The pancreas, a flat, pear-shaped gland that is part of the digestive system, is located behind the lower part of the stomach and surrounded by the liver, small intestines, gallbladder, and spleen. It is composed of endocrine cells that secrete hormones like insulin and exocrine cells that secrete enzymes to aid digestion.
Pancreatic cancer develops in the pancreatic tissues. Most pancreatic tumors are adenocarcinomas that develop in the epithelium of the ductal system. The common bile duct becomes obstructed as the tumor grows and develops, resulting in obstructive jaundice. If the tumor develops in the body or the tail of the pancreas, symptoms may manifest after the tumor growth has already advanced.
Pancreatic cancer often does not produce symptoms until it spreads to other organs. This delay in detection often results in a poor prognosis.
In this article:
- Nursing Process
- Nursing Assessment
- Nursing Interventions
- Nursing Care Plans
- Death Anxiety
- Imbalanced Nutrition: Less Than Body Requirements
- Impaired Comfort
- Ineffective Tissue Perfusion
Nursing Process
Surgery is the most effective treatment for pancreatic cancer. However, only about 20% of patients have resectable tumors at the time of diagnosis. With neoadjuvant chemotherapy, more patients with pancreatic cancer become surgical candidates. If the cancer has metastasized and surgery is not possible, palliative measures like radiation therapy, cholecystojejunostomy, or endoscopically placed biliary stents are indicated.
Nurses provide symptomatic and supportive care to patients diagnosed with pancreatic cancer with interventions like administering medications, providing comfort measures, offering psychological support, ensuring adequate nutrition, and providing patient education and resources.
Nursing Assessment
The first step of nursing care is the nursing assessment, during which the nurse will gather physical, psychosocial, emotional, and diagnostic data. In this section, we will cover subjective and objective data related to pancreatic cancer.
Review of Health History
1. Assess the patient’s general symptoms.
The signs and symptoms of pancreatic cancer are the same as chronic pancreatitis and may include the following:
- Abdominal pain radiating to the back
- Loss of appetite
- Unintentional weight loss
- Dark-colored urine
- Light-colored stools
- Itchy skin
- Fatigue
2. Assess the patient’s risk factors.
Pancreatic cancer risk is increased due to the following factors:
Non-modifiable risk factors:
- Age: The chance of getting pancreatic cancer increases with age. Almost all patients are 45 or older. At the time of diagnosis, the typical age is 70.
- Gender: Males are more likely than women to develop pancreatic cancer because men use tobacco at higher rates.
- Ethnicity: Compared to caucasian people, African Americans have a slightly higher risk of developing pancreatic cancer.
- Family history: Pancreatic cancer may run in families or be related to a genetic condition.
- Inherited genetic syndromes: Mutations in inherited genes can be transferred from parent to child. These gene alterations could cause up to 10% of pancreatic tumors. Genetic syndromes include:
- Hereditary breast and ovarian cancer syndrome (BRCA1, BRCA2, or PALB2 genes)
- Familial pancreatitis (PRSS1 gene)
- Lynch syndrome is caused by a defect in the MLH1 or MSH2 genes
Modifiable risk factors:
- Obesity: A BMI of 30 or higher increases the risk of pancreatic cancer by 20%. Any extra weight as an adult raises the risk as well.
- Physical inactivity: Lack of physical activity raises the pancreatic cancer risk.
- Diet: Saturated fats and red and processed meats may raise the risk of pancreatic cancer. Sugary beverages may also increase this risk.
- Smoking: One of the main risk factors for pancreatic cancer is smoking. The chance of developing pancreatic cancer is around twice as high for smokers.
- Alcohol consumption: Excessive alcohol consumption can result in conditions like chronic pancreatitis, which raises the risk of pancreatic cancer.
- Exposure to chemicals: A person’s chance of developing pancreatic cancer may increase if regularly exposed to specific chemicals used in the metalworking and dry cleaning industries.
3. Review the patient’s history.
Check for any underlying conditions that may cause pancreatic cancer. The following conditions may increase the risk of pancreatic cancer:
- Diabetes: Patients with diabetes are more likely to get pancreatic cancer. The majority of the risk is present in type 2 diabetic patients.
- Chronic pancreatitis: A higher risk of pancreatic cancer is associated with chronic pancreatitis, long-term pancreatic inflammation. Heavy alcohol consumption and smoking are frequently associated with chronic pancreatitis.
- Infections: Pancreatic cancer risk may be increased by hepatitis B infection or stomach infection with the ulcer-causing bacteria Helicobacter pylori (H. pylori).
