Pancreatic cancer has often grown to an advanced stage and spread to other organs by the time it is diagnosed and is challenging to treat successfully. The care of people with pancreatic cancer is therefore best handled by a multidisciplinary team of specialists with expertise in diagnosing and treating this disease and relieving symptoms. This is the approach we take at NewYork-Presbyterian Queens. We offer the latest advanced endoscopic techniques, minimally invasive and complex surgical approaches, chemotherapy, radiation therapy, and investigational treatments. We also provide genetic counseling and surveillance for people at risk of pancreatic cancer due to their family history or pancreatic cysts.
A Team of Pancreatic Cancer Experts
We assemble the team of healthcare professionals you need. Through a collaborative approach, the pancreatic cancer surgeons, gastroenterologists, interventional endoscopists, radiation oncologists, medical oncologists, nurses, and other specialists at NewYork-Presbyterian Queens provide medical, surgical, and supportive care for people with pancreatic cancer. They discuss each patient and design the optimal plan of treatment. Our doctors are also on the cancer care team at Weill Cornell Medicine.
Accurate Diagnosis and Staging
While your initial assessment for pancreatic cancer may include CT scanning and magnetic resonance imaging (MRI), we use more advanced tools to confirm your diagnosis and to determine its extent — a process called staging. These tools include:
- Endoscopic ultrasound (EUS) involves the use of a special endoscope with high-energy sound waves ("echoendoscope") to visualize your digestive tract and nearby organs. We often use it to guide needle biopsy.
- SPYGLASS technology provides a direct view of the bile duct system, enabling our doctors to visualize lesions and narrowed areas (strictures) in the bile ducts and biopsy them to see if they are cancerous.
- Endoscopic retrograde cholangiopancreatography (ERCP) combines x-rays and the use of an endoscope. We may use it to obtain a tissue sample.
- Pancreatoscopy uses a small camera to see the pancreatic duct.
Interventional Endoscopic Therapies
A number of interventional treatments are available to relieve pain, jaundice, and other symptoms in people with advanced pancreatic cancer. Using ERCP, the doctor can open up and drain blocked ducts. We may combine ERCP with radiofrequency ablation (using intense heat to destroy tumor tissue and relieve symptoms) or to insert a stent in a blocked duct. Our doctors also perform "celiac plexus neurolysis" to relieve abdominal pain and insert stents in the small intestine to relieve obstructions.
Pancreatic Cancer Surgery
If we can remove your pancreatic cancer through surgery, you might have the Whipple procedure (removal of the head of the pancreas, part of the small intestine, the gallbladder, part of the stomach, and lymph nodes near the head of the pancreas). This complex surgery is best handled by a surgical team with extensive experience. The pancreatic surgeons at NewYork-Presbyterian Queens are experts in performing the Whipple approach. Some patients have just the pancreas removed (total pancreatectomy), just the tail and body of the pancreas (distal pancreatectomy), or only the body of the pancreas (central pancreatectomy).
Chemotherapy and Radiation Therapy
In some patients, surgery is not possible because the pancreatic cancer has grown around vital structures, such as blood vessels. If your cancer is inoperable, you may benefit from chemotherapy (such as the drugs gemcitabine and nab-paclitaxel), targeted therapies such as erlotinib, and/or radiation therapy. Some patients receive these treatments after surgery to delay or reduce the risk of cancer recurrence; in other cases, medical treatments and radiation therapy can shrink an inoperable tumor enough to make it surgically removable. Chemotherapy and radiation therapy are available in our modern and comfortable infusion center and Radiation Oncology Center.
Preventing Pancreatic Cancer through Cyst Treatment
Some patients with pancreatic cysts may be at increased risk of pancreatic cancer. At NewYork-Presbyterian Queens, our interventional radiologist use radiofrequency n to treat pancreatic cysts, applying intense heat through a needle inserted through an endoscope to destroy the cyst. In some patients, this approach can prevent a precancerous cyst from progressing to pancreatic cancer, effectively preventing the disease.
Clinical Trial Opportunities
Progress against pancreatic cancer requires intensive research efforts to understand this disease better and clinical trials to assess new treatments. At New York Presbyterian Queens, we actively support clinical trial participation. Weill Cornell Medicine investigators are conducting clinical trials of promising new therapies to extend the lives of people with pancreatic cancer and provide hope to individuals suffering from this disease. Your care team will let you know if you can participate in these innovative studies.
We understand that a diagnosis of cancer can take a toll on you as well as your loved ones. That's why we offer a full range of psychosocial, nutritional, and other support services for people with pancreatic cancer. Our palliative care specialists ensure that your quality of life is the best it can be from the moment of diagnosis and throughout your treatment.