The cancer is confined to the pancreas or has directly spread to involve the adjacent small intestine, the bile duct or tissues surrounding the pancreas.
Standard Treatment Stage I cancer is treatable by surgery and is occasionally curable. Radical surgery , the Whipple procedure (pancreaticoduodenal resection), is the standard treatment for cancer of the head of the pancreas or the opening of the pancreatic duct, although very few patients are eligible for total resection (80 to 90 percent have lymph node involvement at the time of diagnosis, and 70 percent have liver metastases).
A radical pancreatic resection, removing the head or all of the pancreas, is very difficult surgery. Five to 30 percent of patients may not survive the operation. Fluid leaks at the connection to the small bowel (jejunum) and bleeding are the major postoperative problems.
Postsurgical local radiotherapy and 5-FU may improve survival. About 40 percent of patients treated with such combined therapy may be alive at two years, representing a twofold increase in survival. (Metallic clips are inserted during surgery to help localize the tumor for radiotherapy.)
Removing cancer involving the tail of the pancreas is uncommon because tumors in the tail are usually large and far advanced before diagnosis.
