Treatments

Pancreatic Cancer Treatments

Your care team will tailor your pancreatic cancer treatment plan to your unique needs. Pancreatic cancer treatment depends on your overall health, the extent of the disease and your tolerance for different therapies.

Treatment options will likely include a combination of the following.

Surgery

Your surgical oncologist (a surgeon who is specially trained in cancer care) can remove a tumor, part of the pancreas, or the entire pancreas and/or small intestine. This can often be done with a minimally invasive approach.

Surgical options include:

  • Whipple procedure (also called pancreaticoduodenectomy): This surgery is the most common for completely removing tumors from the pancreas. This procedure involves the removal of:

    • The head of the pancreas
    • Lymph nodes near the bile duct
    • Duodenum (part of the small intestine)
    • Part of the stomach
    • The body of the pancreas
    • The gallbladder and part of the common bile duct
    After this surgery, bile from your liver, food from your stomach and digestive juices from the remaining part of your pancreas all enter your small intestine, so you can have normal digestion.
  • Pylorus-preserving pancreaticoduodenectomy: This surgery is like the Whipple procedure except your surgeon does not remove the lower part of your stomach.
  • Total pancreatectomy: Less common than the Whipple procedure, the surgeon removes the following:
    • Entire pancreas
    • Distal common bile duct
    • Duodenum
    • Part of your stomach
    • Spleen
    • Gallbladder, if you still have one

After your surgeon removes your whole pancreas, you will not be able to make pancreatic juices or insulin. You will need to test your blood glucose levels, give yourself insulin injections, and take other steps to keep your blood glucose levels normal. You will also need to take pancreatic enzyme pills with food help digest them.

  • Distal pancreatectomy: Your surgeon will consider this surgery if your cancer is only in the tail of your pancreas. For this surgery, your surgeon removes only the tail of your pancreas, which is the thin part, and perhaps part of its body, which is the middle section. The surgeon also usually removes your spleen.
  • Palliative procedures: Your physician may also suggest surgery and other procedures to ease or prevent symptoms associated with pancreatic cancer. These procedures may help restore your bile flow, allow food to leave your stomach into your small intestine and/or ease pain. For example, surgery may relieve a blocked bile duct or blockage at the outlet of the stomach.

    Palliative surgery may include:
    • Surgery to redirect the flow of bile directly into your small intestine
    • Surgery to allow your stomach to empty into another portion of your small intestine
    • Injections to block or numb nerves near your pancreas
    • Placing a stent (a small tube) inside the bile duct or duodenum to help keep it open

Radiation Therapy

Your radiation oncologist (a physician who is specially trained in treating cancer with radiation) will discuss the best treatment options for you. Your treatment may involve different radiation therapies, including:

  • Intensity modulated radiation therapy (IMRT): IMRT is a high-precision radiotherapy that uses computer-controlled linear accelerators to deliver precise radiation doses to a malignant (harmful) tumor.
  • Gamma Knife® radiosurgery (stereotactic radiotherapy): Gamma Knife radiosurgery delivers a single high-dose radiation to a cancerous tumor.
  • Proton therapy: Proton therapy is one of the most precise forms of radiation therapy. It can be precisely controlled so most of the radiation ends up directly in the tumor, reducing the risk of damage to healthy tissues around the tumor. This causes fewer short- and long-term side effects. It has been effective in treating certain types of pancreatic cancer. Northwestern Medicine Proton Center was the first proton center in Illinois, and the ninth in the country.

Chemotherapy

During chemotherapy, medications are given either through your veins or by mouth to interfere with the cancer cells’ ability to reproduce. Your experienced medical oncologist (a physician specially trained to treat cancer with medication) will determine the best combination of chemotherapy medications for your stage of cancer.