Surgery Surgery is rarely curative but can be used for palliation, improving survival and the quality
of life. The radical surgical approach (pancreaticoduodenal resection) depends on whether the tumor is in the head, body or tail of the pancreas.
Cure may be achieved when the tumor is truly localized , but this stage is diagnosed in fewer than 20 percent of cases. Radical surgery (the Whipple procedure) is more feasible when the tumor is small (less than 3/4 in.
/2 cm), no lymph nodes are involved and there is no extension of the cancer beyond the "capsule" of the pancreas (a rare situation).
Surgery may also be advantageously used to bypass any obstruction of the biliary or gastrointestinal tract. In addition, before surgery pancreatic cancer cannot be differentiated from other cancers involving bile ducts. Overall, surgery results in only about 5 percent survival after five years, although about 22 percent are alive five years after radical surgery (Whipple procedure).
Investigational treatment for Stage I to III (locally advanced) cancers, using 5-FU and radiotherapy before surgery, has shown preliminary results of increased resectability and palliation, but further study is needed.
Radiation Sometimes when the tumor cannot be removed surgically, radiation can play a palliative
role after surgery. The risks of radiotherapy can be reduced with proper treatment planning.
