Pancreatic Cancer Treatments

Surgery

The first decision to be made is whether surgery can be performed or not, i.e. is your pancreatic cancer removable (resectable) or non-removable (unresectable).

Surgery for pancreatic cancer

If the tumour is small enough and the cancer has not spread, and if you are fit and healthy enough to tolerate it, surgery will be suggested to try to remove the tumour completely.

Chemotherapy and/or radiotherapy may be given before the surgery (known as neoadjuvant treatment) to try to shrink the tumour and increase the chance that the tumour can be completely removed with good margins of healthy tissue.

There are different types of possible surgery for pancreatic cancer, as follows:

Whipple procedure (pancreatoduodenectomy)

[Illustrations of surgical procedures to be inserted]

This is the most common operation used to treat pancreatic cancer.20 This procedure is recommended if the tumour is in the head of the pancreas.21
It involves removal of the head of the pancreas, the duodenum, a part of your small intestine, your gall bladder and part of your bile duct, and sometimes part of the stomach.

In the reconstruction phase of the operation, the intestine, bile duct and remaining portion of the pancreas are reconnected.22 This should prevent the onset of diabetes in most patients.

The surgery takes about six hours to complete.24

Distal pancreatectomy

This operation is used if the tumour is in the tail of the pancreas. It involves removing the tail and body of your pancreas. In addition, your spleen, part of your stomach, bowel, left adrenal gland, left kidney and left diaphragm may also be removed.20

Total pancreatectomy

This operation involves the removal of the entire pancreas, as well as the bile duct, spleen, gall bladder, part of the small intestine and possibly part of the stomach. The surgery takes about 8 hours to complete.24

After a pancreatectomy, you will need to take enzymes to help your digestive system digest food. You will also have insulin-treated diabetes for the rest of your life because you will lack insulin and other sugar-regulating hormones.20

Stents

In order to relieve the symptoms of jaundice, the doctor may suggest putting a small flexible plastic or metal tube, known as a stent, into the bile duct. The stent allows the bile to flow into the bowel again. Having a stent put in is generally a simple procedure.

It is often done using endoscopy (passing it through the mouth and throat into the stomach).

After surgery

Following surgery, no other treatment may be required. However, to reduce the chances of any cancer cells remaining in the area, after surgery the patient may undergo chemotherapy, known as “adjuvant chemotherapy“.

20. NHS. Cancer of the pancreas — treatment options. Available online: https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/pancreatic-cancer#treating-pancreatic-cancer
21. Patient.co.uk. Pancreatic cancer. Available online: http://www.patient.co.uk/health/Cancer-of-the-Pancreas.htm
22. Mayo Clinic. Whipple procedure. Available online: http://www.mayoclinic.org/tests-procedures/whipple-procedure/basics/definition/prc-20021393
23. John Hopkins Medicine. The Whipple procedure and other pancreas surgeries.
Available online: http://www.hopkinsmedicine.org/kimmel_cancer_center/centers/pancreatic_cancer/treatments/whipple_procedure.html
24. UCLA Center for Pancreatic Diseases. FAQs — new patients. Available online: http://pancreas.ucla.edu/body.cfm?id=64

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