Pancreatic cancer

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Treatments for resectable pancreatic cancer

The following are treatment options for resectable pancreatic cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Surgery

Surgery is the main treatment for resectable pancreatic cancer. The type of surgery done depends on the size and location of the tumour.

The Whipple procedure (also called pancreaticoduodenectomy) is used to remove tumours in the head of the pancreas or in the opening of the pancreatic duct. It removes the head of the pancreas along with the duodenum (the first part of the small intestine), the gallbladder, part of the common bile duct, the pylorus (bottom part of the stomach that attaches to the duodenum) and lymph nodes near the head of the pancreas.

The modified Whipple procedure (also called pylorus-preserving pancreaticoduodenectomy) may also be used to remove tumours in the head of the pancreas that are not large, or bulky, and haven’t grown into the duodenum or spread to the lymph nodes around the pylorus. It is a modification of the Whipple procedure that doesn’t remove the pylorus. Because the modified Whipple procedure doesn’t affect normal stomach function, it avoids nutrition problems that can happen after the Whipple procedure.

Distal pancreatectomy is used to remove tumours in the body or tail of the pancreas. It removes the tail of the pancreas, or the tail and part of the body of the pancreas, and nearby lymph nodes. The spleen is only removed if the tumour has grown into the spleen or the blood vessels supplying the spleen. Distal pancreatectomyis not commonly used because cancer that starts in the body or tail of the pancreas has often spread by the time it is diagnosed.

Total pancreatectomy may be used only if necessary to completely remove the tumour. It is very difficult to recover from this surgery, so it is not used as often as the Whipple procedure or the modified Whipple procedure. Total pancreatectomy removes all of the pancreas along with the duodenum, the pylorus, part of the common bile duct, the gall bladder, sometimes the spleen and nearby lymph nodes.

Chemotherapy

You may be offered chemotherapy after surgery for resectable pancreatic cancer. It usually starts within 3 months of surgery. The purpose of this chemotherapy is to prevent the cancer from coming back.

Chemotherapy drugs used to treat resectable pancreatic cancer include:

  • gemcitabine (Gemzar)
  • 5-fluorouracil (Adrucil, 5-FU) and folinic acid (leucovorin)
  • capecitabine (Xeloda)

Radiation therapy

You may be offered radiation therapy after surgery if there are cancer cells in the margin of tissue removed along with the tumour (called positive surgical margins).

Radiation therapy may be given alone or as part of chemoradiation after surgery.

Clinical trials

Some clinical trials in Canada are open to people with pancreatic cancer. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.

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