Our patients work with their care team to identify the pancreatic cancer treatments best for them. Their treatment plan considers the tumor's location and size, if the cancer has spread, and the patient's general health.
It also considers the latest pancreatic cancer treatment options. The treatment of pancreatic cancer presents different risks and benefits for each person.
Latest treatment for pancreatic cancer
Your pancreatic cancer treatment plan may include these options:
The Whipple procedure is the standard surgery to remove tumors of the head of the pancreas. This operation can now be done in some cases with the aid of the daVinci robot.
Distal pancreatectomy is the removal of the body and tail of the pancreas. This procedure can often be done minimally invasively (laparoscopically).
Studies suggest that pancreatic surgery is best at high-volume hospitals ( more than 16 cases per year). This is true for Virginia Piper Cancer Institute at Abbott Northwestern Hospital. If you have Whipple surgery here, you can expect an average hospital stay of eight days.
The latest radiation treatments for pancreatic cancer offer our patients more accuracy and shorter treatment times than standard radiation therapies.
Intensity-modulated radiation therapy (IMRT) sends hundreds of tiny, pencil-thin radiation beams into the tumor. The beams enter the body from many angles and intersect on the pancreatic cancer.
Stereotactic radiosurgery is a non-surgical treatment. It uses computer imaging to locate a tumor and see it in three dimensions. A single, concentrated dose of radiation then goes directly into the tumor.
A combination of chemotherapy and radiation therapy sometimes treats advanced cancer that is just in the pancreas. This approach can make pancreatic surgery possible. It also requires careful attention to nutrition, symptoms and treatment response.
Whether you are a pancreatic cancer survivor or are undergoing cancer treatment, you may face symptoms that interfere with daily life. Our cancer rehabilitation team can help you overcome:
Participating in a clinical trial may help you take a more active role in your health care. You may also gain access to new drugs, treatments and disease management practices.
Pancreatic cancer stages
When diagnosed with pancreatic cancer, you will be told at what stage the cancer is.
Pancreatic cancer stages outline how extensive or advanced your disease is. They can help you and your care team evaluate what pancreatic cancer treatments may help.
Our doctors use the TNM staging system to define pancreatic cancer stages.
T is for "tumor."
T1 means the size of the tumor in the pancreas is 2 centimeters or less.
T2 means the tumor is more than 2 centimeters across.
T3 means the cancer is growing into tissues around the pancreas, in the duodenum or the bile duct.
T4 means the cancer has grown into the stomach, spleen, large bowel or nearby large blood vessels.
N is for "lymph nodes."
N0 means no lymph nodes have cancer.
N1 means there are lymph nodes which contain cancer cells (cancer in the lymph nodes is a marker for a higher risk of distant spread).
pN1a means cancer is in a single nearby lymph node.
pN1b means cancer is in more than one lymph node.
M is for "metastatic spread."
M0 means the cancer has not spread into distant organs such as the liver or lungs.
M1 means the cancer has spread to other organs.
Pancreatic cancer prognosis: What are the chances of surviving cancer of the pancreas?
Between 2002 and 2006, the average age of Americans who:
were diagnosed with pancreatic cancer was 72.
died from pancreatic cancer was 73.
Survival statistics give a general idea of the outlook for pancreatic cancer. They do not decide your personal pancreatic cancer prognosis.
These numbers are based on Americans who had pancreatic cancer between 1999 and 2005. Ask your doctor or other care team member how they apply to your pancreatic cancer prognosis.
Overall, the five-year relative survival rate was 5.5 percent. This includes all patients – those who had surgery and those who were not candidates for surgery.
Five-year relative survival rates according to pancreatic cancer diagnosis are:
22.2 percent for cancer that is in one area and has not spread
8.7 percent for cancer that has gone to lymph nodes and nearby tissue
1.8 percent for cancer that has spread throughout the body.
A five-year survival rate takes into account the percentage of patients who live at least five years after being diagnosed with cancer. A five-year relative survival rate acknowledges that some patients may die from other causes besides cancer.
This procedure allows the surgeon to look inside your abdomen to see if the cancer has spread in a way that was not seen on a CT or endoscopic ultrasound (EUS).
If the Whipple procedure cannot be done, you will be able to go home after the laparoscopy.
During the Whipple procedure
The Whipple procedure for pancreatic cancer is complex because it involves removing and reconstructing portions of the pancreas, stomach, small intestine and bile duct.
The surgeon makes a rainbow-shaped incision (cut) under your rib cage, mainly on the right side.
The surgeon then removes the head of the pancreas, the first part of the small intestine (the duodenum), the end of the bile duct, and the gallbladder.
Sometimes, the end of the stomach needs to be removed. If this happens, the surgeon will remove one-third of your stomach.
For the final part of surgery, the surgeon connects the end of the small intestine to the pancreas, bile duct and stomach.
Risks of the Whipple procedure for pancreatic cancer
As with all surgeries, the Whipple procedure has risks. Your surgeon will talk with you about the specific risks, some of which are listed below.
Digestive fluids may leak after the pancreas and small intestine are connected. As a result, infection or inflammation could occur around the connection. To lower this risk the surgeon:
may place a small, temporary tube in the pancreatic duct to allow the fluids to enter the intestine from the connection.
may cover the connection with a special adhesive.
will also place a drain (clear plastic tube) out the right side of your abdomen. Fluid goes out the drain into a small suction bulb. The drain would likely be removed before you go home.
Source:Allina Patient Education Reviewed by: Timothy Sielaff, MD, PhD, FACS, medical director, Virginia Piper Cancer Institute; Jennifer Stanek, RN, BSN, manager, Virginia Piper Cancer Institute Clinic First Published: 08/27/2009 Last Reviewed: 08/27/2009
Whether you are a pancreatic cancer survivor or are undergoing cancer treatment, you may face symptoms that interfere with daily life. Our cancer rehabilitation team can help you overcome:
Participating in a clinical trial may help you take a more active role in your health care. You may also gain access to new drugs, treatments and disease management practices.
Pancreatic surgery
Chemotherapy