According to a recent article published in the medical journal Gut, photodynamic therapy may be an effective treatment option for some patients with inoperable pancreatic cancer.
The pancreas is an organ that is surrounded by the stomach, small intestine, bile ducts (tubes that connect the liver to the small intestine), gallbladder, liver and spleen. The pancreas helps the body to break down food and produces hormones, such as insulin, to regulate the body’s storage and use of food. Surgical removal of the cancer typically results in optimal long-term outcomes; however, due to anatomical location of the cancer or advanced disease, many patients are not eligible for surgery. Inoperable pancreatic surgery is rarely curable and treatment efforts are aimed at extending survival time and improving a patient’s quality of life by alleviating symptoms caused by the cancer, including pain and extreme weight loss. Standard treatment for inoperable pancreatic cancer may consist of a chemotherapy regimen containing Gemzar® with or without radiation therapy. However, the majority of patients do not survive beyond one year following therapy. Due to the poor outcomes associated with current treatment for patients with inoperable pancreatic cancer, recent research efforts have been focused on evaluating new therapeutic approaches alone or in combination with other treatment modalities in order to improve survival for patients with this disease.
Photodynamic therapy is an emerging type of treatment that is still being evaluated and refined in clinical trials and laboratories. Photodynamic therapy works through the use of a photosensitizing agent and light. The photosensitizing agent is injected into a patient’s vein a couple of hours prior to surgery. During this time, the agent selectively collects in rapidly growing cells such as cancer cells. During surgery, the physician applies a certain wavelength of light through a hand held wand directly to the site of the cancer and surrounding tissues. The energy from the light activates the photosensitizing agent, causing the production of a toxin that accumulates in the cancer cells and ultimately destroys them.
Researchers from England recently conducted a clinical trial evaluating photodynamic therapy in the treatment of inoperable pancreatic cancer. In this trial, 16 patients were first given the photosensitizing agent meso-tetrahydroxyphenyl chlorin through a vein. Three days later, light was delivered to the cancer through the guidance of computerized tomography (CT) scans. Fourteen patients were able to leave the hospital within 10 days. The average survival time was 9.5 months and 44% of the patients were alive at one year following therapy. Treatment was very well tolerated in the majority of patients; however, two patients developed bleeding that was controlled by surgery and three patients developed an obstruction in their large intestine.
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These results indicate that photodynamic therapy may be a safe and effective treatment option for some patients with inoperable pancreatic cancer. Researchers conducting this trial concluded that further studies evaluating photodynamic therapy in inoperable pancreatic cancer are warranted, alone or in combination with chemotherapy and/or radiation. Patients with pancreatic cancer may wish to speak with their physician about the risks and benefits of participating in a clinical trial further evaluating photodynamic therapy or other promising treatment regimens.
(Brown S, Rogowska A, Whitelaw D, et al. Photodynamic therapy for cancer of the pancreas. Gut. 2002;50:549-557)