• Pancreatic Cancer

    Dana-Farber/Brigham and Women's Cancer Care

    How We Treat Pancreatic Cancer

    Dr. Alec Kimmelman and Dr. Jaekyoung SonRadiation oncologist Dr. Alec Kimmelman and Dr. Jaekyoung "Jay" Son showed that the continued action of an oncogene (Kras) is necessary for pancreatic tumors to survive and grow. 

    The Pancreaticobiliary Tumor Center at Dana-Farber/Brigham and Women's Cancer Center (DF/BWCC) brings together a team of experts who specialize in treating pancreatic cancer. Each year, we see a multitude of patients who have pancreatic cancer, and surgeons at our Center perform about 100 pancreatic resections per year.

    Personalized treatment plans

    We treat the whole person, not just the disease. Our highest priority is providing our patients and their loved ones with exceptional medical and supportive care. An integrated team of medical specialists, nurses specializing in pancreatic cancer, and other support staff collaborate in the management of your care.

    Your health care team will take the time to connect with you one-on-one, listen, and understand your needs and preferences, so that you can be an active participant in your treatment. We offer the most advanced therapies possible, while also helping you maintain your quality of life during treatment. We encourage you to be actively involved in the decision-making process.

    Multidisciplinary approach

    Your team of specialists — gastroenterologists, medical oncologists, radiation oncologists, surgical oncologists, pathologists, radiologists, palliative care physicians, and a dedicated nursing, nutrition and social work staff — works closely together from your initial diagnosis and throughout your entire treatment, ensuring that your care is coordinated.

    Because specialists from each discipline regularly discuss your care, we ensure that all available approaches to treatment are considered, and that you receive the combination of treatments that works best for your care. Our team works closely with other specialists, ensuring that you have access to our entire team of world-renowned experts.

    Clinical trials and tumor testing

    Our specialists are actively involved in research, and apply the latest knowledge to your care. Testing of tumors for genetic changes is available to all of our patients, and this information may be used to make decisions regarding clinical trials and new treatment approaches.

    Supportive resources

    To address all of your physical and emotional needs, we provide a comprehensive range of support services and complementary and integrative therapies. We offer individual and family counseling, rehabilitation and physical therapy, pain and symptom management, acupuncture, massage, Reiki, and support groups.

    If you would like a second opinion, or to have our team consult on your care plan...

    If you have been diagnosed with pancreatic cancer and would like a second opinion, please contact us. To maximize our ability to assist with your care, it is important that you get a second opinion before you start treatment.

    We regularly consult with patients at all stages of pancreatic cancer. We perform specialized diagnostics and surgery on patients from around the world, who then return to their local hospitals for further treatment.

    Our expertise can be invaluable when deciding what kind of treatment to pursue. Some reasons to consider a second opinion include:

    • To confirm your diagnosis
    • To determine the optimal sequence for your therapies
    • To learn more about your pancreatic cancer from a knowledgeable specialist who has treated other patients just like you
    • To better understand your options for treatment
    • To learn if you are eligible for a clinical trial

    Phone: 877-442-DFCI or 877-442-3324
    Online: Complete the Appointment Request Form 

    Treatment for pancreatic cancer

    The main types of treatment for pancreatic cancer include:

    • Surgery
    • Chemotherapy
    • Radiation therapy

    Surgically removing the tumor is the main opportunity to cure a pancreatic tumor that has not spread to involve major blood vessels or to other organs, such as the liver. Therefore, we intently work to make patients on the border of being able to have surgery become candidates through other forms of therapy.

    Radiation therapy and/or chemotherapy may be used before or after surgery or instead of surgery if the cancer cannot be entirely removed.

    You may find it helpful to think of the stages of pancreatic cancer in these treatment-related terms:

    • Resectable: Surgery is the primary treatment, often with chemotherapy and/or radiation before or after surgery.
    • Borderline resectable: Chemotherapy and/or radiation (and possibly targeted agents from a clinical trial) are followed by surgery, if possible.
    • Unresectable: Chemotherapy and sometimes radiation (and possibly targeted agents from a clinical trial) are used without surgery.
    • Metastatic: Chemotherapy (and possibly targeted agents from a clinical trial) is the main treatment.

    Gastroenterology

    A gastroenterologist is often the first physician you see for the initial diagnosis. We use advanced endoscopic techniques, including evaluation of tumors with endoscopic ultrasound, to conduct biopsies and make a diagnosis. You also will see a gastroenterologist if you develop a complication, such as a blocked bile duct, that should be cleared in order for you to start or continue treatment.

    Gastroenterology at our Center includes physicians who manage pancreatic diseases and physicians who perform complex endoscopic procedures to diagnose and manage problems. We also have gastroenterologists who focus on patients who are at high risk for developing pancreatic cancer.

    If you have a family history of gastrointestinal cancer, you can meet with our genetic counselors for an in-depth risk assessment, including a detailed family lineage analysis, genetic evaluation using state-of-the-art molecular tests, and tailored cancer screening and prevention recommendations.

    Surgery

    Dr. Michael ZinnerDr. Michael Zinner is Chairman of the Department of Surgery of the Brigham and Women’s Hospital and is a pancreatic cancer surgeon. 

    A vitally important component of treatment for some patients with a pancreatic tumor is surgery. At the Pancreaticobiliary Tumor Center, our pancreatic surgical team consists of experienced, high-volume surgical oncologists who focus primarily on these diseases.

