Pancreatic Cancer: Types of Treatment

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 pancreatic cancer 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:

Pancreatic Cancer Surgery

Pancreatic cancer treatment options 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:

• 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.
• 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.
• 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.
• 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.
• 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 Options

In addition to progressive surgical options, Hoag also provides the full array of innovative non-surgical options for treating pancreatic cancer, including:

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.

• 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.
• 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.​
• 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 Pancreatic Cancer 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.