The treatment of pancreatic cancer is among the most difficult challenges in cancer care. It is critical that the treatment plan is individualized to each patient. The options, potential risks and benefits will be different for each person so our multidisciplinary team approach is critical.
Surgery
Pancreatic surgery is complex and is the mainstay of pancreatic cancer care. The outcomes of pancreatic surgery are best when performed by experienced surgeons in hospitals with comprehensive support services. Abbott Northwestern Hospital's Virginia Piper Cancer Institute is a high volume center for pancreatic resection with a complete array of support staff to optimize care before, during and after surgery.
Our pancreatic surgery team performs all types of open and laparoscopic pancreatic resections. Our outcomes with pancreaticoduodenectomy (Whipple operation) are excellent with a median hospital length of stay of 8 days, median blood transfusion and ICU stay of zero. Because of our dedication to basic and clinical research in pancreatic cancer, all of our patients are considered for clinical trials and nearly 100 percent of our surgical patients are enrolled in either a treatment or basic science related trials.
Chemotherapy
Systemic chemotherapy is given with a goal of preventing the spread of cancer after surgery (also called adjuvant therapy) or as a primary treatment for metastatic disease. Standard chemotherapy protocols have been well studied for safety and effect and are the mainstay of treatment.
Chemotherapy agents given through a clinical trial are being studied to determine if the study agent(s) is better than standard therapy. There is usually a large body of pre-clinical data that supports the potential of the study for human patients. The trials are evaluated by many physicians and regulatory bodies (such as an Institutional Review Board, IRB) before being offered to our patients. A brief overview of the “phases” of clinical trials includes:
Phase I studies are for new agents for which the safety and effectiveness are not known.
Phase II studies test the safety and effectiveness of new drugs.
Phase III trials are large studies testing new treatments against standard therapy.
Most trials for pancreatic cancer patients are Phase I or II.
Radiation
Radiation therapy treats localized (not metastatic) disease with a variety of potential goals including reducing the tumor size before surgery (neo-adjuvant), slowing tumor growth and spread, or controlling symptoms. Our radiation oncologists have the most advanced radiation therapy technologies and highly skilled technical staff. Together they provide state of the art care, including intensity-modulated radiation therapy (IMRT) and stereotactic radiosurgery. These technologies benefit our patients by increasing accuracy and minimizing treatment time and injury to nearby, organs.
Chemotherapy is often given with radiation in order to improve the effectiveness of the radiation (radiation sensitizing chemotherapy) and/or to ensure treatment of the whole body (systemic).
Combination Therapy for Locally Advanced Pancreatic Cancer
Our team works together to accurately understand the stage of each patient's cancer and to develop a treatment plan. Our surgeons are skilled in portal vein resection and reconstruction as part of pancreatic surgery. However, some patients with locally advanced cancers (not metastatic but not feasible for surgery because of local blood vessel invasion) may benefit from a neo-adjuvant strategy - combining chemotherapy and radiation with a goal of making surgery possible. This approach requires the careful attention to nutrition, symptoms and treatment response that is provided by our multidisciplinary team approach.
Virginia Piper Cancer Institute
Abbott Northwestern Hospital
800 E. 28th St.
Minneapolis, MN 55407
612-863-4633
Source: Timothy Sielaff, MD, PhD
First published: 06/30/2008
Last updated: 06/30/2008