Physical Assessment
1. Perform a physical examination.
The following symptoms are observed during the physical examination for pancreatic cancer:
- General: weight loss, fatigue
- HEENT: yellowish sclera of the eyes
- Gastrointestinal: abdominal pain, nausea, vomiting, poor appetite, abdominal distention, palpable abdominal mass
- Genitourinary: dark urine, light-colored stool, greasy stool (steatorrhea)
- Integumentary: yellowing skin, itchy skin (pruritus)
2. Palpate the abdomen.
During palpation of the abdomen, the patient may complain of mild to severe mid-epigastric tenderness. It is described as pain extending to the mid back or lower back. It implies that the tumor has invaded the celiac plexus behind the peritoneum (retroperitoneum).
3. Check for palpable organs.
Pancreatic cancer occasionally causes the gallbladder and liver to enlarge. The palpable gallbladder will feel like a noticeable lump under the right side of the ribcage, while the edge of the enlarged liver (hepatomegaly) can be palpated below the right ribcage.
4. Monitor blood glucose.
Cancer may produce slight changes in blood sugar levels that do not result in the symptoms of diabetes but can still be found through blood tests.
5. Consider key characteristics.
Painless obstructive jaundice is the most prominent symptom of pancreatic cancer of the head of the pancreas. Jaundice may be observed before reports of epigastric or back pain.
Diagnostic Procedures
1. There is no routine screening.
Pancreatic cancer may not be diagnosed until later stages because tumors are difficult to palpate, and patients may be asymptomatic.
2. Send blood samples for testing.
Blood tests include:
- Liver function tests will reveal elevations that correspond to jaundice, the first sign of pancreatic cancer.
- Tumor markers are found in the blood. Increased CA 19-9 and carcinoembryonic antigen (CEA) helps identify pancreatic cancer.
- Total bilirubin of 2–3 mg/dL indicates jaundice. Clinical jaundice is not noticeable to patients or their relatives until the total bilirubin level reaches 6–8 mg/dL.
3. Prepare the patient for a biopsy.
A small tumor sample (biopsy) must be examined under a microscope to determine the diagnosis. A biopsy can be performed in a variety of ways.
- Percutaneous biopsy or fine needle aspiration (FNA) places a hollow needle through the abdominal skin (percutaneous) to obtain a tumor sample.
- Endoscopic biopsy inserts an endoscope through the mouth to retrieve a piece of the tumor.
- Surgical biopsy uses laparoscopy to create incisions in the abdomen to biopsy multiple organs if metastasis is suspected.
4. Consider genetic counseling and testing.
Some patients with pancreatic cancer have gene mutations (such as BRCA mutations) in their body’s cells, which increases their risk of developing the disease (and possibly other cancers). The results of these gene mutation tests can occasionally influence the best possible course of treatment and the need for other family members to be tested.
5. Analyze the imaging results.
Imaging exams visualize using sound waves, x-rays, magnetic fields, or radioactive materials. They include the following:
- Computed tomography (CT scan) accurately shows the pancreas to diagnose pancreatic cancer. CT scans can also assist in determining whether cancer has spread to lymph nodes or distant organs.
- Ultrasound uses sound waves to present images of the pancreas.
- Abdominal ultrasound is initially done if the pancreatic cancer diagnosis is unclear, though a CT scan is more useful.
- Endoscopic ultrasound (EUS) uses a small probe on the endoscope’s tip to visualize the GI tract and take a tumor sample.
- Magnetic resonance imaging (MRI) scans are an alternative to CT scans. People who may have pancreatic cancer or who are at high risk can also have specific MRI scans:
- MR cholangiopancreatography (MRCP) visualizes the pancreatic and bile ducts.
- MR angiography (MRA) visualizes blood vessels and blood flow.
- Positron emission tomography (PET) scans create images of radioactivity in the pancreas. It also visualizes the spread of exocrine pancreas cancer.
- Angiography shows abnormal blood vessels that have grown surrounding the pancreas or if blood flow is obstructed by a tumor.
6. Review the stage.
After diagnosis, doctors will identify the spread of the cancer using staging. Pancreatic cancers range in stages from 0 (carcinoma in situ) through stages I (1) to IV (4), along with TNM staging, which identifies the extent of the (T) tumor, spread to lymph (N) nodes, and (M) metastasis to other organs or bones.
Nursing Interventions
Nursing interventions and care are essential for the patients recovery. In the following section, you’ll learn more about possible nursing interventions for a patient with pancreatic cancer.
