When you come to Siteman for the treatment of pancreatic adenocarcinoma, you will be in capable, compassionate hands. Our WashU Medicine physicians are highly experienced at treating this disease and will develop a treatment plan personalized to you, your cancer, your lifestyle, and your goals. We offer the newest drugs, the most advanced technology, and approaches guided by our own, world-renowned scientific research.
At Siteman, we understand that you are more than just your cancer. We will provide you with resources to help you and your family cope through the treatment process and beyond. Nurse navigators will guide you and your loved ones as you receive care.
The first important step for every patient is to accurately determine if his or her pancreatic cancer can be safely and entirely removed by surgery.
Surgery is usually the foundation of your treatment plan. But, not always. Siteman offers cutting-edge nonsurgical approaches for pancreatic cancer, too. If surgery is not initially an option, we focus on the most effective drug therapies and advanced radiation to control your cancer. Sometimes, drug therapies and radiation will shrink a tumor so much that surgery becomes an option.
To learn more about treatments for pancreatic neuroendocrine tumors, or PNETS, click here.
Surgery for Pancreatic Cancer
The WashU Medicine surgeons at Siteman are among the most experienced in the country and work to ensure that surgery is possible and safe. They are skilled at performing minimally-invasive, robotic-assisted procedures that are less risky for patients and lead to faster recoveries.
Types of pancreatic cancer surgery
Patients who are eligible for surgery will likely have one of the following procedures:
- Removing the end (tail) of the pancreas: This procedure is called a “distal pancreatectomy.” It’s usually done when the tumors are only in the tail of the pancreas. This surgery removes the end of the pancreas. This portion is called the “tail.” Sometimes, the surgeon also removes part of the body of the pancreas and the spleen. Pancreatic surgeons at Siteman were the first in the world to develop a new method for this surgery. Because it is safer and more effective, cancer centers across the world have adopted our approach.
- Removing the head of the pancreas: This procedure is called a “Whipple procedure.” It’s done when the tumors are located in the head of the pancreas. In a Whipple procedure, your surgeon will take out the head of the pancreas as well as the gallbladder, the bile duct, and part of the small intestine. They do this to remove all cancer cells while leaving part of the pancreas.
- Removing the entire pancreas: This procedure is called a “total pancreatectomy.” In addition to removing the whole pancreas, your surgeon will also take out other organs, including the gallbladder, part of the stomach, part of the small intestine, and nearby lymph nodes.
The benefits of pancreatic surgery at Siteman
Pancreatic surgeries require surgeons who are experts in treating pancreatic cancer. As a top five high-volume pancreatic treatment center, Siteman has the expertise patients need.
WashU Medicine physicians at Siteman use robotic surgery whenever possible, so patients have the benefit of minimally-invasive procedures. This means, instead of making one large incision, your surgeons will make several smaller ones. They will use special tools and cameras to do the surgery inside your body.
There are many advantages to minimally-invasive pancreatic surgeries.
Short-term benefits include:
- During surgery: shorter surgery times, less anesthesia needed, less blood loss
- After surgery: fewer complications
- Recovery:
- Shorter time spent in the hospital
- A quicker return to eating
- Faster return to treatments like chemotherapy
- Less rehabilitation needed overall
In the long term, minimally invasive surgeries may lead to better patient outcomes. Chemotherapies for pancreatic cancer have become much more effective in recent years, and the sooner a patient recovers from surgery, the sooner he or she can begin or continue chemo. This means patients can access life-saving drugs faster.
Not every patient is a candidate for minimally-invasive surgery. Your doctor will carefully evaluate your tumor to decide whether a minimally-invasive procedure is right for you.
Siteman’s “Pre-habilitation” Program for Better Surgical Outcomes
Enhanced recovery after surgery (ERAS) program at Siteman Cancer Center
Recovering from any surgery takes time. But we have developed a way to get patients back to normal life, sooner. At Siteman, we have developed a special program for patients with pancreatic cancer. This research-based program helps our patients prepare for surgery and guides you into long-term recovery. We call it “pre-habilitation.”
