• 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. 

    Dana-Farber/Brigham and Women's Cancer Center provides exceptional care to patients challenged with pancreatic cancer. An integrated team of medical specialists, nurses specializing in pancreatic cancer, and other support staff will collaborate in the management of your care. 

    Pancreatic cancer is treated at the Center for Gastrointestinal Oncology at Dana-Farber/Brigham and Women's Cancer Center (DF/BWCC). Our multidisciplinary team includes surgeons, gastroenterologists, medical oncologists, radiation oncologists, radiologists, pathologists, palliative care physicians, and a dedicated nursing, nutrition and social work staff.

    Gastroenterology

    A gastroenterologist is often the first physician the patient with pancreatic cancer sees for the initial diagnosis or for the management of complications – such as a blocked bile duct – that must be corrected before surgery or chemotherapy can begin. Our gastroenterologists have extensive experience in bile duct stenting. 

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

    The Endoscopy Center at Brigham and Women's Hospital offers evaluations and treatments for disorders of the esophagus, stomach, small bowel, colon and the biliary/pancreatic system.

    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. 

    Our pancreatic surgical team, one of the most experienced in the country, has been working together for more than a decade. Because of the team's close integration with other specialists in treating diseases of the pancreas, they offer patients their collective expertise when formulating an optimal care plan. The team includes surgical nurses who specialize in gastrointestinal and pancreatic procedures. 

    A vitally important component of treatment for some patients with a pancreatic or biliary tumor is surgery. We know that quality is associated with experience: we perform more than 100 pancreatic cancer surgeries per year, including over one Whipple procedure per week.

    Surgeons at our Pancreaticobiliary Tumor Center use a variety of innovative surgical techniques including:

    • Staging laparoscopy in appropriate cases to exclude spread of disease before further surgery
    • Laparoscopic (or minimally invasive) distal pancreatectomies, depending upon the tumor
    • Spleen preservation when possible
    • Standard Whipple procedures which removes tumors of the head of the pancreas, distal bile duct, and duodenum
    • Pylorus-preserving Whipple procedures, depending upon the tumor
    • Portal vein resection for selected patients
    • Preoperative chemotherapy or chemo-radiotherapy in selected cases

    Medical Oncology and Chemotherapy

    Our medical oncologists will work with the large multidisciplinary team to direct care and formulate a clear treatment plan to rapidly engage all of our resources. 

    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 oncologists use their extensive expertise to determine the right care plan for each patient.

    • At the first meeting, we address difficult symptoms the patient may be experiencing including pain, jaundice, nausea, weight loss and emotional distress. We will also arrange meetings with our extensive support services staff including palliative care, nutrition and social work services.
    • We provide efficient and rapid processes to begin treatment as soon as possible through coordination of diagnostic testing, evaluation, and diagnosis with the entire team.
    • We have experience with the latest therapies and have the expertise to tailor these therapies to each patient for the greatest likelihood of success. Our team will discuss these options with you and help to determine the right care plan.

    Our medical oncologists are national leaders in improving the use of chemotherapy for pancreatic cancer through clinical trials and basic research that improves our understanding of the disease.

    Clinical Trials

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

    More than ever before, there is new hope for patients with pancreatic cancer. We are at the frontier of new therapies to treat this disease. 

    Dana-Farber/Brigham and Women's Cancer Center offers the largest number of medical oncology clinical trials for pancreatic cancer in New England, providing patients with innovative treatment options that may not be available elsewhere. Our medical oncologists are leading national and international trials of cutting-edge therapies. Because we are a research facility as well as a clinical provider, we have the capacity to move discoveries from the laboratory quickly into the clinic for the benefit of our patients.

    Clinical trials are part of the cancer research process. Clinical trials explore if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. We are also working hard to understand the basic biology of this disease in order to develop more effective treatments.

    Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring or reduce the side effects of cancer treatment.

    Patients can enter clinical trials before, during, or after starting their cancer treatment. 

