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CANCER CARE SERVICES

Care & Treatment

Pancreatic Cancer

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Whipple procedure (pancreaticoduodenectomy)

Whipple procedure

NewYork-Presbyterian offers this highly specialized surgery for pancreatic cancer in the head of the pancreas. The Whipple procedure is the most common operation for pancreatic cancer. We successfully perform this operation in older patients with successful outcomes . Patients with tail of the pancreas masses can also get surgery: distal pancreatectomy and splenectomy.

Advanced interventional techniques

Advanced interventional techniques

NewYork-Presbyterian, our interventional radiologists and interventional endoscopists use cutting-edge interventional approaches for digestive cancers, including:

  • Interventional biopsy to retrieve tissue for analysis without surgery.
  • Embolization to block the flow in blood vessels feeding a tumor, such as liver tumors.
  • Ablation to destroy a tumor with radio waves, light-sensitive drugs, or extreme temperatures.
  • Interventional endoscopy to relieve obstructions, remove superficial tumors, and insert stents in a blocked bile duct or an esophagus narrowed by cancer.

Chemotherapy

Chemotherapy

Chemotherapy may be used before or after surgery, or as a primary treatment for advanced disease. We give intravenous chemotherapies in our warm, supportive infusion centers, where we can monitor your side effects and address your comfort.

Chemotherapy options include:

  • Presurgical chemotherapy. Some patients receive chemotherapy before pancreatic cancer surgery to shrink the tumor. Your doctor will let you know if this is an option for you.
  • Chemotherapy after surgery. Many patients with digestive cancers receive anticancer chemotherapy drugs after surgery to reduce the risk of recurrence. You may receive a combination of medications.
  • Targeted therapies. We treat some digestive cancers with targeted therapies, which work by shutting down certain proteins that cancer cells need to grow. Examples of targeted therapy drugs include trastuzumab for some stomach cancers, cetuximab, and bevacizumab for colorectal cancer, and sorafenib for liver cancer.
  • Immunotherapy. These treatments harness the power of the immune system to fight cancer. There are many types of immunotherapy drugs used to treat other cancers that are now being evaluated in clinical trials for patients with digestive cancers including colon, pancreas, stomach, and liver cancers.
  • Heated intraperitoneal chemotherapy. This special technique combines chemotherapy and surgery in one procedure and is used primarily to destroy any unseen cancerous tissue in the abdomen after all visible tumors have been removed.

Early detection and high-risk screening

Early detection and high-risk screening

Currently, there is no recommended routine pancreatic cancer screening for average-risk, asymptomatic adults. Most people who develop this type of cancer typically do not have many symptoms until pancreatic cancer progresses or becomes advanced. 
Early-detection surveillance programs traditionally focus on high-risk individuals. Although the exact cause of pancreatic cancer cases is unknown, here are some of the risk factors that could warrant pancreatic cancer tests:

  • Family history of pancreatic cancer.
  • Genetic variations, including individuals with the BRCA1, BRCA2, or PALB2 mutation. 
  • Peutz-Jeghers syndrome (PJS), associated with STK11 gene mutations.

Tests used to diagnose pancreatic cancer include:

  • Imaging tests, including CT scans, MRI, and positron emission tomography (PET) scans. 
  • Endoscopic ultrasound (EUS). A long, thin tube with a camera is passed down the throat to the stomach to take pictures of the pancreas.
  • Biopsy. During an EUS, a sample of the pancreas can be taken via a fine-needle aspiration.
  • Blood tests, to detect for certain proteins (tumor markers).
  • Genetic tests, through blood. If you are already diagnosed, a genetic test can help guide your treatment and determine whether family members have an increased risk of pancreatic cancer.

