Pancreatic Cancer Treatment in Los Angeles

• Your age, overall health, and medical history
• Location and extent of the disease
• Type of cancer
• Your tolerance of specific medicines, procedures, or therapies
• Expectations for the course of the disease
• Your opinion or preference

Depending on the type and stage, pancreatic cancer may be treated by a number of methods, outlined below.

Staging Pancreatic Cancer

Staging is a way of describing where the cancer is located, if or where it has spread, and whether it is affecting the functions of other organs in the body.

Diagnostic tests are used to determine the cancer’s stage, so staging may not be complete until all the tests are finished.

Knowing the stage helps decide what type of treatment is best and can help predict a patient’s chance of survival.

• Stage 0: Refers to cancer in situ, in which the cancer has not yet invaded outside the duct (or tube) in which it started (Tis, N0, M0).
• Stage IA:The tumor is 2 cm or smaller in the pancreas. It has not spread to lymph nodes or other parts of the body (T1, N0, M0).
• Stage IB: A tumor larger than 2 cm is in the pancreas. It has not spread to lymph nodes or other parts of the body (T2, N0, M0).
• Stage IIA: A tumor extends beyond the pancreas, but the tumor has not spread to nearby arteries or veins. It has not spread to any lymph nodes or other parts of the body (T3, N0, M0).
• Stage IIB: A tumor of any size has not spread to nearby arteries or veins. It has spread to lymph nodes but not to other parts of the body (T1, T2, or T3; N1; M0).
• Stage III: A tumor has spread to nearby arteries, veins, and/or lymph nodes but has not spread to other parts of the body (T4, N1, M0).
• Stage IV: Any tumor that has spread to other parts of the body (any T, any N, M1).
•  Recurrent: Recurrent cancer is cancer that comes back after treatment. If there is a recurrence, the cancer may need to be staged again (called re-staging).

Surgery

Surgery may be necessary to remove the entire tumor, a section, or the entire pancreas and often parts of other organs. The type of surgery performed depends on the stage of the pancreatic cancer, the location and size of the tumor, and your overall health. Dr Bilchik and his team have extensive experience operating on the pancreas. These operations, because of their complexity should be done at centers of excellence, of which Providence St John’s is one. Blood transfusion and admission to the intensive care unit are rarely required. Most patients can eat soon after surgery and generally leave the hospital in less than one week.

Types of surgery for pancreatic cancer include the following:

• Whipple procedure: This procedure involves removal of the head of the pancreas, part of the small intestine, the gall bladder and part of the common bile duct and lymph nodes near the head of the pancreas. Most pancreatic tumors occur in the head of the pancreas, so the Whipple procedure is the most commonly performed surgical procedure for pancreatic cancer.
• Distal pancreatectomy: If the tumor is located in the body and tail of the pancreas a distal pancreatectomy can be performed. This is most often done using minimally invasive techniques; recovery is rapid.
• Total pancreatectomy: The entire pancreas, part of the small intestine and stomach, the common bile duct, the spleen, the gallbladder, and some lymph nodes will be removed. This type of operation is not done often.
• Palliative surgery: For more advanced cancers that cannot be completely removed, surgery may be undertaken to relieve symptoms caused by problems such as a blocked bile duct or obstruction of the stomach.

External Radiation (external beam therapy)

Radiation treatment, administered by a radiation therapist, sends high levels of radiation precisely and directly to the cancer cells. Since radiation is used to kill cancer cells and to shrink tumors, special shields may be used to protect the tissue surrounding the treatment area. Radiation treatments are painless and usually last a few minutes. Radiation therapy may be given alone, or in combination with surgery and/or chemotherapy.

Chemotherapy

Chemotherapy involves the use of anticancer drugs to kill cancer cells. In most cases, chemotherapy works by interfering with the cancer cell’s ability to grow or reproduce. Different groups of drugs work in different ways to fight cancer cells. Chemotherapy may be given alone, or in combination with surgery and radiation therapy. Chemotherapy and radiation can sometimes be given before surgery to shrink the tumor, making the surgery easier to perform.

Outcomes and quality of life

Dr. Bilchik and his team focus not only on prolonging survival in patients with pancreatic cancer but also improving quality of life using the latest technology available.