Pancreatic Cancer Treatments
Our fellowship-trained physicians are specialists in treating pancreatic cancer, using a combination of surgery, chemotherapy and radiation therapy. We will build a customized treatment plan for you, using a multidisciplinary approach that combines the latest options available. Our team includes gastroenterologists, endocrinologists, internationally recognized interventional endoscopy physicians, pancreatic surgeons, medical oncologists, radiation oncologists, pathologists, radiologists, physicians specializing in genetic and palliative medicine, and nutrition specialists.
Curative treatment of pancreatic cancer typically involves a combination of chemotherapy and surgery, sometimes with radiation therapy. In general, treatment options are decided based on clinical and radiological characteristics, broken down into four groups, based on patient clinical condition and the anatomic relationships of the tumor with the surrounding vasculature. Molecular profiling of pancreatic cancer with genetic analysis is increasingly being used at our center to formulate treatment decisions.
Resectable: If the cancer has not spread beyond the pancreas, and the entire tumor can be removed, surgery, often combined with chemotherapy, is the preferred treatment. This group typically includes cancers that are stage I or II. With this diagnosis, your doctor may recommend upfront surgery. Chemotherapy and radiation may also be used.
Borderline resectable: When the cancer has reached nearby blood vessels, surgery may still be possible. You would first be treated with chemotherapy and often radiation therapy followed by surgery. Cancers are typically stage II or III.
Locally advanced (Unresectable): These cancers are still primarily confined to the pancreas and nearby organs, but also have spread to surrounding major blood vessels. Chemotherapy is likely to be followed by radiation therapy. Depending on tumor response, surgical removal may be an option. This group typically includes stage III cancers.
Metastatic: When the cancer has spread to distant organs, treatment is through chemotherapy, if it can be done safely. Radiation therapy may be used to improve symptoms.
Among the specific treatment options:
Also known as the Whipple procedure, this is the most common surgery for pancreatic tumors. Your surgeon will remove parts of the pancreas, intestines, lymph nodes and gall bladder with reattachment of the pancreatic and biliary ducts.
This palliative endoscopic treatment may be offered if tumor removal is not possible immediately, either because chemotherapy is initially being offered or when tumors are at more advanced stages. Metal or plastic tubes (stents) are used to keep the bile duct open. Your surgeon typically inserts the stent using an endoscope – a thin flexible tube inserted through the mouth.
Your surgeon reroutes food or bile directly to the intestines, bypassing the pancreas, whenever tumor removal with surgery is not feasible. This can provide longer-lasting relief than stents.
Drugs are used to kill cancer cells, slow their growth or relieve symptoms. It may be given before or after surgery. Sometimes it is used in combination with radiation.
Higher-than-normal doses of radiation are used to target the tumor from different angles. This precision treatment is guided by advanced imaging and computerized analysis.
This high-dose therapy uses 3D imaging for precision targeting of the tumor, with minimal damage to nearby healthy tissue.
This more traditional method uses 3D imaging to map out and target the tumor.
The procedure uses proton beams, instead of X-rays. These positively charged particles, at high energy, can destroy cancer cells without causing excessive damage to healthy tissue.
Specific molecular agents, antibodies or drugs are used when certain genetic alterations are detected in pancreatic cancer sub-types.
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