To find out if it might be possible to remove the cancer, your surgeon will look at:
- the size of the tumour
- where it is in the pancreas
- whether the cancer has grown into the tissues around the pancreas
- whether the cancer is in any of the
lymph nodesaround the pancreas
- whether the cancer has grown into the major blood vessels in or around the pancreas
- whether the cancer has spread to any other parts of the body
Your scans show the size and position of the tumour. A tumour less than 3cm across is likely to be removable.
Surgeons are more likely to be able to remove cancers in the head of the pancreas than in the body or tail of the pancreas. This is because they tend to be diagnosed at an earlier stage.
Scans might show cancer spread to other parts of the body. In some cases, your surgeon may still advise you to have surgery even if there is a suspicion the cancer might have spread to the nearby lymph nodes or major blood vessels.
Different types of surgery
If it is possible to remove your cancer your surgeon might suggest a:
Your surgeon removes all your pancreas.
Your surgeon removes the body and tail of your pancreas.
Pylorus preserving pancreaticduodenectomy (PPPD)
A PPPD operation means removing:
- the head of your pancreas
- the duodenum - the first part of the small bowel (intestine)
- part of the bile duct
Kausch Whipple operation
This is usually called a Whipple's operation. It's the same as a PPPD operation but you also have part of your stomach removed.
The opening of the bile duct is right next to the opening of the pancreatic duct. So it is not unusual for pancreatic cancer to block the bile duct by pressing on it or growing over it. This can stop bile draining from the liver, causing jaundice. You might have yellowing of the skin or whites of the eyes.
You might have an operation to relieve symptoms caused by a blockage in the bile duct, such as sickness and jaundice.
You might be very sick if the cancer is blocking the very top of your small bowel (duodenum). This is because the blockage stops food passing into the bowel. Your surgeon might do an operation to bypass any blockages.
Small tubes (stents) to help with symptoms
Instead of surgery, you are now more likely to have a small tube (stent) put in to keep the bile duct or duodenum open to help relieve symptoms.