Treatment Options

Pancreas cancer is often far advanced by the time symptoms occur and the diagnosis is established. As indicated by five-year survival rates of less than five percent, successful treatment is rare.

Pancreas cancer is difficult to manage, but much can be done to control symptoms and prolong life. A team of specialists, which may include surgeons, medical oncologists, radiation oncologists, and endocrinologists, treat patients with pancreas cancer. Many patients are treated with surgery (removing the cancerous tissue), radiation therapy (using high-energy rays to kill cancer cells), or chemotherapy (using drugs to rid cancer cells). Researchers are also testing several types of biological therapy (stimulating the body's immune system) to fight pancreas cancer, or to protect the body from treatment side effects.

Surgery

Surgery is the standard treatment and can be very effective; there's a low risk of complications, even for older patients. For patients whose cancer has not spread, surgery is typically the only hope for a cure. For patients whose cancer has spread outside the pancreas, surgery can relieve symptoms and prevent other problems. This type of surgery is known as palliative. Effective pain management is one of the major focuses of this treatment.

The most common type of surgery is the Whipple procedure, also known as a pancreatoduodenectomy, because Dr. Alan O. Whipple first described the procedure in 1935. In this procedure, the surgical team removes the head of the pancreas, as well as the gallbladder, part of the stomach, the lower half of the bile duct, and part of the small intestine. The surgery takes about six to eight hours in the operating room.

Other less commonly used procedures include: a total pancreatectomy (total removal of the pancreas, along with the gallbladder, part of the stomach, part of the small intestine, the bile duct, the spleen, and nearby lymph nodes); and a distal pancreatectomy (performed when the tumor is growing in the tail of the pancreas-the tail of the pancreas is removed, along with the spleen).

Radiation Therapy

Radiation therapy usually combined with chemotherapy, is often used to treat patients after surgery to prevent recurrence of pancreas cancer. Radiation therapy is also often used to treat patients whose pancreas cancer is too widespread to be removed surgically. The most common type of radiation therapy is called external beam radiation therapy. Patients may also receive a new treatment, called intraoperative radiation therapy. In this procedure, the surgeon removes the tumor, and the patient receives a high-dose of radiation therapy while still in the operating room.