Innovative Treatment Options Tailored to the Patient
When it comes to pancreatic cancer and other gastrointestinal conditions,
expert evaluation is vital to accurately diagnose pancreatic cancer and
then determine the best course of treatment for the individual patient.
At Hoag, our multidisciplinary team of experts work together to thoroughly
review and determine the best treatment option suited to each individual patient.
The team then carefully tailors a personalized treatment plan to effectively
achieve the best possible outcome for the patient. This emphasis on a
collaborative, comprehensive approach to patient-centered care is why
Hoag patient outcomes rank are among the nation’s best.
Once pancreatic cancer is diagnosed, important staging tests (such as diagnostic
laparoscopic examination) are performed to determine if the cancer has
spread, and if so, to what extent. The type of treatment recommended depends
upon the stage of the cancer and may include options such as:
Surgery
Treatment for pancreatic cancer depends on the type of tumor and where
in the pancreas the tumor is located.
Innovative surgical treatment is offered for patients with an adenocarcinoma
of the pancreas since this tumor is associated with a poor outcome if
not completely eradicated by surgery. However, in patients with less aggressive
cancers, surgical treatment, including minimally invasive approaches,
may be indicated in selected cases. Hoag’s philosophy is to always
emphasize organ preservation whenever possible.
When it comes to advanced surgical care, the Hoag surgical team performs
more complex pancreatic surgeries than any other surgical program in Southern
California including state-of-the-art procedures that may not available
at most centers. Being a high-volume pancreatic cancer surgical program
enables the gastrointestinal experts at Hoag to achieve a technical skill
level not all facilities can match.
Some of the advanced surgical options for treating tumors of the pancreas include:
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The Whipple Operation involves resection (removal) of the head of the pancreas, a portion of
the bile duct, the gallbladder and the duodenum. Occasionally, a portion
of the stomach may also be removed. The Whipple Operation is often used
to treat patients with adenocarcinoma of the pancreas, although it may
be recommended for some patients with benign disorders such as chronic
pancreatitis and benign tumors of the head of the pancreas.
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Central Pancreatectomy may be recommended for patients who have low-grade malignant or benign
tumors in the neck of the pancreas. Removal of tumors in this area often
requires removing a large portion of the pancreas. However, Hoag offers
a highly specialized surgical procedure that removes only the tumorous
portion of the neck of the pancreas, thereby preserving the head, body
and tail of the pancreas.
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Laparoscopic/Robotic-Assisted Pancreatectomy is a minimally invasive surgical procedure where the body and tail of
the pancreas is removed along with the spleen. This procedure is most
frequently performed in patients with adenocarcinoma of the pancreas.
However, Hoag routinely provides laparoscopic spleen-preserving pancreatectomy
for patients with cystic tumors and
neuroendocrine tumors.
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Duodenum Preserving Pancreatic Head Resection is offered primarily to patients with chronic pancreatitis, although the
procedure may also be offered to some patients with neuroendocrine tumors
who would otherwise require a Whipple Operation. In this procedure, the
head of the pancreas is removed while preserving the bile duct and duodenum
(the first part of the intestine). Hoag is one of the few centers in the
United States to offer this innovative surgical procedure.
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Enucleation of pancreatic islet cell tumors is surgical procedure that carefully removes islet cell tumors without
removing any pancreatic tissue. Pancreatic islet cell tumors (also called
neuroendocrine tumors) are small tumors found on the surface of the pancreas.
Hoag surgeons have developed a laparoscopic technique for enucleation
of pancreatic islet cell tumors, which provides a number of benefits to
patients including a faster recovery and return to daily activities.
Locally Advanced Pancreatic Cancer
Locally advanced pancreatic cancer describes pancreatic cancer that involves
other structures near the pancreas. The most frequently involved structure
is the portal vein.
At Hoag, our expert team of hepatobiliary surgeons is experienced in advanced
surgical techniques that allow the cancer to be removed with reconstruction
of the portal vein utilizing an innovative vein graft procedure. In addition
to the portal vein, other adjacent structures can also be removed, if
necessary, and reconstructed using similar advanced surgical techniques.
It’s important to note that often patients with pancreatic cancer
are told that their cancer is not resectable, or that they may not be
a candidate for surgery. At Hoag, our academic-level hepatobiliary surgeons
have extensive experience and training in complex pancreatic surgery,
and can often resect locally advanced tumors due to their expertise, which
is why it’s important to seek out a second opinion.
Non-Surgical Treatment
In addition to progressive surgical options, Hoag also provides the full
array of innovative non-surgical options for treating pancreatic cancer,
including:
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Radiation therapy may be recommended before or after cancer surgery, often in combination
with chemotherapy. Combination radiation therapy and chemotherapy may
also be utilized in cases where a cancer cannot be treated surgically.
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Chemotherapy uses drug therapy to help destroy cancer cells. Chemotherapy is often
combined with radiation therapy to treat cancer that has spread beyond
the pancreas to nearby organs, but not to distant regions of the body.
This combination chemotherapy-radiation therapy protocol may also be used
after surgery to reduce the risk that pancreatic cancer may recur. In
individuals with advanced pancreatic cancer, chemotherapy may be used
alone or it may be combined with targeted drug therapy.
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Targeted therapy uses drugs that attack specific abnormalities within cancer cells. For
example, the targeted drug erlotinib (Tarceva) blocks chemicals that signal
cancer cells to grow and divide. This drug is usually combined with chemotherapy
for use in people with advanced pancreatic cancer.
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Clinical Trials play a significant role in gastrointestinal cancer treatment. Hoag physicians
participate in a variety of clinical trials in order to bring advanced
care to Hoag pancreatic cancer patients.
The Most Advanced Treatment Options Are Available at Hoag
When it comes to seeking out the most advanced pancreatic cancer care,
there is no longer any need to travel long distances. Hoag Family Cancer
Institute offers the latest in state-of-the-art diagnosis and leading-edge
treatment options that may not be readily available at other centers,
including resection of advanced pancreatic cancers, as well as participation
in clinical trials that helps to bring advanced care to even more patients.
Perhaps the most distinguishing aspect of Hoag’s advanced treatment
of pancreatic conditions is that in each and every case, treatment is
always specifically tailored to the meet the unique needs of the individual patient.
Expert Care You Can Trust
Hoag Family Cancer Institute provides state-of-the-art, compassionate pancreatic
cancer care. Hoag’s committed to accurate diagnosis, combined with
progressive therapeutic options enables Hoag patients to achieve some
of the highest clinical outcomes in the nation.
To schedule a comprehensive diagnostic evaluation, or a second-opinion
consultation with a Hoag pancreatic cancer expert, call us at 949-764-5350.