Manage Cancer and Symptoms
1. Assist with surgical interventions.
The primary type of treatment for pancreatic cancer is surgery. However, chemotherapy and radiation therapy play a significant role in patients with unresectable disease and as adjuvant or neoadjuvant treatment.
- Whipple procedure (pancreaticoduodenectomy) benefits most patients with tumors in the pancreas head or the junction between the small intestines and the pancreas. The distal pancreatic duct and biliary system are surgically drained during the procedure due to shared blood supply. It usually involves removing the pancreatic head, duodenum, gallbladder, and stomach’s antrum.
- Distal pancreatectomy is indicated for malignancies found in the body or tail of the pancreas. The spleen may be removed as well.
- Total pancreatectomy is the least performed surgical procedure. The entire pancreas, gallbladder, part of the stomach, small intestine, and spleen are removed.
2. Educate on the different cancer treatment modalities.
Treatment options for patients with pancreatic cancer depend on the type, stage, and other aspects of cancer:
- Neoadjuvant treatment (chemotherapy and/or radiation) prior to surgery is preferred for locally advanced unresectable pancreatic cancer.
- Adjuvant therapy includes treating patients with resected pancreatic cancer with FOLFIRINOX (FOL = Leucovorin Calcium (Folinic Acid); F = Fluorouracil; IRIN = Irinotecan Hydrochloride; OX = Oxaliplatin) chemotherapy regimen.
3. Control the tumor growth.
Radiation treatment can be coupled with chemotherapy (chemoradiation). Typically, chemotherapy treats cancer that has not metastasized (spread) to other organs from the pancreas. Chemotherapy may control tumor growth, ease symptoms, and extend survival in patients with advanced pancreatic cancer and metastasis.
4. Consider radiation therapy.
Traditional radiation therapy employs X-rays to treat cancer, but a more recent radiation treatment uses protons. Proton therapy can treat pancreatic cancer and have fewer adverse effects than conventional radiation therapy.
5. Offer clinical trials.
The patient may be offered to participate in clinical trials for new targeted therapies, chemotherapy, immunotherapy, or vaccinations. Clinical trials may include unknown adverse side effects and cannot promise a cure. Contrarily, cancer clinical trials are monitored closely to ensure they are carried out as safely as possible.
6. Provide palliative therapy as recommended.
Patients with pancreatic cancer who choose not to have their tumors removed should concentrate on managing their primary symptoms. The focus of palliative care in pancreatic cancer is managing pain and improving quality of life.
7. Relieve the pain.
It is essential to utilize narcotic analgesics promptly and in appropriate dosages. Tricyclic antidepressants or antiemetics can enhance the analgesic effects of narcotic analgesics. Narcotics may not be enough for some people, and other pain relief methods (such as neurolysis of the celiac ganglia or radiotherapy) must be considered.
Provide Adequate Nutrition
1. Monitor the weight regularly.
Patients with pancreatic carcinoma frequently exhibit weight loss due to anorexia (loss of appetite), as do most patients with advanced malignancy.
2. Determine the presence of malnutrition.
Assess if malnutrition is present and identify the possible cause, such as:
- Pancreatic cancer itself
- Secondary causes (such as cachexia- muscle wasting)
- Side effects of treatment modality
- Depression
- Comorbidities (such as diabetes mellitus)
3. Try an appetite stimulant.
The pharmacological management of cachexia includes administering medications that increase appetite and managing secondary symptoms that exacerbate cachexia. Cachexia cannot be consistently and successfully treated with a single medication in individuals with pancreatic cancer.
4. Administer pancreatic enzymes as prescribed.
Pancreatic enzyme supplements may help patients with diarrhea caused by malabsorption who are also losing weight. Encourage the patient to:
- Take the enzymes with meals and dairy products
- Swallow the capsule whole with a few sips of liquids
- Avoid hot drinks together with the capsule, as they will not work properly
- Prevent crushing or chewing the capsules
- Take more enzymes for high-fat or larger meals
5. Avoid alcohol and fats.
Patients with pancreatic cancer should refrain from drinking alcohol and eating fatty, fried meals since they are hard to digest and can cause diarrhea, gas, and bloating.
6. Relieve the symptoms.
A patient’s appetite can be influenced by pain, discomfort, nausea, and vomiting. Offer pain medication and antiemetics to alleviate symptoms while eating.
7. Promote enteral feeding.
Enteral nutrition increases energy while minimizing complications and hospital stays, making it preferred over parenteral nutrition.
