Pancreatic Cancer Treatments

Surgery for Pancreatic Cancer

Surgery for Pancreatic Cancer is provided at CentraState by a team of highly experienced surgeons led by fellowship trained Hepatobiliary surgeon Alexander Itskovich, MD.

If possible, your doctor may recommend surgery for your cancer. However, only about 20 percent of pancreatic cancer patients are surgical candidates. This is because pancreatic cancer has few symptoms and are often diagnosed after the cancer has spread beyond the pancreas. If you are a surgical candidate for cancer, your options may include:

• Whipple surgery: Whipple surgery, or pancreaticoduodenectomy, is the most common type of pancreatic cancer surgery. The procedure involves removal of the pancreas head and then the duodenum, the first portion of the small bowel. Sometimes the body of the pancreas and nearby lymph nodes may be removed, as well. A portion of the pancreas is left to continue to produce digestive juices and insulin.
• Total pancreatectomy: This procedure removes the entire pancreas, part of the stomach and small intestine, the common bile duct, the gallbladder, the spleen, and close by lymph nodes. While this surgery is less common due to the side effects of removing the whole pancreas, it may be a choice if the cancer spread throughout the pancreas and can still be removed.
• Distal pancreatectomy: This surgery removes the body and tail of the pancreas. The surgeon may also remove the spleen if the cancer has spread to the spleen.

Your surgeon may also recommend treatment before surgery for pancreatic cancer to shrink the size of the tumor. This is known as neoadjuvant therapy and generally involves chemotherapy, radiation therapy or both.

Radiation Therapy for Pancreatic Cancer

Radiation therapy is administered at CentraState’s Karen Olbis Radiation Oncology Center. Our Radiation Oncology Center has earned full accreditation by the American College of Radiology for expertise in Radiation Therapy.

The center is fully equipped with state of the art equipment, plus highly trained and experienced physicians, physicists, dosimetrists, therapists and oncology certified nurses. Therapeutic radiation approaches for pancreatic cancer include:

• External beam radiotherapy (EBR): Uses a machine called a linear accelerator to deliver high doses of radiation to the cancer site while limiting exposure to healthy tissues and organs and minimizing side effects. This includes: 3-D conformal radiotherapy, Intensity-modulated radiation therapy (IMRT), Image-guided radiation therapy (IGRT).

Chemotherapy for Pancreatic Cancer

Chemotherapy is provided at the Jean Mehr Infusion Therapy Center and administered by Magnet-designated nurses credentialed in chemotherapy and certified in cancer care. Infusion therapy uses medicines that kill or halt the growth of cancer cells. This approach is generally used in three ways:

• Adjuvant chemo: Chemo used after surgery is known as adjuvant chemo. It is given after all visible cancer has been removed to lower the chance that it will come back, sometimes used along with radiation. It works by killing the small number of cancer cells that may have been left behind at surgery because they were too small to see. Adjuvant chemo is also aimed at killing cancer cells that might have escaped from the main tumor and settled in other parts of the body (but are too small to see on imaging tests).
• Neoadjuvant chemo: For some cancers, chemo is given (sometimes with radiation) before surgery to try to shrink the cancer and make surgery easier. This is known as neoadjuvant treatment and is often used in treating pancreatic cancer.
• Chemotherapy for advanced cancers: The goal of chemotherapy for pancreatic cancer is not necessarily to cure the cancer but to relieve symptoms, slow the cancer’s growth and help you live longer.

Clinical Trials for Pancreatic Cancer

Some patients may be eligible to participate in clinical trials for pancreatic cancer in which they receive an emerging pancreatic cancer treatment before it becomes publicly available. Talk to your oncologist or surgeon to learn more. You may also want to speak with CentraState’s cancer navigator (732-294-4994).