Although there are various treatment options for pancreatic cancer, surgery is often considered the best approach for achieving long-term survival. However, pancreatic cancer is very complex, and surgery is only possible if the tumor's location and stage permit it. If your doctor has recommended surgery as part of your pancreatic cancer treatment plan, you may feel nervous about the procedure and want to know what to expect. Before treatment begins, here are some things you need to know about surgery for pancreatic cancer.
Determining Whether Pancreatic Cancer Surgery Is a Suitable Treatment Option
The location and stage of your pancreatic cancer play a significant role in determining whether you are a suitable candidate for surgery. Your surgeon will review test results and images to determine if the tumor is resectable, meaning it can be surgically removed.
Patients with resectable pancreatic cancer are usually diagnosed in the early stages of the disease when the tumor is still confined to the pancreas or the surrounding area.
If the tumor has spread to nearby blood vessels, it is considered "borderline resectable," which means that chemotherapy is needed to shrink it before surgery can be considered.
Other treatment options will be recommended for patients with unresectable tumors.
Surgical Options for Pancreatic Cancer
There are two main surgical approaches for pancreatic cancer:
- Potentially curative surgery: This approach is used when it's possible to resect all of the cancer, which is typically the case when pancreatic cancer is detected at an early stage. Removing the tumor completely provides the best chance for full recovery.
- Palliative surgery: This type of surgery is not intended to cure the cancer, as the tumor may be too large or advanced. Instead, it aims to relieve symptoms.
Potentially Curative Surgeries for Pancreatic Cancer
Potentially curative surgical options include:
- Whipple procedure (pancreatoduodenectomy): This surgery involves removing the head of the pancreas, the duodenum, a portion of the stomach, and other surrounding tissues. The remaining bile duct and pancreas are then attached to the small intestine, allowing bile and digestive enzymes to enter the digestive tract (gut). The ends of the small intestine (or the stomach and small intestine) are then reconnected to allow food to pass through normally.
- Distal pancreatectomy: This procedure removes the body and tail of the pancreas. The spleen may also be removed in a procedure known as a splenectomy.
- Total pancreatectomy: This operation removes the entire pancreas, gallbladder, common bile duct, part of the stomach, small intestine, and spleen.
Palliative Surgeries for Pancreatic Cancer
Palliative surgery options include:
- Biliary bypass: This procedure reroutes the gallbladder, or part of the bile duct, to bypass a blockage created by the pancreatic tumor, which helps when bile accumulates in the gallbladder.
- Endoscopic stent: A stent, a small metal or plastic tube, is inserted into the duct to keep it open. This is typically done through an endoscope (a long, flexible tube) while the patient is sedated.
- Gastric bypass: This operation involves attaching the stomach to the small intestine in a new way to allow for normal digestion, which can help when pancreatic tumors block the flow of food from the stomach.
Preparing For Pancreatic Cancer Surgery
What to Expect Before Surgery
Your gastrointestinal (GI) cancer specialist will need to make sure you are healthy enough for pancreatic cancer surgery. Their assessment of your health often includes several tests to ensure you are physically prepared to handle the operation. If surgery is possible, you'll receive instructions on how to prepare for the procedure.
This is also an ideal time to gather your post-surgery support system. A strong support team of friends and family can help make the recovery process much smoother.
What to Expect After Surgery
After surgery, you will be moved to a room to start recovering. This often includes getting up to move on the day or the day after surgery. How long you stay in the hospital depends on the type of surgery you had and your health before the surgery. On average, patients who have a Whipple procedure are in the hospital for five to seven days.
It's not uncommon to feel weak or tired after surgery. For some patients, this can last for several months. You may also experience constipation due to pain medicine use, dehydration, or inactivity. Discuss ways to manage these side effects with your doctor.
Once you're home, rely on your support system so you can focus on recovery. Allow your friends and family to help with tasks such as meal preparation, grocery shopping, and cleaning.
Possibility of Additional Treatments After Pancreatic Cancer Surgery
The primary goal of surgery for pancreatic cancer is to remove all cancerous cells in the pancreas. Depending on the stage and location of the tumor, your treatment plan may also include additional pancreatic cancer therapies, such as chemotherapy or radiation therapy, to eliminate any cancer cells that may have been left behind.
Unfortunately, pancreatic cancer is challenging to treat, and there is a significant risk of recurrence, which means the cancer may return after treatment. Typically, curative surgery isn’t an option for recurrent pancreatic cancer.
If you have advanced pancreatic cancer or if it has returned, your gastrointestinal (GI) specialist may suggest palliative treatments to help manage symptoms and improve your quality of life. You may also be eligible to participate in a clinical trial that offers access to new therapies.
Pancreatic Cancer Care and Treatment in Portland, Oregon, and Vancouver, Washington
If you were diagnosed with pancreatic cancer, the GI cancer specialists at Compass Oncology are here to support you. We carefully assess your diagnosis to create a personalized treatment plan tailored to your needs.
Our cancer experts are well-versed in the latest pancreatic cancer research and advances in pancreatic cancer treatment, ensuring that our patients receive the best possible support. We encourage patients who live in the Portland, Oregon, and Vancouver, Washington, areas to request an initial consultation or a second opinion at one of our cancer centers.
