Pancreatic cancer arises when abnormal cells in the pancreas grow uncontrollably, forming a tumor. It most often involves the exocrine cells (adenocarcinoma) and can spread locally or to distant organs.
Why Do I Need Evaluation and Treatment?
You may be evaluated if you experience:
- Painless jaundice (yellowing of skin/eyes)
- Unexplained weight loss or poor appetite
- Upper abdominal or back pain
- New-onset diabetes or worsening blood-sugar control
- Imaging (CT/MRI) shows a pancreatic mass
Early diagnosis and a tailored treatment plan increase the chance of successful therapy and symptom relief.
How Should I Prepare?
- Arrange companion support for appointments and recovery.
- Fasting for 6–8 hours before imaging (CT/MRI) or endoscopic procedures.
- Bring a complete list of current medications and allergies.
- Undergo preoperative blood tests (CBC, liver/kidney function, coagulation) and cardio-pulmonary evaluation.
- Meet with nutrition and endocrine teams to plan enzyme supplementation and blood-sugar monitoring.
What Happens During Diagnosis and Treatment?
- Staging and Biopsy
- Contrast-enhanced CT or MRI pancreas protocol to assess tumor size, vessels, and spread
- Endoscopic ultrasound (EUS) with fine-needle aspiration (FNA) for tissue diagnosis
- Multidisciplinary Planning
- Specialists in surgery, oncology, gastroenterology, radiology, and nutrition review your case and recommend the optimal sequence of treatments.
- Surgical Resection (if tumor is resectable)
- Whipple procedure (pancreaticoduodenectomy) for head-of-pancreas lesions
- Distal pancreatectomy (± spleen removal) for body/tail tumors
- Neoadjuvant Therapy (borderline resectable)
- Chemotherapy ± radiation to shrink the tumor before surgery
- Adjuvant Therapy (after resection)
- Combination chemotherapy (e.g., FOLFIRINOX or gemcitabine-based) to reduce recurrence
- Definitive Chemoradiation (locally advanced)
- Concurrent chemotherapy and targeted radiation when surgery is not feasible
- Palliative and Supportive Care (unresectable or metastatic)
- Systemic chemotherapy regimens to control tumor growth
- EUS-guided celiac plexus neurolysis for refractory pain
- ERCP or EUS-guided biliary stenting to relieve jaundice
- Pancreatic enzyme supplements and dietary adjustments for malabsorption
What Can I Expect Afterwards?
- Hospital Stay:
• Surgery: 7–14 days
• EUS/ERCP interventions: same day to 1–2 days
• Chemotherapy infusions: outpatient or short admission - Diet & Nutrition:
• Start with clear liquids; advance to soft, then regular meals as tolerated
• Pancreatic enzyme capsules with every meal
• Small, frequent, high-protein, high-calorie meals - Pain & Symptom Management:
• IV and oral analgesics; neurolysis for intractable pain
• Antiemetics to control nausea
• Blood-sugar monitoring and insulin adjustments - Activity:
• Early mobilization after surgery; gentle at-home activity during chemotherapy
• Avoid heavy lifting for 6–8 weeks post-surgery
Risks & Possible Complications
- Surgical:
• Pancreatic fistula (10–20%)
• Delayed gastric emptying (20–30%)
• Bleeding, infection - Chemotherapy:
• Neutropenia, fatigue, nausea, neuropathy - Radiation:
• Skin changes, fatigue, GI irritation - Interventions:
• Post-ERCP pancreatitis (5–10%)
• Stent occlusion or migration
Report immediately any of the following:
• High fever, chills, or signs of infection
• Uncontrolled abdominal or back pain
• Severe nausea/vomiting or inability to eat
• Jaundice recurrence or dark urine
• Sudden weight gain or swelling
Follow-Up
- Imaging & Markers: CT/MRI and CA 19-9 every 3 months for the first 2 years, then every 6 months
- Clinical Reviews: Oncology and surgical visits post-treatment to monitor recovery and manage side effects
- Nutrition & Endocrine: Regular dietitian counseling and glucose tests to optimize digestion and metabolic control
- Palliative Support: Ongoing symptom management and psychosocial care as needed