8. Choose foods that are easy to digest.
The pancreas is essential in digesting food but may not work as well due to cancer or treatments. Instruct on easy-to-digest foods like soft or boiled foods and less meat, raw vegetables, and sugar.
9. Consult with a dietitian.
A dietician can create diet plans considering the unique needs of a patient with pancreatic cancer, such as irregular glucose levels, muscle wasting, and altered digestion.
Provide Emotional Support
1. Talk to the patient about their views regarding cancer.
Pancreatic cancer has a low survival rate. Allow the patient to express their feelings around their diagnosis, fears, and medical decisions.
2. Answer questions and provide information.
Understanding the benefits, drawbacks, and uncertainties associated with various cancer treatment options is essential for making well-informed decisions. The more information they have, the more confident they will be when making decisions about their care.
3. Include family members and loved ones in care planning.
Family and loved ones assist patients emotionally and may influence their decisions. Moreover, family members may support or interfere with a patient’s decision to forego additional cancer-specific treatment in favor of supportive care.
4. Propose support groups and mental health services.
Engaging with others undergoing cancer treatment or survivors enables patients to cope with the challenges of cancer. In addition to helping the patient understand their feelings and behaviors, counseling provides a safe environment to discuss concerns.
Nursing Care Plans
Once the nurse identifies nursing diagnoses for pancreatic cancer, nursing care plans help prioritize assessments and interventions for both short and long-term goals of care. In the following section, you will find nursing care plan examples for pancreatic cancer.
Acute Pain
Acute pain caused by pancreatic cancer is described as a dull pain in the upper abdomen that can radiate to the back. If the tumor has grown and advanced, the pain can become more frequent, last longer, and worsen after eating or lying down.
Nursing Diagnosis: Acute Pain
Related to:
- Disease process
- Effects of cancer treatment
- Effects of chemotherapy
- Nerve damage
- Inflammatory process
- Tumor growth
As evidenced by:
- Expressive behavior
- Positioning to ease pain
- Facial expressions of pain
- Protective behavior
- Guarding behavior
- Diaphoresis
- Reports pain intensity
- Distraction behavior
Expected outcomes:
- Patient will report a significant reduction in pain and discomfort.
- Patient will utilize pharmacologic measures prescribed to control pain.
Assessment:
1. Assess and evaluate the patient’s pain history.
The location, duration, intensity, and frequency of the pain can help determine causative factors of pain and guide appropriate interventions for pain relief in patients with pancreatic cancer.
2. Assess discomfort from side effects of cancer treatments.
Chemotherapy and radiation may damage nerves and tissue, aggravating the patient’s pain experience.
Interventions:
1. Administer pain medications as indicated.
Drug therapy, including long-acting oral morphine and fentanyl patches, is indicated for patients with pancreatic cancer to help reduce discomfort.
2. Evaluate the precipitating factors of breakthrough pain.
Increasing pain intensity and duration that requires a higher dosage of pain medication may indicate a developing complication or progression of cancer.
3. Encourage the use of nonpharmacologic pain relief interventions.
Massage, imagery, and diversional activities can help reduce anxiety, refocus attention, and relieve discomfort in patients with pancreatic cancer. Cognitive-behavioral therapy and other mental health services can teach coping strategies for managing pain sensations.
4. Assist with palliative care measures.
Palliative care is not curative and focuses on managing symptoms and pain for improved quality of life. This can be achieved through surgical procedures, nutritional support, chemotherapy, and more.
Death Anxiety
Patients with pancreatic cancer often report symptoms of anxiety, distress, and depression due to the poor prognosis of the condition. The anticipation of death and the process of dying can negatively affect the patient’s quality of life.
Nursing Diagnosis: Death Anxiety
Related to:
- Anticipation of death
- Disease process
- Poor prognosis
- Uncertainty of prognosis
- Anticipation of pain
- Anticipation of suffering
- Awareness of imminent death
- Unpleasant physical symptoms
As evidenced by:
- Expresses concern about the impact of death
- Expresses deep sadness
- Express fear of loneliness
- Expresses fear of pain related to dying
- Expresses fear of premature death
- Expresses fear of the dying process
- Expresses powerlessness
- Expresses fear of the unknown
- Expresses concern over role changes
Expected outcomes:
- Patient will verbalize acceptance of their prognosis and peace with dying.
- Patient will identify and verbalize interventions that can help control anxiety.
