Knight Cancer Institute experts work together to give you tailored care for pancreatic cancer. We know how important it is to provide the right treatments in the right order.

Our care includes:

• World-class surgeons who make surgery possible for more patients
• Compassionate providers to help you live the best and longest life possible
• Advanced chemotherapy and radiation therapy
• Specialists who pool their knowledge to review results and plan treatment
• Clinical trials and advanced therapies in collaboration with the Brenden-Colson Center for Pancreatic Care

This page focuses on care for exocrine pancreatic cancer. We also treat pancreatic neuroendocrine tumors, or NETs.

Treatment goals

We have patients who are long-term survivors of pancreatic cancer. For most patients, though, a cure isn’t possible because the cancer spread too far.

Even so, you may enjoy years or months of meaningful life. You may set goals such as taking a special trip or attending a loved one’s wedding or graduation.

At the Knight Cancer Institute, your goals become our goals. Your team will be devoted to extending and improving your life regardless of your long-term outlook.

Whether your tumor can be removed in surgery will guide many decisions. This is important because removing all of the tumor, combined with other treatments, is the only path to a cure.

Based on your diagnosis, your tumor will be described one of these ways:

• Resectable: Removable with surgery
• Borderline resectable: May be removable with surgery
• Locally advanced: May or may not be removable with surgery
• Unresectable: Not removable with surgery

Resectable or borderline resectable

You may have chemotherapy or chemoradiation (a combination of chemotherapy and radiation therapy) to shrink the tumor before surgery. This helps increase the chance that surgeons can remove all the cancer.

If you have surgery, you may have more treatments to destroy any remaining cancer cells. This lowers the chances of cancer coming back.

Locally advanced

You will get chemotherapy and maybe radiation therapy. Some patients with locally advanced pancreatic cancer have surgery.

Unresectable

Your treatment plan may include:

• Chemotherapy and radiation therapy to slow cancer and control symptoms
• A procedure to keep your bile duct open
• Palliative care to control pain and ease symptoms
• A clinical trial with a new therapy that may lengthen and improve your life

Chemotherapy for pancreatic cancer

Chemotherapy delivers cancer drugs in an IV, in a process called infusion. Depending on the drugs, patients may have an infusion every week or every other week. Each infusion takes several hours.

Chemo can come with big side effects. Still, research shows that it helps people with pancreatic cancer live longer and more comfortably.

Our medical oncologists (doctors who are experts in cancer medications):

• Use the most advanced drugs and infusion techniques
• Tailor drugs to each patient’s needs
• Provide chemotherapy in a way that offers the best outcome, for example by making sure a patient still qualifies for clinical trials

When chemotherapy is given

Doctors decide when to offer chemotherapy based on each patient’s needs.

Before surgery (neoadjuvant): 

• Chemotherapy can destroy cancer cells, helping make sure surgery removes more cancer.
• It can shrink some borderline tumors enough to be removed with surgery.
• It can attack tiny clusters of cancer cells that doctors can’t see, making surgery more successful.
• It can help doctors see if chemotherapy fights the cancer. This helps avoid putting people through major surgery that won’t help.

After surgery (adjuvant): Chemotherapy after surgery can kill cancer cells circulating nearly anywhere in the body, increasing chances of living longer.

If you’re not having surgery: Some patients receive only chemotherapy or radiation therapy.

Radiation therapy for pancreatic cancer

Radiation therapy uses beams of energy to destroy cancer cells. For pancreatic cancer, radiation therapy is external, meaning you get it from a machine outside your body.

The Knight Cancer Institute uses the most precise methods. We are also one of the nation’s top cancer centers to offer radiation therapy during surgery.

When radiation therapy is given

Studies show that patients with pancreatic cancer do best when they receive radiation therapy before or after surgery, not both. Radiation during surgery, however, can be combined with either.

Before surgery (neoadjuvant): Radiation therapy might be combined with chemotherapy to shrink a tumor before surgery.

During surgery: Interoperative radiation therapy can be precisely delivered in a large dose.

After surgery (adjuvant): Radiation therapy can kill any cancer cells left after surgery, improving chances of living longer.

If you’re not having surgery: You might have radiation therapy to slow the cancer’s growth and to control symptoms.

Pancreatic cancer surgery

We provide the highest level of surgical care and make surgery possible for as many patients as possible. Our surgeons do nearly 100 pancreatic surgeries each year.

• Your care team will make sure you are as healthy as possible for surgery.
• Your pancreatic surgeons and vascular surgeons will work together to remove cancer and repair blood vessels.
• We offer minimally invasive and robotic-assisted surgery for patients who qualify.
• We offer complete follow-up services to keep you healthy after surgery.

Preparing for pancreatic surgery

Proper nutrition and activity in the weeks before surgery can lower the risk of complications and speed recovery.

If you are having surgery, first you will see:

• A cancer dietitian, to help you improve your diet and activity
• A physical therapist, to help improve your fitness
• A mental health counselor, if needed, for you and your family
• Staff in our pre-operative medicine clinic, to make sure you are ready for surgery for the best results
• Our perioperative team, to make sure the day of surgery is as safe and comfortable as possible.

The Whipple procedure is the most common surgery to remove pancreatic cancer. It’s named after Allen Whipple, the first American doctor to do it. Because it has a higher risk of complications and requires a long recovery, our doctors advise some patients against it.

How it’s done: The surgeon removes most of the pancreas. The surgeon may also remove the duodenum (top of the small intestine), gallbladder, part of the bile duct and part of the stomach. The surgeon reconnects the remaining pancreas, bile duct and small intestine so you can digest food. The surgeon also reattaches the stomach and small intestine to restore your digestive tract.

Why experience matters: This surgery is very complex. Skilled surgeons can greatly lower risk. Knight surgeons do dozens of these surgeries a year. We are consistently named as one of the best hospitals in the country for gastrointestinal surgery.

Vascular expertise: Our pancreatic surgeons work with expert vascular surgeons to repair and rebuild blood vessels damaged by or surrounded by cancer. This makes surgery possible for patients who didn’t qualify in the past.

Follow-up care

After surgery, many people need:

• Enzyme pills for digestion
• Insulin shots in the hospital to control blood sugar

After you leave the hospital, you can continue care with a cancer dietitian or an endocrinologist, a doctor who is an expert in hormones.

Clinical trials

As Oregon’s only academic health center, OHSU is a leader in researching new ways to prevent, detect, treat and manage pancreatic cancer. We offer clinical trials to test therapies for every stage of illness. Your care team will work to find a trial for you.

Learn more

• OHSU Brenden-Colson Center for Pancreatic Care
• Treating Pancreatic Cancer, American Cancer Society
• Pancreatic Cancer Treatment, National Cancer Institute
• Treatment, Pancreatic Cancer Action Network
• Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment, National Cancer Institute