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Pancreatic Cancer Treatments
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When detected at an early stage, pancreatic cancer has a higher chance of being successfully treated. However, treatments are also available that can help control the disease for patients with later-stage pancreatic cancer to help them live longer. UT Southwestern Medical Center offers treatments for patients with all stages of pancreatic cancer.
Systemic Therapies for Pancreatic Cancer
Chemotherapy is a type of cancer treatment that uses powerful drugs to kill cancer cells. It works by stopping the cancer cells from growing and dividing. For pancreatic cancer, they are mostly given intravenously through a catheter connected to your bigger veins called a port. Chemotherapy can be offered before and after surgery and if the cancer metastasizes. Your doctor will explain the process, potential side effects, and duration of treatment based on your stage.
Targeted therapies are treatments designed to specifically attack cancer cells, while causing less harm to normal cells. They work by focusing on certain characteristics of your cancer, such as genes or proteins that help the cancer grow. Your doctor will discuss with you whether targeted therapies are a good option for your type of pancreatic cancer, as not all patients maybe eligible for these treatments. These can be offered as a standard of care or in a clinical trial setting. Ongoing research is helping to try to have these treatments be offered to a larger set of patients.
Immunotherapy is a type of cancer treatment that helps your body's immune system fight cancer. It works by boosting the immune response or helping it recognize and attack cancer cells more effectively. This treatment can be different from traditional options like chemotherapy, as it focuses on using the body's natural defenses. While immunotherapy might be now approved for a 1-2% of pancreatic research patients, it has shown promising results for other certain types of cancer. Your doctor will discuss with you whether immunotherapy is a good choice for you. More research is needed to explore its tool in fighting pancreatic cancer whether as a single agent or in combination with other therapies.
Radiotherapy for Pancreatic Cancer
Radiation therapy is used in pancreatic cancer to achieve two main goals:
Definitive Radiotherapy:
- Aims to control the tumor and possibly achieve long-term remission
- Used in cases where the tumor cannot be removed surgically
- Often involves advanced techniques like IMRT (Intensity-Modulated Radiotherapy) or SABR (Stereotactic Ablative Radiotherapy) to target the tumor with high precision while protecting healthy tissue
Palliative Radiotherapy:
- Focuses on relieving symptoms and improving quality of life
- Helps with severe pain, bleeding, or blockages caused by the tumor
- Delivered in shorter treatment courses to minimize the impact on daily life
Types of Radiotherapy: Chemoradiation vs. SABR
Chemoradiation:
- Combines chemotherapy with radiation to improve tumor control
- Typically involves a longer treatment schedule with lower daily doses of radiation
- Used for borderline operable or locally advanced tumors to shrink the tumor or improve local control
SABR (Stereotactic Ablative Radiotherapy):
- Delivers high-dose, precise radiation in just one to five treatments
- Ideal for localized tumors or limited metastatic disease
- Has fewer side effects and allows for breaks in systemic chemotherapy
Radiotherapy is recommended either before or after surgery to improve tumor control and reduces recurrence risk, especially if the tumor is near major arteries.
Dawn embraces future after tumors removed
From eastern Louisiana, Dawn Averett was told she only had 3 months to live when she was diagnosed with pancreatic cancer in 2019, two decades after her battle with breast cancer. She was referred to UT Southwestern and drove 5 hours each way to receive treatment. “UT Southwestern means everything to me,” Dawn says. “I’m 5 years out, and I was given 3 months.”
Surgery for Pancreatic Cancer
Surgery is the only treatment with the potential to cure pancreatic adenocarcinoma, the most common type of pancreatic cancer. However, surgery is an option only when the cancer is still localized within the pancreas and resectable (removable). Because pancreatic cancer is rarely diagnosed at this stage, only about one in five people diagnosed with pancreatic cancer are candidates for surgery.
Pancreatic tumors that initially appeared to be resectable during diagnosis sometimes turn out to be too advanced to be removed completely during surgery. In these cases, the operation might be stopped entirely, or we might continue with a smaller operation with the goal of relieving or preventing symptoms.
Choosing the patients most likely to benefit from surgery for pancreatic cancer is critical. For patients with pancreatic cancer who have been identified as candidates for surgery, selecting the appropriate operation is also very important.
Inside the OR: Robotic Pancreatic Surgery
The Whipple procedure is one of the most technically challenging abdominal surgeries – and it is also a UT Southwestern specialty. In this video, Dr. Herbert Zeh, Chair of our Department of Surgery, and Dr. Patricio Polanco, a GI and robotic surgery expert, take you inside the operating room for a firsthand look at this complex surgery.
The Whipple Procedure
UT Southwestern surgeons have extensive experience in treating localized pancreatic cancer through the Whipple procedure, also known as pancreaticoduodenectomy.
The Whipple procedure is the most commonly performed surgery to remove tumors in the head of the pancreas.
During the procedure:
- The surgeons remove the head of the pancreas.
- Parts of the small intestine, bile duct, gallbladder, and lymph nodes near the pancreas are also removed. In some cases, part of the stomach may be removed.
- The remaining parts of the pancreas and bile duct are reconnected with the small intestine to allow for digestion.
Robot-Assisted Whipple Procedure
Until recently, the Whipple procedure always required a large incision. UT Southwestern now offers a robotic approach to the surgery, which can reduce pain and speed recovery compared to the traditional method. Our team is among the most experienced in the world in robotic procedures for complex gastrointestinal and hepato-pancreato-biliary (HPB) malignancies.
In robot-assisted Whipple procedure, our surgeons:
- Make several small incisions in the abdomen.
- Insert surgical instruments and a camera to allow them to clearly see inside the body.
- Use the robot to guide the surgical instruments to remove the parts of the pancreas, small intestine, gallbladder, and nearby lymph nodes.
- Reattach the remaining parts of the pancreas and bile duct to the small intestine to allow for digestion.
Additional Surgical Approaches
Our surgical oncologists are also experts in a number of other surgical procedures that can extend and improve the lives of people with pancreatic cancer.
When pancreatic cancer has been diagnosed as locally advanced or borderline resectable, it often cannot be completely removed because it has grown into or surrounded nearby major blood vessels. But that doesn’t mean no treatment is possible: UT Southwestern surgical oncologists are among the few in the region who can remove and reconstruct blood vessels affected by pancreatic cancer.
Palliative Care for Pancreatic Cancer
Palliative care is a specialized medical care approach that focuses on providing relief from the symptoms and stresses of a serious illness. It aims to improve the quality of life for patients and their families. Palliative care can be integrated at any stage of disease.
Key aspects:
- Symptom Management: Providing expert pain and symptom management, including the use of medications, non-pharmacological interventions, and advanced pain management techniques
- Psychosocial Support: Addressing the emotional, social, and spiritual needs of patients and their families, including grief counseling, bereavement support, and spiritual care
- Communication and Coordination: Facilitating communication and coordination among the patient, family, and the healthcare team
- Early Integration: Palliative care can be integrated with curative treatment from the time of diagnosis, providing concurrent support and addressing the patient's overall well-being