    • Our gastrointestinal surgeons specialize in pancreatic cancer.
    • Our surgical nurses specialize in gastrointestinal and pancreatic procedures.

    Quality is associated with experience: We perform more than 100 pancreatic cancer surgeries per year, including the Whipple procedure (a complex procedure to remove the head of the pancreas, the duodenum, part of the common bile duct, gallbladder, and sometimes part of the stomach). Studies show that high surgical volume directly relates to improved patient outcomes. While postoperative mortality at high-volume pancreatic centers across the country is approximately four percent, high-volume pancreatic surgeons at the Center have postoperative mortality rates at one percent or below, among the lowest rates reported.

    Dedicated pancreatic surgeons use a variety of innovative techniques including:

    • Minimally invasive and robotic surgeries using laparoscopic techniques.
    • Spleen preservation, when possible, for distal pancreatectomy.
    • Whipple procedures, including pylorus-preserving procedures, depending upon the tumor.
    • Portal vein resection for selected patients.
    • Newer surgical procedures to remove larger tumors that were previously considered inoperable.

    Medical oncology and chemotherapy

    Dr. Charles FuchsDr. Charles Fuchs is Director of the Center for Gastrointestinal Cancer and is a pancreatic cancer medical oncologist and researcher. 

    Our 20 medical oncologists are national leaders in improving the use of chemotherapy for pancreatic cancer through clinical trials and basic research.

    We work with our large multidisciplinary team to direct your care. Because of our close integration with other specialists in our Center, our team offers you their collective expertise when formulating and executing an optimal care plan.

    When indicated, our medical oncologists administer chemotherapy, a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Our medical oncologists are highly experienced in optimizing chemotherapy and reducing side effects, and your oncologists use their extensive expertise to determine the most appropriate care plan for you. Our medical oncologists:

    • Have experience with the latest therapies and have the expertise to tailor these therapies to each patient for the greatest likelihood of a good outcome. Our team will discuss these options with you and your family to determine the right care plan.
    • Address difficult symptoms you may be experiencing, such as jaundice, nausea, weight loss, and emotional distress.

    Throughout your treatment, our team of nurses, dietitians, social workers, and other staff will work to minimize side effects of chemotherapy and maximize your quality of life.

    Clinical trials

    Because we are a research center as well as a clinical provider, the Pancreaticobiliary Tumor Center offers you clinical trials for pancreatic cancer and provides you with the most innovative treatment options, which may not be available elsewhere. We typically have multiple clinical trials open at a time for patients with pancreatic cancer.

    Clinical trials study the safety and efficacy of new treatments or new combinations of treatments. Most of today's standard treatments for cancer are based on earlier clinical trials.

    Some clinical trials include only patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not improved. There are also clinical trials that test new ways to stop cancer from recurring or reduce the side effects of treatment. Patients can enter clinical trials before, during, or after starting cancer treatment, depending on the design of the trial.

    Radiation oncology

    Our radiation oncologists are national leaders in the use and study of radiation therapy for pancreatic cancer. You will receive a carefully considered, customized plan to use radiation therapy when it is likely to be most effective.

    It is critical that radiation therapy is appropriately sequenced for treatment because the order in which you receive treatments makes a difference. We encourage patients who have been diagnosed elsewhere to see us for a second opinion before starting radiation therapy.

    • Radiation therapy uses high-energy x-rays to kill cancer cells or keep them from growing. External radiation therapy uses a machine outside the body to send radiation toward the cancer.
    • Internal radiation therapy, sometimes used if your cancer affects the biliary tract, uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.

    Radiation therapy may be recommended:

    • After surgery and chemotherapy to further decrease the chance of the cancer returning.
    • To reduce the tumor prior to surgical resection.
    • Prior to surgery to help reduce the tumor so it's operable.
    • To help control cancers that cannot be removed surgically.

    Your hospital care

    We treat the whole person, not just the disease. 

    If your treatment calls for a surgical procedure or you need to be admitted to the hospital for any reason, you will receive your care at Brigham and Women's Hospital.

    Learn more about your hospital stay at Brigham and Women's Hospital.

    Surgical, post-surgical and additional inpatient care is provided by the Dana-Farber/Brigham and Women's Cancer Center team at Brigham and Women's Hospital.

    All outpatient infusion therapy is provided at the Yawkey Center for Cancer Care at Dana-Farber Cancer Institute, one of the most advanced outpatient cancer centers in the country.

    Radiation Oncology has two separate units, one at Brigham and Women's Hospital and the other at Dana-Farber. Both are staffed by 25 radiation oncologists who work at both locations.

    For Referring Physicians

    Because you are an integral part of your patient's care team, we are committed to collaborating with you in the care of your patient.

    If you are a physician and have a patient with a pancreatic cyst, or with diagnosed or suspected pancreatic cancer, we look forward to working with you and encourage you to contact us early in your patient's care.

    Find out more about how to refer a patient to DF/BWCC.

    Next: Our Pancreatic Cancer Specialists 

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    • For adults:
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  • Pancreaticobiliary Tumor Center

    • Learn how the Pancreaticobiliary Tumor Center at Dana-Farber/Brigham and Women's Cancer Center brings together the resources and focus of our patient caregivers and scientists, to advance research and treatment of pancreatic and biliary tract diseases.
  • Find a Pancreatic Cancer Clinical Trial

  • Dana-Farber/Brigham and Women's Cancer Center Patient Handbook