    Find a clinical trial for pancreatic cancer 

    Radiation Oncology

    Each patient will receive a carefully considered, customized plan to use radiation therapy when it is most likely to be effective. Our radiation oncologists are national leaders in the improvement of radiation therapy for pancreatic and biliary cancers. 

    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 for biliary tract cancers, uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated. Radiation therapy is often recommended in the following settings:

    • After surgery and chemotherapy to further decrease the chance of the cancer returning
    • Prior to surgery to help shrink the tumor and make the surgery more likely to succeed
    • To help control cancers that cannot be removed surgically

    Patients treated with neoadjuvant (preoperative) or adjuvant (postoperative) chemotherapy and/or radiation therapy are discussed at our multidisciplinary treatment conference.

    Inpatient Care

    We treat the whole person, not just the disease. 

    Patients requiring surgery for pancreatic cancer are cared for by a dedicated team of pancreatic specialists who are part of our specialized gastrointestinal surgical oncology team. Our medical, nursing, and support staff all have special expertise in working with patients with these cancers – providing treatment and assisting each patient through a medically and emotionally challenging time.

    Surgery takes place in the operating rooms at Brigham and Women's Hospital, whose gastrointestinal and cancer surgery program is recognized widely as one of the best in the country. Post-surgical care and other inpatient care are provided by the Dana-Farber/Brigham and Women's Cancer Center team at Brigham and Women's Hospital.

    Most of our outpatient care takes place at Dana-Farber Cancer Institute. Infusion therapy is provided at the new Yawkey Center for Cancer Care, one of the most advanced outpatient centers in the country, which was designed with the input of patients and families to meet their specific needs.

    Information about your hospital stay at Brigham and Women's Hospital 

    For Referring Physicians

    Because the patient’s primary care physician or community specialist is an integral part of the patient’s care team, we are committed to collaborating in the care of your patient.

    If you are a physician and have a patient with pancreatic cancer, we look forward to working with you.

    How to refer a patient 

    Managing Symptoms and Side Effects

    We understand that both the symptoms from pancreatic cancer and cancer treatment can be physically and emotionally challenging. We offer a complete range of support services to address these issues. 

    Pain Management

    The Adult Palliative Care Division of the Psychosocial Oncology and Palliative Care Department at Dana-Farber/Brigham and Women's Cancer Center helps adults with cancer live as well as possible while facing a serious or life-threatening illness.

    Our expert physicians and nurse practitioners are available as consultants to your clinical team, and we see patients with pancreatic cancer from the time of first diagnosis. Ask your clinical team to consider consulting with us if you are suffering from uncontrolled pain, nausea, vomiting or other symptoms, or if you have questions about how palliative treatment can help you meet your personal goals.

    Find out more about our pain management and palliative care services 

    Fatigue and Depression

    Fatigue and depression are often experienced by individuals going through cancer treatment. Our adult psychosocial oncology team helps pancreatic cancer patients and their families maintain the best quality of life during and after treatment. Our clinicians include physicians, psychiatrists, psychologists, nurses, social workers, and a pharmacist who work closely with patients and their health care team to provide integrated care and support your unique needs.

    Find out more about these and other services provided by our Adult Psychosocial Oncology Program 

    Weight Loss

    Patients with pancreatic cancer have special nutritional needs. Surgery to remove the pancreas may interfere with the production of pancreatic enzymes that help to digest food. As a result, patients may have problems digesting food and absorbing nutrients into the body. To prevent malnutrition, your doctor may prescribe medicines that replace these enzymes.

    Our nutrition department is available to further support your nutritional needs and answer any questions you may have regarding your diet. Our nutritionists are registered dietitians with special expertise in managing challenges experienced by pancreatic cancer patients.

    About our nutrition services for pancreatic cancer patients 

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  • Gastrointestinal Cancer Treatment Center

    • Learn more about Dana-Farber/Brigham and Women's Cancer Center's treatment and support for patients with gastrointestinal cancers.
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