So you have pancreatic cancer. Now what?


by Amar Gupta, MD

Oct 3, 2022

Like any cancer, a diagnosis of pancreatic cancer comes with a lot of questions. Because this type of cancer is relatively rare, you might not be as familiar with it as other types of cancer like breast or colorectal.

Symptoms of pancreatic cancer can include the skin or eyes turning yellow, unintentional weight loss, getting full too soon and, rarely, abdominal pain. However, these symptoms can be vague or don’t begin until pancreatic cancer is advanced. As a result, only about 25-30% of pancreatic cancers are found early enough that they can be treated with curative therapy.

But even if your cancer isn’t caught in the earliest stages, you still have options and hope. The care we can offer people based on their specific type of cancer has grown over the last 10-15 years, and research continues to bring new treatment options to the forefront of cancer care.

If you or a loved one has been diagnosed with pancreatic cancer, here’s what to expect.

Choosing your pancreatic cancer care team

When it comes to choosing a care team, you want to be fully evaluated by a group of clinicians that cares for pancreatic cancer every day. Look for a dedicated center, like the Pancreatic Cancer Research and Treatment Center at Baylor University Medical Center, that brings together numerous health providers into one team.

With a dedicated center, you don’t have to visit several offices or wonder if you are seeing the right physician. Protocols are in place for each patient to be evaluated by a collaborative team and be considered for a variety of treatments and trials.

Your care team may include several medical specialties, such as:

  • Medical oncology for chemotherapy
  • Radiation oncology if radiation treatment is needed
  • Dedicated pancreas surgeons
  • Interventional radiology
  • Advanced endoscopy
  • Pain management
  • Palliative and supportive care

One of the central parts of the team is your nurse navigator. Because care for pancreatic cancer involves many different clinicians, your nurse navigator is there to help you coordinate visits and guide you through each step of your care—so you’re never alone in this journey.

Finally, a robust genetics department and research department are also extremely important. Genetic testing can provide valuable information about your cancer. And an active research team gives you access to clinical trials, potentially broadening your care options.

Deciding on your plan of care

After your initial diagnosis, you’ll be seen by several members of the team to come up with a care plan. When considering treatment, our cancer programs approach everything with a holistic view. We’re not just treating cancer—we’re treating a human being.

Usually, a surgeon and medical oncologist will evaluate your case together first. To make a tentative plan for your next steps, they’ll use several factors, such as:

  • Clinical exam
  • Symptoms
  • Health history
  • Imaging tests
  • How early the cancer was detected
  • Location of the cancer within the pancreas
  • What other organs or tissues are involved

Then, a team of multiple providers will review your case during a meeting called a tumor board. As a group, they decide whether you may benefit from surgery and make a recommendation for your specific care. With so many specialized experts on your side, you can feel confident taking the next steps in your cancer journey.

Individualized treatment options

Treatment options for pancreatic cancer might include chemotherapy, radiation, surgery or enrollment in a clinical trial. We’ll personalize care based on your needs, but generally, treatment plans fall into one of four groups:

  1. Upfront resectable: A small group of patients has pancreatic cancer that can be fully removed with an operation. You’ll have surgery without any additional treatment, and minimally invasive surgery is an option for about half of patients.
  2. Borderline resectable: The next group has the potential for an operation to fully remove the cancer but needs chemotherapy before surgery to improve the odds of removing 100% of it and the odds of it not coming back.
  3. Locally advanced pancreatic cancer: For this group, the cancer has spread to vital structures in the body, which may prevent surgery. Many of our teams have experience in advanced blood vessel surgery which allows us to offer surgery to some patients in this group who wouldn’t otherwise have a surgical option. However, for most, treatment options include chemotherapy, radiation and clinical trials.
  4. Stage 4: If the cancer has left the pancreas and spread through the blood to other parts of the body—commonly called stage 4 cancer—surgery isn’t an option. Treatment focuses on slowing the progression of the pancreatic cancer and managing symptoms.

Offering hope for pancreatic cancer

Even if we can’t offer surgery, we have therapies and options like clinical trials that can give you and your family hope. Especially if your cancer has progressed, clinical trials and research remain one of the most important pieces of your care.

Only about 1 in 5 patients with pancreatic cancer follows the traditional care route that includes surgery. Our team is actively involved in clinical trials for pancreatic cancer to keep bringing additional options to the table. These trials are advancing the future of pancreatic cancer care.

While pancreatic cancer can be an overwhelming diagnosis, a dedicated pancreatic treatment center can give you the resources you need as take your next steps. No matter where you are in your cancer journey, the whole reason a team like ours exists is for your care and support. We’re here to make sure you aren’t navigating your diagnosis alone.

Next steps

About the Author

Dr. Amar Gupta is an abdominal transplant surgeon on the medical staff at Baylor University Medical Center - Dallas with a primary interest in complex gastrointestinal issues in the pancreas, liver and bile ducts. In his dual role as a transplant and hepato-pancreato-biliary surgeon, he offers patients a variety of unique treatment and surgical options at the Liver and Pancreas Disease Center. Dr. Gupta is Director of the Abdominal Transplant Surgery Fellowship program at Baylor University Medical Center and is Assistant Professor of Surgery at Texas A&M School of Medicine and TCU/UNTHSC School of Medicine in Fort Worth.

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