Pancreas Cancer Treatment | Apollo Cancer Centres

Surgery is the only curative option for Pancreatic cancers. Depending on the location of tumour, the surgical options vary.
Potentially curative surgery for the early stage of diagnosis

Pancreaticoduodenectomy (Whipple procedure)- Whipple procedure involves the removal of the Head and neck portion of the pancreas along with the duodenum, distal stomach, bile duct, gall bladder and proximal jejunum. It is a complex surgery performed by a highly skilled team of surgical oncologists specialising in GI oncology.
Enucleation of the tumour - Certain Pancreatic tumours, like Neuroendocrine tumours can be treated by simple excision of the mass from the pancreas without removal of normal Pancreatic tissue. This offers the advantage of preservation of the pancreas and its digestive functions. However, Enucleation can be done only in benign or specific tumours like Pancreatic neuroendocrine tumours.
Distal Pancreatosplenectomy - A tumour of the tail of the pancreas can be well treated by distal Pancreaticosplenectomy, where cancer and the distal part of the pancreas and spleen are removed.
Minimally Invasive Pancreatic surgeries - The procedures mentioned above can be done by minimally invasive approach through Laparoscopy and Robotic platforms in suitable patients.

Surgery for Palliative Care- In certain advanced cases of Pancreatic cancer, the tumour infiltrates the major vascular structures and is not amenable for surgical removal. However, the tumour can cause symptoms such as persistent vomiting (gastric outlet obstruction) or jaundice, compromising the quality of life. In such cases, a bypass procedure could be offered to help relieve the symptoms.
Ablation or Embolization treatments In tumours that cannot cure with surgical resection, an ablation or embolization procedure is done to control the tumour growth. These treatments are often used along with other modes of treatment like chemotherapy or radiation which help to relieve symptoms. This is used when there are only a few areas of spread-E.g. Radiofrequency ablation (RFA), Arterial embolization etc.

Radiotherapy is advised in Pancreatic cancers when either the tumour is inoperable or the patient is unfit for surgery. The doctor can also recommend it after surgery based on the tumour pathology.
Radiation therapy can be given by:

External beam therapy- This is done by directing a radiation beam at the affected body area (external beam radiation therapy). High precision techniques like Intensity Modulated Radiotherapy (IMRT), Image-guided Radiotherapy (IGRT) and Volumetric Modulated Arc therapy (VMAT/Rapid Arc) help target the tumor accurately and avoiding normal tissue injury.
Sometimes, Stereotactic Body Radiotherapy (SBRT) is advised for Pancreatic, small tumours. This treatment helps deliver large doses of radiation in a highly focused manner, with maximal sparing of adjacent normal structures.

Chemotherapy - Pancreatic cancers can be adenocarcinomas or neuroendocrine tumours/carcinomas. Adenocarcinomas are aggressive malignancies. Chemotherapy plays a vital role after surgery and in advanced, widespread disease. The doctors can also give it before surgery to reduce the size of the tumour and increase the feasibility of complete removal of the malignancy. In metastatic disease, chemotherapy can reduce the tumour burden and improve survival. The regimen depends on the general condition of the patient. Based on the genetic backbone of the tumour, maintenance therapy after the initial chemotherapy may also be an option in selected individuals.
Immunotherapy - In recurrent or progressive disease, further chemotherapy or Immunotherapy is possible. The doctors can also make these decisions based on the tumour's genetic profile.
Hormonal Therapy - Metastatic neuroendocrine tumours can be treated with hormonal therapy or chemotherapy based on the aggression and certain pathological determinants. Nuclear medicine therapy is also an option in advanced neuroendocrine tumours.