Assessment:
1. Assess the patient’s level of anxiety.
Understanding the patient’s anxiety level and the effects on their life can help plan an appropriate approach to providing interventions.
2. Assess for damaging behaviors and set limits on inappropriate behaviors.
Mood swings and aggression can indicate poor coping mechanisms in patients with anxiety.
3. Assess the patient’s knowledge about the current condition, its prognosis, complications, and treatment.
Assessing what the patient knows about pancreatic cancer, its prognosis, and treatment options can help the nurse dispel myths and provide accurate information.
Interventions:
1. Acknowledge the patient’s feelings and concerns.
Shock, anger, and despair are normal responses upon the initial diagnosis of pancreatic cancer. Reassure the patient that their feelings are normal and valid.
2. Educate and reinforce information about the condition, symptoms, and treatment.
Knowing what to expect allows for better self-control, reduced anxiety, and adherence to the treatment regimen.
3. Encourage the patient to plan activities.
Staying busy helps some patients not to focus on their anger or depression. Encourage hobbies like gardening, crafts, time in nature, or anything they are interested in.
4. Instill hope.
Some medical practitioners believe hope and a positive outlook can help heal the body. The nurse can support this belief by reminding the patient to live life like they always have, practice gratitude, and participate in activities that spark joy.
5. Refer the patient to community and support groups.
Peer and community groups can provide additional support for patients with pancreatic cancer.
Imbalanced Nutrition: Less Than Body Requirements
Pancreatic cancer and its treatments are associated with malnutrition, with significant effects on the patient’s overall well-being and quality of life.
Nursing Diagnosis: Imbalanced Nutrition
Related to:
- Disease process
- Hypermetabolism
- Insufficient pancreatic enzymes
- Side effects of cancer treatment
- Chemotherapy
- Radiation therapy
- Pancreatic resection
As evidenced by:
- Abdominal cramping
- Abdominal pain
- Loss of appetite
- Altered taste sensation
- Food intake less than recommended daily allowance (RDA)
- Hyperactive bowel sounds
- Diarrhea
- Steatorrhea
- Weight loss
Expected outcomes:
- Patient will exhibit a progressive weight gain toward the desired goal.
- Patient will verbalize the causes of malnutrition and strategies to improve deficiencies.
Assessment:
1. Assess the patient’s nutritional status.
Assessing the patient’s current nutritional status through daily intake and weight can help plan appropriate interventions.
2. Assess the pathology of malnutrition.
Surgical procedures can affect the function of the pancreas. Pancreatic cancer may cause insufficient secretion of enzymes for digestion, and the reduced secretion of insulin often results in patients becoming diagnosed with diabetes mellitus.
3. Assess for biomarkers of malnutrition.
The nurse can assess transferrin, albumin, total protein, and specific vitamins for deficiencies.
Interventions:
1. Administer pancreatic enzymes.
If the pancreas can no longer secrete enzymes necessary for digestion, supplemental enzymes can be provided to help break down fats, carbohydrates, and protein.
2. Refer the patient to a dietitian.
A dietitian is vital in planning nutritional interventions for patients with pancreatic cancer and those currently undergoing chemotherapy or radiation therapy.
3. Administer antiemetics and pain medications before meals.
Pain, discomfort, nausea, and vomiting can affect the patient’s appetite.
4. Encourage the patient to avoid alcohol and fried foods.
Alcoholic beverages and greasy, fried foods are to be avoided by patients with pancreatic cancer as these foods are difficult to digest and can result in diarrhea, gas, and bloating.
5. Administer enteral nutrition.
Enteral nutrition is recommended over parenteral nutrition and has been shown to reduce complications and hospital stays while increasing energy.
Impaired Comfort
Pancreatic cancer can cause severe pain, unpleasant GI symptoms, disruptions in sleep, and emotional distress.
Nursing Diagnosis: Impaired Comfort
Related to:
- Inadequate control of the health crisis
- Inadequate situational control
- Physical symptoms
- Disease process
- Inflammatory process
- Cancer treatment
As evidenced by:
- Anxiety
- Crying
- Expresses discomfort
- Abdominal pain
- Abdominal swelling
- Difficulty relaxing
- Irritable mood
- Expresses psychological stress
- Itching
- Restlessness
- Nausea and vomiting
Expected outcomes:
- Patient will verbalize improved comfort and experience reduced incidence of abdominal pain, nausea and vomiting, and fatigue.
- Patient will implement two strategies to improve their sense of comfort.
