Pancreatic Cancer (cont.)

Surgery

The treatment of pancreatic cancer depends on whether complete surgical removal of the cancer is possible. Complete surgical removal of the cancer is the only known cure for pancreatic cancer. Only 15-20% of people with pancreatic cancer have disease that can be surgically removed at the time of diagnosis.

Cancer that is localized may be completely removed and thereby considered resectable. If all the cancer could not be removed with surgery or if a surgery would not be safe to perform, then the cancer is considered unresectable.

The features of unresectable pancreatic cancer include the following:

• The cancer has spread (metastasized) outside of the pancreas to other organs (for example, liver or lungs).
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• The cancer is wrapped around one of the major blood vessels near the pancreas.

If the cancer is resectable and if no other health issues exist that make the surgery unsafe, then a surgeon attempts to remove the cancer.

• Whipple procedure: This is done when the pancreatic cancer is in the head or uncinate process. This procedure removes the head and uncinate process of the pancreas, the duodenum, and the gallbladder. A portion of the stomach is often removed as well.
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• Distal subtotal pancreatectomy: This is performed when the pancreatic cancer is in the body or tail of the pancreas. This procedure removes the body and tail of the pancreas as well as the spleen.

Mortality rates are lower if the surgery is performed in a center where a lot of pancreatic surgeries are performed. Centers that have a low volume of pancreatic surgeries produce a 10%-15% mortality rate. Those centers with a high volume of pancreatic surgeries produce a 2% mortality rate.

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