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Understanding Treatment
Surgical Candidate
The Whipple procedure (pancreatoduodenectomy) is the primary surgical treatment for pancreatic cancer at this time. If you are a candidate for a Whipple, make sure you ask the right questions, especially regarding how many Whipples your doctor and his/her affiliated institution have performed. Don't be afraid of offending the doctor. As with any surgery, there is a correlation between surgery volume and successful outcome.
Borderline Cases
If surgery has been ruled out, but your cancer is somewhat contained, you'll want to consider a multi-disciplinary approach. This means that an entire team works together to treat you as a whole. If this is the correct approach for you, you need to ask which doctors are assigned to your team and how they will communicate with each other and you as they plan and carry out treatment. Again, do not be afraid to ask questions. If your doctors cannot communicate with you now, this does not bode well for their ability to communicate with each other during treatment.
Stage 4
Stage 4 means the cancer has traveled to distant organs, and I understand that most medical professionals will treat with chemotherapy. One of the standard chemotherapy drugs for the treatment of pancreatic cancer is Gemzar. Some larger centers do offer clinical trials mostly comparing the efficacy of Gemzar versus Gemzar in combination with additional drugs. My understanding is that there are no placebo treatments in pancreatic cancer trials but if this is a concern, consult with the trial coordinator prior to participating. Be persistent in getting information, and don't fear getting your doctor angry. When it comes to pancreatic cancer, the squeaky wheel does get the grease.
