Treating Pancreatic Cancer
By Cleveland Clinic
Summary
## Key takeaways - **Surgery decision factors for pancreatic cancer**: Surgical treatment options for pancreatic cancer are determined by whether the cancer can be completely removed, its stage and spread, if it's a new or recurrent diagnosis, the cancer type, and the patient's overall health. [00:18] - **Curative vs. Palliative Pancreatic Surgery**: Pancreatic cancer surgeries fall into two categories: potentially curative, aiming for complete cancer removal, and palliative, focused on easing symptoms or preventing complications to improve quality of life. [00:45], [02:08] - **The complex Whipple procedure**: The Whipple procedure, a complex surgery for pancreatic cancer, can take five to eight hours and involves removing the head of the pancreas, the first part of the small intestine, and portions of the bile duct and gallbladder. [01:00] - **Total pancreatectomy risks**: A total pancreatectomy, which removes the entire pancreas, bile duct, gallbladder, spleen, and nearby lymph nodes, is often avoided because it leads to diabetes. [01:27], [01:49] - **Non-surgical options for blockages**: Blockages in the bile duct or intestine caused by tumors can sometimes be treated non-surgically by placing plastic, metal tubes, or stents to restore flow, avoiding the need for bypass surgeries. [02:48], [03:17]
Topics Covered
- Pancreatic cancer surgery: Curative vs. Palliative.
- The complex Whipple procedure explained.
- Total pancreatectomy: A drastic measure.
- Palliative surgery eases symptoms, not cure.
- Non-surgical options for bile and stomach blockages.
Full Transcript
- [Narrator] You or someone you love has been diagnosed
with pancreatic cancer.
And while you might be feeling overwhelmed,
lost, angry or discouraged, there is hope.
That hope might come in the form of surgery.
Surgical treatment options for pancreatic cancer
depend on a few things:
If your cancer can be 100% removed for cure,
the stage of your cancer
and its spread to other parts of the body,
if your diagnosis is new or the cancer has come back,
the type of pancreatic cancer, your overall health.
Surgical options for pancreatic cancer
tend to fall under two categories:
potentially curative or palliative.
Potentially curative surgery comes into play
when it's possible to remove all of the cancer.
These can be done with open, laparoscopic
or robotic surgery.
The Whipple procedure
is one potentially curative surgical option.
It's also a very complex one.
This surgery takes anywhere from five to eight hours
and involves the removal of the head of the pancreas,
the first portion of the small intestine
and parts of the bile duct and gallbladder.
The surgeon will then reconnect the remaining parts
so food can move through.
Another potentially curative surgical option
is a total pancreatectomy.
This is recommended if the cancer has spread
throughout the pancreas,
or if there are precancerous risk factors.
During this procedure,
a surgeon will remove the pancreas,
bile duct, gallbladder, spleen, and nearby lymph nodes,
along with parts of the stomach and small intestine.
However, total pancreatectomies are often avoided
because they will cause diabetes.
And lastly, a distal pancreatectomy
is a potentially curative procedure
where the body or tail of the pancreas
is removed with the spleen.
Palliative surgery is done to ease symptoms
or prevent complications
like blocked intestines or bile flow.
The purpose for this type of surgery
is not to remove cancer
but to help improve the quality of life.
A biliary bypass is done
if a cancer tumor is blocking the bile duct.
A surgeon will remove the gallbladder
and cut the bile duct near the blockage
and sew the cut part to the small intestine.
This allows digestive fluid
to flow around the area that is blocked.
When a tumor is blocking the bile duct,
a gastroenterologist or radiologist
can place plastic or metal tubes in the duct
to restore bile flow.
This can be done without surgery.
If food can't leave the stomach
because a tumor is blocking the intestine
just past the stomach, a surgeon can do a gastric bypass.
This involves sewing the stomach to the small intestine
so you can eat without any problems.
There's a non-surgical alternative to this as well.
A gastroenterologist can also place a metal stent
in the intestine to relieve the blockage
so you can eat.
Hearing about these options can be a lot,
but your healthcare provider will walk you through them
and recommend the best solution for you.
Don't be afraid to ask questions either.
Your needs and concerns are valid.
Have open and honest conversations
about them with your provider
so you can get the peace of mind that you deserve.
Loading video analysis...