Assessment:
1. Assess factors contributing to the patient’s discomfort.
Patients with pancreatic cancer often experience various symptoms that can affect the patient’s comfort, including nausea and vomiting, abdominal pain, difficulty sleeping, irritable mood, and anxiety.
2. Continuously monitor the progression of the patient’s pain experience.
Pain in pancreatic cancer often occurs at night or is related to eating. It can become severe and unrelenting as cancer progresses and complications occur, like leakage of pancreatic fluids into the peritoneum affecting the nerve plexus and other gastrointestinal organs, causing infection and inflammation.
3. Assess the patient’s past interventions and coping strategies for improving comfort.
This will help identify interventions that have worked in improving comfort in the past. Over time, as cancer progresses, interventions may not be as effective and require manipulation.
Interventions:
1. Maintain a relaxing and calm environment.
Unnecessary environmental stimuli can aggravate the patient’s pain and discomfort. Ensuring a relaxing, quiet, and calm environment can help promote a sense of control and increase the patient’s comfort.
2. Encourage the patient to participate in mental and physical activities.
Participating in activities within the patient’s ability, like reading, arts and crafts, social interactions, games, walking, and hobbies, can divert the patient’s focus from the discomfort while reducing anxiety and depression.
3. Administer opioid analgesics as indicated.
Patients with pancreatic cancer are often prescribed high doses of opioid analgesics to help control severe pain associated with cancer.
4. Encourage the patient to utilize nonpharmacologic comfort measures.
Aside from the administration of opioids, other comfort measures like meditation, relaxation techniques, and massage are encouraged to alleviate discomfort.
5. Encourage the patient to express feelings, fears, and expectations.
Emotional and spiritual comfort is vital in alleviating fear and anxiety. Offer time for listening so the patient can express their thoughts.
Ineffective Tissue Perfusion
Pancreatic cancer is associated with mutations to the pancreatic cells and tissues, causing changes in blood supply and perfusion to the organ.
Nursing Diagnosis: Ineffective Tissue Perfusion
Related to:
- Disease process
- Esophageal varices
- Inflammatory process
- Obstruction
As evidenced by:
- Abdominal pain
- Jaundice
- Weight loss
- Internal bleeding
- Abdominal distension
- Palpable abdominal mass
Expected outcomes:
- Patient will not experience perfusion complications from pancreatic cancer like gastrointestinal bleeding, blood clotting, jaundice, or ascites.
- Patient will not demonstrate worsening in tumor grading (metastasis).
Assessment:
1. Conduct a comprehensive abdominal assessment.
Pancreatic cancer causes tissue perfusion symptoms of the gastrointestinal tract, like abdominal pain, ascites, and gastrointestinal bleeding. Abdominal distension and swelling may also be observed. Upon percussion, an ascitic abdomen will elicit dullness.
2. Assess and review laboratory data.
While no specific blood test can diagnose pancreatic cancer, patients often exhibit elevated serum amylase, lipase, bilirubin, and alkaline phosphatase levels as pancreatic tissue perfusion and function become affected by cancer.
3. Assess diagnostic studies and review results.
Diagnostic imaging studies like an abdominal ultrasound, contrast-enhanced CT scan, endoscopic ultrasonography, and CT perfusion scan can help visualize the tumor and abnormalities in blood flow.
Interventions:
1. Prepare the patient for surgical intervention.
Surgical interventions like complete resections, partial pancreatectomy, and laparoscopic surgery are considered the most effective treatment for pancreatic cancer. With surgery, pancreatic tumors are removed to help improve pancreatic function and perfusion.
2. Assist in providing neoadjuvant chemotherapy.
Many patients are already in the advanced stages of cancer at the time of diagnosis and may need neoadjuvant chemotherapy to reduce tumor size and promote adequate tissue perfusion awaiting surgical intervention.
3. Provide palliative care as indicated.
Palliative therapy may be indicated for patients with pancreatic cancer, depending on the severity and progression of the cancer. A palliative procedure involving the placement of a stent can help with pancreatic tissue perfusion, as its purpose is to bypass blocked ducts and other affected organ systems.
4. Administer prescribed IV fluid therapy as indicated.
Administration of IV fluids is vital to the management of pancreatic cancer as this can ensure adequate tissue perfusion throughout the body, considering the patient is at risk for bleeding, hypovolemia, and shock.
5. Monitor the patient for possible complications after surgery.
The development of bleeding, anastomotic leaks, and fistulas are serious postoperative complications that can occur following surgery, causing the leakage of pancreatic fluids or blood into the peritoneum.
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