Pancreatic Cancer Treatment
What is the Pancreas?
The pancreas is an important gland, which produces chemical substances that assist in the digestion of food and controls the body’s sugar level. It lies in the upper part of the abdominal cavity behind the stomach.
Cancer of the Pancreas
Cancer of the pancreas causes poor absorption of food, with resultant weight loss, loss of appetite and sometimes abdominal and back pain.
It can cause blockage of bile flow where the stools can become pale and the urine dark. Yellow jaundice and itching may develop. Diabetes may occasionally develop.
How the diagnosis is made?
The symptoms mentioned above, along with blood tests could indicate that there is a problem with the pancreas.
- Ultrasound scan - which will display a picture of the pancreas and bile duct and any abnormalities, may be seen.
- CT scan - this will provide detailed pictures of the pancreas and the surrounding structures/organs.
- ERCP (endoscopic retrograde cholangiopancreatography) - this is a special investigation using a flexible tube containing a camera. Under sedation the tube is passed down the gullet, into the stomach and through an opening leading to the pancreas and gallbladder. Using xrays the ducts (tubes) leaving the pancreas and gallbladder can be seen.
- Endoscopic ultrasound - in some cases it may be possible to use this technique which combines ultrasound and a camera on a flexible tube passed through the mouth to the stomach to provide close up images of the pancreas.
Available treatments
There are a number of treatments available and we will discuss with you the most suitable treatment for your individual case. The treatment chosen depends on a number of factors: where the cancer is, whether there is any spread, your age and general health.
- Surgery - it is sometimes possible to remove or bypass the tumour surgically. However this is a major procedure and is not suitable for everyone. To assist us in making this decision you may have further tests to assess blood vessels around the pancreas and your fitness for major surgery. A visceral angiography, a special x-ray of blood vessels in your abdomen, will be able to show if the tumour has involved blood vessels or not around pancreas. An echocardiography and lung function tests which assess the health of your heart and lungs.
- Endoscopic stenting - a flexible tube is passed through the mouth, down the gullet into the stomach and then through the opening that leads to the pancreas and gallbladder. A thin hollow tube called a stent can then be placed in the tube leaving the liver (bile duct) to relieve any blockages.
- Radiotherapy/chemotherapy - these are occasionally helpful in cancer of the pancreas and in a few patients may play a role in treatment.
Being told you have cancer is naturally a shock to you and your family. During this time you may experience a wide range of emotions and may find it difficult to remember all you are told. The written information provided here is a guide to what may happen. We will discuss your individual treatment plan with you. You may find that other people with cancer of the pancreas are having different treatments from you. This will often be because their illness takes a different form and requires different treatment.
About your Surgery
Surgery remains the best treatment option for pancreatic cancer.
There are basically two types of procedures commonly performed in our hepatopancreaticobiliary centre: PPPP (pylorus preserving proximal pancreoduodenectomy) and Whipple’s procedure. Both procedures are essentially similar involving the removal of part of the pancreas, the duodenum, and bile duct except that in Whipple’s operation part of stomach is also removed.
Organs removed during a Whipple
Most common anatomy after Whipple
Benefits of operation
- For cancer of the pancreas region this is the most effective treatment as it removes the cancer.
- The operation also relieves the symptoms associated with the cancer.