Other Risk Factors for Pancreatic Cancer

Other Risk Factors for Pancreatic Cancer

While not all of these risk factors are definitive for pancreatic cancer, they may include:

  • Diabetes. People with diabetes may be at higher risk of pancreatic cancer, especially when someone has had it for many years. People who suddenly develop diabetes as an adult should consult with a doctor, as this can be an initial sign of pancreatic cancer.
  • Age. The risk of developing pancreatic cancer increases with age. Most people who develop this kind of cancer are older than 45.
  • Sex. Men are diagnosed with pancreatic cancer slightly more often than women.
  • Race/ethnicity. Black people and people of Ashkenazi Jewish heritage or more likely to develop pancreatic cancer than Hispanic, white, or Asian people.
  • Lifestyle. A high-fat diet, chronic alcohol use, tobacco use, and a sedentary lifestyle can all increase the risk of developing pancreatic cancer.
  • Infections. Some infections, especially those of the stomach or gums, may elevate pancreatic cancer risk, particularly a bacteria called Helicobacter pylori, or H. pylori.
  • Some autoimmune conditions. Certain autoimmune conditions, such as Sjögren’s disease or lupus, can make one more susceptible to cancer of the pancreas.
  • Some inherited conditions. Certain inherited conditions, including Li-Fraumeni syndrome (LFS) and Familial adenomatous polyposis (FAP) can make one more likely to develop pancreatic cancer.
  • Injury or trauma to the pancreas. Pancreas injury or trauma can lead to pancreatitis (chronic inflammation of the pancreas), which in turn can increase one’s risk of pancreatic cancer.

FAQs

FAQs

The survival rate of pancreatic cancer will depend on the stage at which it is diagnosed. Most cases of pancreatic cancer are diagnosed at later stages, meaning the survival rate is low. The five-year relative survival rate (the percentage of people in a study or treatment group alive five years after being diagnosed with or starting treatment) for all stages combined is 11%.

Some early warning signs of pancreatic cancer include jaundice (yellowing of the skin and eyes), pain or discomfort in the abdomen or back, weight loss or lack of appetite, and sudden onset of diabetes. Pale, floating, dark, or tarry stools are also common.

Because the pancreas is located deep within the body, behind the stomach, it’s usually hard to spot tumors early. People usually have no symptoms in the early stages. For these reasons, treatment typically begins in stages with more advanced pancreatic cancer. Once it is diagnosed, the tumors are difficult to treat and don’t respond as well as other types of cancer. This results in a poor pancreatic cancer prognosis for most patients.

Early diagnoses of pancreatic cancer are usually the result of genetic testing. For people with a family history of pancreatic cancer, other types of cancers, or certain hereditary conditions, testing can be used to identify gene mutations that may cause cancer. Genetic tests show whether you have certain hereditary conditions that may increase your risk of pancreatic cancer, and from there, you can consult with your doctor about how to proceed.

Pancreatic cancer accounts for about 3% of all cancer diagnoses in the United States, and about 7% of all cancer deaths. It’s slightly more common in men than in women. The average lifetime risk of developing pancreatic cancer is approximately one in 64, though some people may have personal or family risk factors that increase their risk.

In most cases, exact pancreatic cancer causes are unknown. However, the cell mutations that cause it can be inherited or acquired. Inherited gene mutations, called germline mutations, can be passed down from generation to generation. Acquired gene mutations, on the other hand, refer to DNA changes that occur throughout a person’s lifetime; these cannot be passed down from a parent to a child. Family and personal history (such as a history of smoking) can increase one’s risk of developing pancreatic cancer.

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Trust NewYork-Presbyterian for Pancreatic Cancer Treatment

The experts at NewYork-Presbyterian treat all types of pancreatic cancer. Our team works closely with every patient to understand any symptoms they may be experiencing, discuss diagnostic testing options, and create a detailed, personalized treatment plan.

As part of our commitment to best-in-class cancer care for all patients, NewYork-Presbyterian holds multidisciplinary clinics and tumor boards every week, bringing together specialists from various treatment modalities to discuss your unique treatment needs and develop a comprehensive and customized course of action.