Surgical Treatment of Pancreatic Cancer

Can Pancreatic Cancer be treated surgically? How?

By the time a patient is diagnosed with pancreatic cancer, the disease is often already in an advanced stage. For this reason, a large majority of patients are not candidates for surgical treatment. We are making advances in understanding the early stages of this disease that, in time, will help us to detect more pancreatic cancers while they are still operable. Click here for more information about our early detection lab.

Surgery may be suggested as a potentially curative treatment or as a palliative measure to improve the patient's quality of life. Before reviewing the surgical procedures, it is important to emphasize that every patient has a unique case that should be discussed in detail with your healthcare providers. Click here to see overview illustrations of the anatomy and the Whipple procedure.

When is surgery possible?

Generally if the cancer is localized, surgical treatment, by resection or removal of the tumor, can be pursued. This means that the cancer has not spread to any blood vessels, distant lymph nodes or other organs, such as the liver or lung. These characteristics are determined through various complimentary diagnostic techniques. If the cancer has spread to nearby lymph nodes that are routinely removed during a given surgical procedure, surgery will usually still be possible. Also, recent developments have allowed for surgical replacement of the portal vein, a major blood vessel that carries blood to the liver.

What excludes surgery as a treatment option?

Generally, if the cancer is found in distant lymph nodes, other organs or blood vessels, surgical resection will not be pursued. If this is the case, the doctors and/or nurses will discuss possible medical treatments and/or palliative procedures. Surgery may still be considered to alleviate some symptoms and make the patient more comfortable (see bypass) but not as a curative measure.

What types of surgical procedures are performed to treat pancreatic cancer?

This depends where the tumor is located within the pancreas. The five parts of the pancreas are reviewed below. For a detailed explanation and illustrations of a particular surgical procedure, click on the name of the procedure.

Cancer in the Head, Neck or Uncinate Process of the Pancreas:
The Whipple Procedure

Cancer in the Body or Tail of the Pancreas:
Distal Pancreatectomy and Splenectomy

How can palliative surgery improve quality of life?

Double By-pass- A palliative surgical procedure to alleviate jaundice, nausea and vomiting for patients with advanced tumors in the head of the pancreas. The double bypass involves a bypass to the bile duct and a bypass to the stomach. Often a celiac nerve block is also performed.

Celiac Nerve Block- Can be done during a surgical procedure or as a separate non-surgical procedure. This improves tumor-associated pain and may reduce the need to use pain medications.