Pancreatic Cancer
The pancreas is an organ that is located behind the stomach. Pancreatic
cancer is aggressive with few symptoms until the cancer is advanced. Symptoms
may include abdominal pain, weight loss, diarrhea, and jaundice. Treatments
include surgery, chemotherapy, and radiation.
Screening
In order to accurately diagnose pancreatic cancer, a physician will perform
a thorough physical exam and ask about symptoms and medical history. Tests
may also be ordered to check the blood and urine, as well as to determine
if there is any hidden blood in the stool.
Imaging tests such as the following may be used evaluate the pancreas and
nearby structures:
- CT scan
- MRI scan
- Endoscopic retrograde cholangiopancreatography (ERCP)
- Percutaneous transhepatic cholangiography (PTC)
Your physician may also order a biopsy, which is the removal of a sample
of pancreatic tissue in order to test for cancer cells.
These exams and tests will help determine the stage of cancer you have.
Staging is then used to guide your individualized treatment plan. Like
other cancers, pancreatic cancer is staged from I-IV, with stage I indicating
a localized cancer, and stage IV indicating spread to other areas of the body.
Treatments
The
pancreatic cancer treatment plan often requires a combination of methods depending on the stage of
the cancer. Surgeons use several different techniques to remove
pancreatic tumors.
Distal pancreatectomy
This procedure removes the body and tail of the pancreas, while leaving
the head of the pancreas left to maintain normal function. The procedure
often involves removing the spleen as well, depending on the exact tumor
location. Our surgeons routinely perform this procedure laparoscopically,
which results in a shorter hospital stay, less post-operative pain, and
minimal scarring than traditional, open surgery.
Whipple procedure or pancreaticoduodenectomy
In this procedure, the surgeon removes the head of the pancreas and the
other attached organs, including part of the stomach, the gallbladder,
and the common bile duct. The procedure leaves the body and tail of the
pancreas, which is enough to maintain production of insulin and digestive
enzymes. Our surgeons also favor leaving the entire stomach (pylorus-preserving
pancreaticoduodenectomy) when this does not compromise tumor removal.
Radiation therapy for pancreatic cancer
Depending on the clinical scenario,
radiation therapy may also be added to your regimen. This is the use of radiation to destroy
cancer cells and reduce the size of tumors.
Chemotherapy
Chemotherapy is the use of drugs to kill cancer cells, and it may be administered
in many forms including a pill, IV infusion through a vein or via a port.
These drugs enter the bloodstream and also affect healthy cells. Chemotherapy
may be used to shrink a tumor prior to surgery, to treat a cancer that
has spread, or to lower the chance of recurrence after surgery.
Several reports have shown that outcomes for pancreatic cancer are best
when patients are cared for at high-volume centers. Our highly skilled
pancreatic cancer surgeons have significant experience treating this type
of cancer at all stages. Every patient with a diagnosis of pancreatic
cancer is presented at our interdepartmental tumor board to incorporate
treatment recommendations from our colleagues in Medical Oncology, Radiation
Oncology, and advanced Gastroenterology. The care we provide is further
enhanced by our robust research activities, which offer patients access
to emerging treatments through clinical trials available nationally.