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Cancer care: Pancreatic cancer

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Pancreatic cancer treatments

Your treatment plan

Our patients work with their care team to identify the pancreatic cancer treatments best for them. Their treatment plan considers the tumor's location and size, if the cancer has spread, and the patient's general health.

It also considers the latest pancreatic cancer treatment options. The treatment of pancreatic cancer presents different risks and benefits for each person.

Latest treatment for pancreatic cancer

Your pancreatic cancer treatment plan may include these options:

Pancreatic surgery
Chemotherapy
Radiation therapy
Combination of chemotherapy and radiation therapy

Dealing with cancer treatment side effects

Cancer treatment can cause many side effects. Here's how to deal with some common side effects.


Source: American Cancer Society, All About Pancreatic Cancer; National Cancer Institute, Pancreatic Cancer Treatment (PDQ®); Virginia Piper Cancer Institute
Reviewed by: Timothy Sielaff, MD, PhD, FACS, medical director, Virginia Piper Cancer Institute; Jennifer Stanek, RN, BSN, manager, Virginia Piper Cancer Institute Clinic
First Published: 08/27/2009
Last Reviewed: 08/27/2009

Pancreatic cancer stages

When diagnosed with pancreatic cancer, you will be told at what stage the cancer is.

Pancreatic cancer stages outline how extensive or advanced your disease is. They can help you and your care team evaluate what pancreatic cancer treatments may help.

Our doctors use the TNM staging system to define pancreatic cancer stages.

T is for "tumor."

  • T1 means the size of the tumor in the pancreas is 2 centimeters or less.
  • T2 means the tumor is more than 2 centimeters across.
  • T3 means the cancer is growing into tissues around the pancreas, in the duodenum or the bile duct.
  • T4 means the cancer has grown into the stomach, spleen, large bowel or nearby large blood vessels.

N is for "lymph nodes."

  • N0 means no lymph nodes have cancer.
  • N1 means there are lymph nodes which contain cancer cells (cancer in the lymph nodes is a marker for a higher risk of distant spread).
  • pN1a means cancer is in a single nearby lymph node.
  • pN1b means cancer is in more than one lymph node.

M is for "metastatic spread."

  • M0 means the cancer has not spread into distant organs such as the liver or lungs.
  • M1 means the cancer has spread to other organs.

Pancreatic cancer prognosis: What are the chances of surviving cancer of the pancreas?

Between 2002 and 2006, the average age of Americans who:

  • were diagnosed with pancreatic cancer was 72.
  • died from pancreatic cancer was 73.

Survival statistics give a general idea of the outlook for pancreatic cancer. They do not decide your personal pancreatic cancer prognosis.

These numbers are based on Americans who had pancreatic cancer between 1999 and 2005. Ask your doctor or other care team member how they apply to your pancreatic cancer prognosis.

Overall, the five-year relative survival rate was 5.5 percent. This includes all patients – those who had surgery and those who were not candidates for surgery.

Five-year relative survival rates according to pancreatic cancer diagnosis are:

  • 22.2 percent for cancer that is in one area and has not spread
  • 8.7 percent for cancer that has gone to lymph nodes and nearby tissue
  • 1.8 percent for cancer that has spread throughout the body.
What does 'five-year relative survival rate' mean?

Source: National Cancer Institute, Pancreatic Cancer Treatment (PDQ®); Surveillance Epidemiology and End Results (SEER) database; Virginia Piper Cancer Institute
Reviewed by: Timothy Sielaff, MD, PhD, FACS, medical director, Virginia Piper Cancer Institute; Jennifer Stanek, RN, BSN, manager, Virginia Piper Cancer Institute Clinic
First Published: 08/27/2009
Last Reviewed: 08/27/2009

Whipple procedure for pancreatic cancer

A Whipple procedure is a surgical treatment for pancreatic cancer in the head of the pancreas.

  • The surgeon removes part of the pancreas (the head), the first part of the small intestine, the end of the bile duct, and the gallbladder.
  • The remaining pancreas, small intestine, bile duct and stomach are connected to the small intestine.

Before the Whipple procedure

Before the Whipple procedure for pancreatic cancer, you will have a laparoscopy.

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Laparoscopy

Laparoscopy describes a group of operations performed with the aid of a camera placed in the abdomen.

Learn more about laparoscopy in our health encyclopedia.

This procedure allows the surgeon to look inside your abdomen to see if the cancer has spread in a way that was not seen on a CT or endoscopic ultrasound (EUS).

If the Whipple procedure cannot be done, you will be able to go home after the laparoscopy.

During the Whipple procedure

The Whipple procedure for pancreatic cancer is complex because it involves removing and reconstructing portions of the pancreas, stomach, small intestine and bile duct.

  • The surgeon makes a rainbow-shaped incision (cut) under your rib cage, mainly on the right side.
  • The surgeon then removes the head of the pancreas, the first part of the small intestine (the duodenum), the end of the bile duct, and the gallbladder.
  • Sometimes, the end of the stomach needs to be removed. If this happens, the surgeon will remove one-third of your stomach.
  • For the final part of surgery, the surgeon connects the end of the small intestine to the pancreas, bile duct and stomach.

Risks of the Whipple procedure for pancreatic cancer

As with all surgeries, the Whipple procedure has risks. Your surgeon will talk with you about the specific risks, some of which are listed below.

  • Digestive fluids may leak after the pancreas and small intestine are connected. As a result, infection or inflammation could occur around the connection. To lower this risk the surgeon:
    • may place a small, temporary tube in the pancreatic duct to allow the fluids to enter the intestine from the connection.
    • may cover the connection with a special adhesive.
    • will also place a drain (clear plastic tube) out the right side of your abdomen. Fluid goes out the drain into a small suction bulb. The drain would likely be removed before you go home.
  • You may develop diabetes.
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    Diabetes

    Diabetes is a lifelong disease that cannot be cured, but it can be controlled.

    Diabetes overview.

    This means the level of glucose (sugar) in your blood is too high. This disease can be managed through lifestyle changes and medicine.
  • You may require a blood transfusion. It is uncommon but the surgery staff will be prepared. Risk of infection from a transfusion is low.
  • Infection may occur in your abdomen or in the incision. To lower this risk you:
    • will take a shower using a special soap before surgery.
    • will receive antibiotic medicine through your intravenous (IV) line right before surgery.
  • Your stomach may have problems sending digested food to the small intestine. This is called delayed gastric emptying. To lower this risk:
    • Eat five small meals a day for the first few weeks after surgery.
    • Follow the diet information you receive.
  • Other general risks of surgery include:

Source: Allina Health's Patient Education Department
Reviewed by: Timothy Sielaff, MD, PhD, FACS, medical director, Virginia Piper Cancer Institute; Jennifer Stanek, RN, BSN, manager, Virginia Piper Cancer Institute Clinic
First Published: 08/27/2009
Last Reviewed: 08/27/2009