent placement, pathologists specializing in hepatobiliary diseases, interventional radiologists, radiation oncologists, medical oncologists, a full complement of operative, surgical, and oncology nurses, clinical dietitians, diabetic specialists, pain specialists, social services, and often wound and ostomy nurse specialists. The advanced practitioner in oncology is critical to the overall coordination of the multidisciplinary approach to treatment, as well as the complex symptom management associated with either treatment approach. The diagnostic evaluation, clinical presentation, and treatment selection—including surgery, radiation, and systemic treatment options—will be discussed, with an emphasis on supportive care throughout the continuum of care for the patient with pancreatic cancer.
