What is the treatment for resectable pancreatic cancer?
If a pancreatic cancer is found at an early stage (stage I and stage II) and
is contained locally within or around the pancreas, surgery may be recommended.
Surgery is the only curative treatment for pancreatic cancer. The surgical
procedure most commonly performed to remove a pancreatic cancer is a
"Whipple"
procedure (pancreatoduodenectomy). It often comprises removal of a portion of
the stomach, the duodenum (the first part of the small intestine), pancreas,
bile ducts, lymph nodes, and gallbladder. It is important to be evaluated at a
hospital with lots of experience performing pancreatic cancer surgery because
the operation is a big one and evidence shows that experienced surgeons better
select people who can get through the surgery safely and also better judge who
will most likely benefit from the operation. In experienced hands, mortality
from the surgery itself is less than 4%.
After the Whipple surgery, patients typically spend about one week in the
hospital recovering from the operation. Complications from the surgery can
include blood loss (anemia), leakage from the reconnected intestines or ducts,
or slow return of bowel function. Recovery to presurgical health can often take
several months.
After patients recover from a Whipple procedure for pancreatic cancer,
treatment to reduce the risk of the cancer returning is a standard
recommendation. This treatment, referred to as "adjuvant therapy," has proven to
lower the risk of recurrent cancer. Typically six months of chemotherapy is
recommended, sometimes with radiation incorporated into the plan.
Unfortunately, only about 20 people out of 100 diagnosed with
pancreatic cancer are found to have a tumor amenable to surgical resection. The
rest have tumors that are too locally advanced to completely remove or have
metastatic spread at the time of diagnosis. Even among patients who are amenable
to surgery, only 20% live five years.