During this program, you will meet regularly with expert nurses. They will teach you how to care for yourself before surgery and during recovery. They will also monitor your health and will be monitoring carefully for complications and setbacks.
Enhanced surgical recovery ensures that you:
- Are in the best possible condition before surgery.
- Have personalized care both during and after surgery.
- Experience the best possible outcome and rehabilitation after surgery.
Navigating pancreatic cancer surgery is a team effort, and you are just as much a part of the team as your surgeons and nurses. Patients who are active partners in their care have:
- An improved experience.
- An earlier return to normal activities.
- Reduced exposure to hospital infection.
- Fewer complications.
- Fewer readmissions to the hospital.
Drug Therapy for Pancreatic Cancer
Drug therapy, also called “systemic therapy,” is the use of medications to kill or block cancer cells. These medications are often given into a vein through an IV or taken as pills.
Overall, approximately 80% of pancreatic cancer treatment involves drug therapy.
These are the types of medications given for pancreatic cancer.
- Chemotherapy: Chemotherapy drugs shrink tumors, reduce the risk of the cancer coming back, and stop the tumor from growing or spreading.
- Immunotherapy: This is a newer form of drug therapy that helps your immune system recognize and attack cancer cells. It can cause fewer side effects than chemotherapy.
- Targeted therapy: Like immunotherapy, targeted therapy can have fewer side effects. These drugs target specific genetic or molecular parts of your cancer cells. They block what the cancer cells need to grow and spread. Instead of doing more harm, cancer cells are starved and die, and the tumor stops growing. Sometimes targeted therapy causes a tumor to shrink.
Drug therapy can be used before surgery to shrink a tumor, or it can be used after surgery to improve long-term outcomes.
Not all patients are eligible for surgery. Drug therapy can help treat these patients’ cancers like a chronic illness or prepare them to receive chemotherapy.
Patients with metastatic cancer (cancer that has spread to other places in the body) will primarily be treated with drug therapy because it can slow and limit cancer from spreading. This can add more quality years to life.
Radiation Therapy for Pancreatic Cancer
Radiation therapy uses beams of energy to kill cancer cells. It can be an excellent option for patients with pancreatic tumors that can’t be removed safely with surgery.
At Siteman Cancer Center, we offer a revolutionary radiation treatment called MR-Guided Daily Adaptive Stereotactic Body Radiation Therapy (SBRT) for pancreatic cancer. This means that we use magnetic resonance imaging (MRI) during radiation therapy to target the tumor precisely.
Siteman helped pioneer this technology, becoming the first center in the world to treat patients with the MRIdian system in January 2014, and the first to perform adaptive radiation therapy under MR-guidance.
This advanced, personalized radiation therapy is redefining what’s possible for patients with pancreatic cancer.
What does this mean for you?
- Unmatched precision: Using real-time MRI imaging, our team can see your tumor and surrounding organs during each treatment session. This is important because your body and your tumor move constantly, even as you lie still and breathe. Radiation is delivered directly to the tumor and tracks the tumor as it moves. The technology also allows us to adapt the radiation plan daily, ensuring the highest dose goes to the tumor while protecting healthy tissues, such as the colon, that are constantly moving around the tumor.
- Fewer treatments: This highly-focused approach often means fewer treatment sessions than conventional radiation. Patients often complete the treatment in just five sessions.
- Better outcomes: This procedure gives patients who can’t have surgery more options. Somtimes their tumors are controlled for years even without ongoing chemotherapy.
Clinical Trials at Siteman
WashU Medicine physicians at Siteman cancer are actively involved in clinical trials. These studies are aimed at improving outcomes for patients with operable, inoperable, and metastatic pancreatic cancers.
Clinical trials may test:
- New chemotherapy combinations
- New immunotherapy approaches
- Targeted medicines directed at specific tumor mutations
- Promising combinations of systemic therapy with surgery or radiation
The WashU Medicine physicians on your care team will likely be leading clinical trials, and they may suggest trials that could be a good match for you.