Pancreatic Cancer

Cancer of the pancreas is the fourth most common cause of cancer death in the United States. Pancreatic cancer occurs when a cell in the pancreas—which produces fluids that help digest food and hormones (such as insulin) to control blood sugar levels—is damaged. This malignant (cancer) cell starts to grow out of control. Digestive fluids are made by exocrine pancreas cells and hormones are produced by endocrine pancreas cells. Roughly 95 percent of pancreatic cancers begin in exocrine pancreas cells. Pancreatic tumors are sometimes discovered during imaging studies to investigate symptoms or during an evaluation for another condition. They may also be found during screening for families with a history of pancreatic cancer. Learn more about cancer of the pancreas.

Surgeons at Brigham and Women’s Hospital (BWH) specialize in pancreatic cancer. As the surgical team for the Pancreas and Biliary Tumor Center at Dana-Farber Brigham Cancer Center, our board certified surgeons work with a group of pancreatic cancer specialists to provide compassionate and highly coordinated care for patients with pancreatic lesions. Our surgeons use the latest minimally invasive surgery techniques and perform more than 100 pancreatic cancer operations per year, including the Whipple procedure.

Watch this video of Thomas E. Clancy, MD, FACS, Surgical Oncology, and Brian M. Wolpin, MD, Medical Oncology, explain the mission and treatment approaches of the Pancreas and Biliary Tumor Center.

Read the Pancreas and Biliary Tumor Center video transcript.

Cancer of the Pancreas Surgeons

Risk Factors for Pancreatic Cancer

Factors that contribute to an increased risk for cancer of the pancreas include:

Aged 55 and older
More common in men than women
Pancreatic cysts
Smoking
Diabetes
Chronic pancreatitis
Cirrhosis of the liver
Obesity
Workplace exposures
Race (More common in African-Americans than Asians, Hispanics, or whites)
Family history of cancer of the pancreas
Genetic syndromes

Learn if you are at risk for cancer of the pancreas.

Symptoms of Pancreatic Cancer

Pancreatic cancer is difficult to detect early as it does not cause symptoms right away. Symptoms associated with pancreatic cancer include:

Weight loss
Loss of appetite
Nausea
Indigestion
Jaundice
Vomiting, diarrhea
Dark yellow urine
Pain in the upper or middle part of the abdomen and back
New development of diabetes
Fatigue
Light-colored stool and general itchiness

Diagnosis of Pancreatic Cancer

If you are having symptoms of pancreatic cancer, your surgeon will ask about your health history, your family’s history of cancer and risk factors. Diagnostic tests may include:

Endoscopic ultrasound (EUS)
Endoscopic retrograde cholangiopancreatography (ERCP)
Percutaneous transhepatic cholangiography (PTC
Chest X-ray
Computed tomography scan (CT or CAT scan)
Magnetic resonance imaging (MRI)
Pancreas biopsy. A procedure in which a sample of pancreatic tissue is removed (with a needle or during surgery) for examination under a microscope.
Special blood tests
Positron emission tomography (PET scan)

Learn more about the above diagnostic tests for pancreatic cancer.

Stages of Pancreatic Cancer

With the results of diagnostic tests, your doctor will assign your cancer a stage, depending upon the size and spread of the cancer.

Learn more about pancreatic cancer staging.

Treatment for Pancreatic Cancer

Our surgeons offer extensive expertise in the most advanced minimally invasive procedures for cancer of the pancreas, using laparoscopic techniques when appropriate. Types of surgery include:

Pancreatoduodenectomy (Whipple procedure) involves removal of the head of the pancreas, part of the small intestine, the gallbladder and part of the common bile duct, part of the stomach, and lymph nodes near the head of the pancreas. Most pancreatic tumors occur in the head of the pancreas, so the Whipple procedure is the most commonly performed surgical procedure for pancreatic cancer.
Pylorus-preserving pancreaticoduodenectomy is similar to the Whipple procedure. However, your surgeon does not remove the lower part of your stomach.
Robotic distal pancreatectomy removes benign and malignant cysts and tumors in the body or the tail of the pancreas using the da Vinci® Surgical System
Total pancreatectomy includes removing the entire pancreas, part of the small intestine and stomach, the common bile duct, the spleen, the gallbladder and some lymph nodes. This type of operation is not done often.
Palliative surgery involves more advanced cancers. Surgery may be done not to cure the cancer, but to relieve problems such as a blocked bile duct.
Portal vein resection for selected patients.
Newer surgical procedures are used to remove larger tumors that were previously considered inoperable.

The Whipple procedure and distal pancreatectomy are highly complex operations that require an experienced surgeon and a concentrated team approach to keep risks to a minimum. At the Pancreas and Biliary Tumor Center, our surgical specialists perform a high volume of these complicated surgeries. This experience and our advanced training and skill translate to successful surgical outcomes for our patients. Our patient mortality rates are well below the national average.

Learn more about the types of surgery for pancreatic cancer. View video: Indications for Pancreatic Resection and Robotic Surgical Technique.

Non-Surgical Treatment

Learn the questions to ask about pancreas cancer treatment.

What You Should Expect

You will receive a thorough diagnostic examination to evaluate if you have pancreatic cancer and determine what course of treatment is needed. Careful monitoring and the involvement of an experienced surgeon are important to the successful outcome for patients with cancer of the pancreas.

If you are having surgery or a procedure, you will likely be scheduled for a visit to the Weiner Center for Preoperative Evaluation for pre-operative information and tests.

The day of surgery, you will be cared for in the operating room by surgeons, anesthesiologists and nurses who specialize in surgery for patients with pancreatic cancer. After surgery, you will recover in the post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.

Learn more about your hospital stay and returning home.

Multidisciplinary Care

The Pancreas and Biliary Tumor Center at Dana-Farber Brigham Cancer Center provides advanced multidisciplinary care for patients with gastrointestinal diseases, such as pancreatic cancer. Our treatment team includes surgeons, medical and radiation oncologists, radiologists, pathologists, endoscopists, anesthesiologists and gastroenterologists. In addition, patients have full access to BWH’s world-renowned academic medical community with its diverse specialists and state-of-the-art facilities.

Cancer Surgery Appointments and Locations

Contact one of our cancer surgeons in the list at the top of the page to make an appointment.

Cancer Surgery Locations

Resources

Learn more about pancreatic cancer in our health library.

Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families to access computers and knowledgeable staff.

Visit the Weiner Center for Preoperative Evaluation.