Who can have surgery to remove pancreatic cancer?
Pancreatic cancer that can be removed by surgery is called resectable (operable) cancer. You may be able to have surgery to completely remove the cancer if:
- There are no signs that the cancer has spread beyond the pancreas
- You are fit and healthy
You need to be fit and well enough to have surgery and will have tests to check this.
Surgery might not be possible if the tumour has grown too large, and spread outside the pancreas to nearby large blood vessels. Or if the cancer has spread to other parts of the body such as the liver or lungs (advanced or metastatic cancer). Instead you may be offered other treatment to help control the growth of the cancer and any symptoms.
When the cancer is close to major blood vessels
Sometimes the cancer may grow very close to the major blood vessels near the pancreas. This is called borderline resectable pancreatic cancer. This means that it may be possible to remove the cancer, but it depends which blood vessels are affected and how far the cancer has grown.
If the cancer is touching an artery, you may be offered chemotherapy first to try to shrink the cancer, and then surgery later on. But if the cancer has grown around the artery, it is not usually possible to remove the cancer with surgery, even after chemotherapy. If it’s not possible to remove the cancer, you may be able to have other treatments, such as chemotherapy. You can also ask for a second opinion from a different doctor.
When is it not possible to remove the cancer?
Sometimes the surgeon may start the operation, but find that it’s not possible to remove the cancer. This may happen because:
- The cancer has spread to your liver
- The cancer has spread to the lining of your abdomen (tummy area)
- The cancer has grown into or around the blood vessels near the pancreas in a way that means it can’t be removed.
If surgery isn’t possible, you may be offered chemotherapy to help control the cancer.
Chemotherapy and radiotherapy
Chemotherapy may be given before surgery to try and shrink the cancer, so that the surgeon has a better chance of removing it. Some people with borderline resectable cancer may be offered chemotherapy or chemoradiotherapy.
Chemotherapy may be given after surgery to try and reduce the chances of the cancer coming back. The chemotherapy drug most often used is gemcitabine. Capecitabine with gemcitabine may help make the chemotherapy more effective.
Speak to your doctor or nurse about whether surgery is an option for you, and whether you will have chemotherapy and/or radiotherapy.
Published February 2017
Review date February 2019