How is pancreatic cancer treated?
Every patient at Miami Cancer Institute receives a personalized treatment plan put together by our team of medical oncologists, surgical oncologists, radiologists, interventional oncologists and interventional gastroenterologists, who meet weekly to discuss patient cases and find the best possible treatment. Through this collaboration, all under one roof, you receive a second or third opinion that allows your care team to tackle the most complex pancreatic cancer cases.
Our philosophy is to find the plan that effectively treats the cancer and fits your needs as a patient. Your care team will consider your specific diagnosis and type of tumor, the stage of disease, size and location of tumor and whether it has spread to other parts of your body. We also work closely with physical therapists, nurses, nutritionists and psychosocial experts to ensure we address any potential side effects of treatment.
In recent years, advances in chemotherapy for pancreatic cancer have significantly improved quality of life and survival for patients. If the cancer has spread to other parts of the body, your care team will likely start with chemotherapy treatment. Chemotherapy uses medicine that goes through the body to kill cancer cells wherever they are. Chemotherapy may be combined with radiation therapy, a combination that is called chemoradiation.
Surgery is typically the first treatment used for pancreatic cancers that have not spread outside the pancreas or don’t involve any major blood vessels. Your care team may also choose to do surgery after you complete chemotherapy treatment. The surgical oncologists at Miami Cancer Institute are experts in the latest surgical treatments for pancreatic cancer, including minimally invasive laparoscopic or robotic surgery techniques. Our surgical specialists understand and use the latest technology and are part of national organizations to develop improved surgical guidelines for pancreatic cancer.
The type of surgery you will receive depends on the location of the tumor. The most common surgery used to treat pancreatic cancer is the Whipple procedure. During this complex procedure, surgeons remove the right side, or head, of the pancreas, the lower half of the bile duct, part of the small intestine, gallbladder, surrounding lymph nodes and sometimes part of the stomach. The surgeons then reconnect the rest of the small intestine, stomach and pancreas so the body can digest food.
At Miami Cancer Institute, our surgeons perform minimally invasive laparoscopic Whipple procedures, which can reduce post-surgery pain and shorten recovery time.
Other surgeries that may be used to treat pancreatic cancer include:
- Distal pancreatectomy. During this procedure, surgeons remove the left side, or tail, of the pancreas, and sometimes part of the body of the pancreas and spleen.
- Total pancreatectomy. During this procedure, surgeons remove the entire pancreas, part of the stomach, gallbladder, part of the small intestine, part of the bile duct, spleen and nearby lymph nodes.
If you undergo surgery to treat your pancreatic cancer, our specialists will work with you to provide a faster, less painful recovery process that involves fewer tubes and drains. Miami Cancer Institute has a team dedicated to the Enhanced Recovery After Surgery (ERAS) practice, which helps develop procedures that will improve patient outcomes and recovery.
Our interventional oncologists use advanced imaging technology to diagnose and treat cancer through targeted, minimally invasive procedures. These complex treatments are often faster, safer and less painful alternatives to more invasive surgical options.
Treatment options for pancreatic cancer include:
- Irreversible electroporation (IRE) therapy.This procedure, also called the NanoKnife, uses a CT scan to help doctors place needles near the tumor. Once the doctors place the needles, electricity is sent through the needles to kill the tumor. We are pioneers in using this therapy to treat pancreatic cancer. For tumors that are too large or too close to critical structures, IRE provides an often-effective alternative to traditional surgery. IRE has also been shown to improve survival in patients compared with chemotherapy alone for certain cancers.
- Radiofrequency ablation or microwave ablation. This procedure uses imaging technology and needle-like probes to deliver heat directly to the tumor. The probe uses radiofrequency or microwave energy to quickly and effectively destroy cancer cells.
If the cancer has spread to nearby organs, your care team will likely recommend treatment with chemotherapy and possibly radiation therapy before surgery.
If the cancer has spread to nearby organs, your care team may also recommend treatment with radiation therapy before surgery. At Miami Cancer Institute, our advanced radiation oncology department gives patients access to every form of radiation treatment, all available under one roof:
- Proton therapy. Miami Cancer Institute is proud to be the only center in the region to offer this unique treatment, which uses pencil beam scanning technology. Proton therapy is a form of radiation therapy that uses external beams of protons to deliver high doses of radiation directly to the tumor, while sparing surrounding tissue. In this treatment, protons are used instead of X-rays.
- Stereotactic Body Radiation Therapy (SBRT). SBRT delivers high doses of radiation using X-rays with pinpoint accuracy. Miami Cancer Institute offers the most advanced technology to deliver SBRT including CyberKnife, TrueBeam and MRIdian Linac.
- MR-guided Radiation Therapy. Miami Cancer Institute was the second center in the United States to treat patients with the ViewRay MRIdian Linac, a type of machine that uses MRI scans to continuously track tumors during treatment. This allows for higher doses to be given to tumors, improving tumor control and delivering less radiation to normal tissues to decrease side effects.
A significant number of our patients have surpassed the expected survival for this deadly disease, with many alive several years after their initial diagnosis,” said Michael Chuong, M.D., director of MRI-Guided Radiation Therapy at the Institute and a radiation oncologist specializing in gastrointestinal cancers.
A multidisciplinary team of cancer experts including surgeons, medical oncologists, radiation oncologists, plastic reconstructive surgeons, pathologists, radiologists, genetic counselors, medical geneticists, social workers, patient navigators and clinical trials staff meet weekly to discuss select complex cases and determine the best course of care. Stem cell transplantation experts and hematologic oncology experts are also available to discuss complex cases.
Pancreatic cancer tends to be resistant and often does not get enough chemotherapy when it is delivered via an intravenous approach,” Dr. Gandhi explains. “With the intra-arterial approach of administering high doses of chemotherapy directly to the pancreatic tumor, we have the potential to control the disease and improve survival — and we can improve the patient’s quality of life.
Miami Cancer Institute can provide access to clinical trials not widely available elsewhere. Clinical trials find new ways to treat and diagnose cancer and are ongoing. If an appropriate trial is available, we will talk to you about the benefits and risks.
South Florida's First Proton Therapy Center
Proton therapy is a highly specialized treatment that directs proton particles toward tumors to destroy cancer cells while largely sparing healthy tissue and decreasing the risk of side effects. This sophisticated treatment is used only for certain types of cancers and in a limited number of individuals.