Pancreatic Cancer Treatments
Pancreatic cancer treatment depends on your overall health, extent of the disease and your tolerance for various therapies. Treatment options will likely including a combination of the following treatments.
Your surgical oncologist can remove a tumor, part of the pancreas, or the entire pancreas and/or small intestine. In many instances this can be done using 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 similar to the Whipple procedure, however, your surgeon does not remove the lower part of your stomach.
- Total pancreatectomy: Less common than the Whipple procedure, in the pancreatectomy, surgery will involve the removal of:
- Entire pancreas
- Distal common bile duct
- Part of your stomach
- Gallbladder, if you still have one
Once your surgeon removes your entire pancreas, you won’t 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 to aid in digestion.
- Distal pancreatectomy: Your surgeon will consider this surgery if your cancer is confined to 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, the middle section. The surgeon also usually removes your spleen.
- Palliative procedures: Your physician may suggest surgery and other procedures to ease or prevent symptoms associated with pancreatic cancer, but these surgeries are not intended to cure the disease. These procedures may help restore your bile flow, allow food to leave your stomach into your small intestine, or ease pain. For instance, surgery may relieve a blocked bile duct by bypassing it. Surgery may also relieve a blockage at the outlet of the stomach to the first part of the duodenum by bypassing it. This is called bowel-bypass surgery. It doesn’t cure the disease. 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
Your radiation oncologist will discuss the best treatment options for your diagnosis. Your treatment may involve various radiation therapies, including:
- Intensity modulated radiation therapy (IMRT): IMRT is a high-precision radiotherapy uses computer-controlled linear accelerators to deliver precise radiation doses to a malignant tumor.
- Gamma Knife® radiosurgery (stereotactic radiotherapy): Gamma Knife® radiosurgery is the delivery of a single high-dose radiation treatment or a few fractionated radiation treatments to a malignant tumor.
- Proton therapy: Proton therapy is one of the most precise forms of radiation therapy, proton treatment can be precisely controlled so most of the radiation ends up directly in the tumor, reducing the risk of damage to surrounding healthy tissues and causing fewer short- and long-term side effects. It has been effective in treating certain types of pancreatic cancer. Northwestern Medicine Proton Center* is the first and only health system in Illinois and the ninth in the country to offer proton therapy.
- Radioembolization: A specialized interventional radiologist may use intra-arterial yttrium-90 radioembolization, or Y-90, to deliver radiation directly to a liver tumor using radioactive isotopes. This method may be used if your colorectal cancer has spread to the liver.
- Chemoembolization: A specially trained interventional radiologist can perform chemoembolization, in which anticancer drugs are administered directly into a tumor through its feeding blood supply. This allows for a higher concentration of the drug to be in contact with the tumor for a longer period of time.
- Ablation therapies: Ablation is a type of treatment that destroy tumors without removing them. This technique may be used for patients when surgery is not a good option because of poor health or reduced liver function. Often, ablation can be done without surgery by inserting a needle or probe into the tumor through the skin.
During chemotherapy, drugs are administered, either intravenously or orally, to interfere with the cancer cell’s ability to reproduce. Your experienced medical oncologist will determine the best combination of medications for your stage of cancer.
Side effects from cancer treatment can impact your quality of life and your body’s ability to respond to treatment. Northwestern Medicine is home to a diverse team of palliative medicine specialists who work with your oncologist to help relieve your pain and manage your symptoms. The palliative medicine specialists offer:
- Treatment of pain and other physical symptoms of cancer, such as fatigue, nausea, trouble sleeping, poor appetite, breathing difficulties and weight loss
- Treatment of emotional symptoms, such as depression and anxiety
- Improvement of your body’s ability to tolerate cancer treatments
- Help to better understand tests, procedures and options
- Guidance for you and those who care for you to helpful outside resources
From your initial diagnosis throughout your care, help you remain stronger in your fight against cancer and feel better, every step of the way.