If you or someone you know recently received a pancreatic cancer diagnosis, knowing what to expect from treatment can help you cope. Learn about the risk factors, when pancreatic cancer surgery is an option and how doctors can treat and prevent symptoms. The more you know, the more you can do to lower your risks.
The Basics of Pancreatic Cancer Surgery
Determining who is eligible for pancreatic surgery depends on several factors. For example, the cancer stage and tumor location impact whether surgery is a viable option. Patients with metastatic disease may not benefit from tumor removal.
What Types of Pancreatic Surgeries Are There?
Several pancreatectomies exist. There are two broad categories of pancreatic surgeries when a case involves cancer:
- Palliative surgery is not a curative option. When cancer progresses, surgical removal may not be an option. However, palliative surgery could help relieve symptoms or remedy complications, such as common blockages.
- Attempted curative/resectable surgery is an option when testing shows complete cancer removal is possible.
Partial removal of pancreatic cancer is not curative. When resectable surgery results in the discovery of unknown growth, complete removal may be impossible, causing the surgeon to stop the procedure or continue with the goal of preventing or relieving symptoms.
Options for Minimally Invasive Surgery
Some treatments for pancreatic cancer are less invasive, shortening recovery time and reducing some risks. For many patients, laparoscopic surgery is an option.
Laparoscopic Surgery
Laparoscopy, or keyhole surgery, is an operation where the surgeon uses a small tube with a camera and light to enter the abdomen through a thin cut. They can follow the tube’s path using ultrasound technology and examine the area around the pancreas. This is a common technique for biopsies, and patients may be able to go home as soon as the same day.
Potentially Curative Surgery
At present, the only cure for pancreatic cancer is surgery. Whipple procedure, distal pancreatectomy and total pancreatectomy are the three types of pancreatic cancer surgery.
Whipple Procedure
When cancer removal is possible, the most common operation is the Whipple procedure, during which the surgeon removes the head and potentially other parts of the pancreas. Depending on where the cancer spread, they may remove part of the stomach, bile duct, gallbladder and nearby lymph nodes. The surgeon then attaches the remaining stomach pieces, small intestine or both.
Distal Pancreatectomy
During a distal pancreatectomy, the surgeon removes the pancreas tail and a section of the body. Often, they remove the spleen as well. Unfortunately, many patients with cancer in these areas are not eligible for surgery because the spread is too far before detection.
Total Pancreatectomy
During a total pancreatectomy, surgeons remove the entire pancreas, gallbladder and spleen. They also take a portion of the stomach and small intestine. This can be an effective way to remove cancer, but the risks are high. Additionally, life without a pancreas can create other serious health issues.
Palliative Surgery
Patients may benefit from palliative surgery when curative pancreatic cancer surgery is not an option. This can remedy blockage that may cause pain and digestive issues. The most common types of palliative surgery include stent placement and bypass surgery.
Stent placement
Stent placement is minimally invasive. Doctors use an endoscope that passes through the throat and into the small intestine to place a stent into the bile duct, removing the blockage. They may also insert a stent through the skin using a procedure called percutaneous transhepatic cholangiography.
The bile duct will remain open with a stent, even as cancer places more pressure on it. However, patients may need additional surgery to clear clogs or replace the stent. Sometimes doctors place a stent before curative surgery to help with jaundice.
Bypass surgery
Bypass surgery reroutes bile flow from the pancreas directly into the small intestine. Some advantages of bypass surgery include the following:
- It works when a stent is not possible.
- It offers relief that lasts longer than a stent.
- During the operation, doctors may be able to relieve pain produced in nerves around the pancreas.
Laparoscopic pancreatic cancer surgery is ideal because having to make a large incision otherwise requires extensive recovery.
Risks To Consider
Curative pancreatic and bypass procedures are major surgeries. Advancements in robotic technology can make it less invasive than open surgery. Still, patients can experience complications even under ideal circumstances:
- Issues with food digestion and stomach emptying
- Bleeding and infections
- Changes in bowel movements
- Leaking in areas where the surgeon connected organs
Patients who undergo a total pancreatectomy are at high risk for diabetes. This is because the pancreas contains cells that produce insulin and other hormones needed to regulate blood sugar. As a result, they often depend entirely on insulin shots and enzyme pills to digest food properly.
What To Expect During the Procedure
Pancreatic surgery for cancer can take four to 12 hours, depending on the stage and location of the tumor as well as any potential complications that may arise. Without insurance, pancreatic cancer treatment averages $50,000-$200,000, depending on the type of surgery. However, it can be more or less based on various factors, including where you receive treatment and the technology used for the procedure.
What To Expect After the Procedure
Depending on the type of pancreatic cancer surgery you need, recovery can take up to a month. Survival rates vary as well. For example, only about 20% of pancreatic cancer patients are eligible for the Whipple procedure, and the survival rate after five years is between 20% and 25%. The rate is higher for patients whose cancer did not spread to the lymph nodes.
The risk of cancer returning varies based on the type of procedure you undergo and the post-surgery treatments, such as chemotherapy and radiation, you receive after surgery. In addition, some patients face other issues due to complications during surgery. Speak with an expert surgeon to better understand your options and risks.
Learn More About Your Options for Pancreatic Cancer Surgery
Every patient is different, but pancreas diseases and cancer are often treatable and sometimes curable. The qualified surgeons at Arizona Premier Surgery may be able to provide lifesaving treatment while preserving normal digestive function through the Whipple procedure. To learn more about pancreatic cancer surgery and the options available, contact Arizona Premier Surgery and take the first step toward recovery.
Sources:
https://www.hopkinsmedicine.org/health/conditions-and-diseases/pancreatic-cancer/pancreatic-cancer-surgery
https://www.mayoclinic.org/tests-procedures/whipple-procedure/about/pac-20385054
https://www.cancer.org/cancer/pancreatic-cancer/treating/surgery.html
https://www.webmd.com/cancer/pancreatic-cancer/whipple-procedure
