Inoperable Pancreatic Cancer

Medically reviewed by Yamini Ranchod on October 30, 2017Written by Julie Marks on October 30, 2017

What is inoperable pancreatic cancer?

Pancreatic cancer is cancer that starts in the pancreas — an organ in your body that sits behind your stomach. Your pancreas helps your body digest food and regulate blood sugar.

Inoperable pancreatic cancer means doctors can’t remove the cancer surgically. Usually, surgery isn’t an option because the cancer has spread to other areas in your body or is in a problematic location.

More than 53,000 Americans are told they have pancreatic cancer each year. Yet only between 15 percent and 20 percent of people with pancreatic cancer are candidates for surgery.

Read on to learn more about what treatments are available for inoperable pancreatic cancer.

Types of inoperable pancreatic cancer

Metastatic cancer

Your doctor might say your condition is inoperable if the cancer has metastasized. This means your tumor has spread to other parts of your body and can’t be removed by surgery.

Pancreatic cancer commonly spreads to the liver. Additionally, other organs, such as the lungs, bone, and brain, may be affected.

If your cancer has spread to other organs, your doctor might label it as stage 4.

Locally advanced

A locally advanced tumor is one that hasn’t spread to other organs but still can’t be removed with surgery. A lot of times, the cancer can’t be taken out because it’s too close to major blood vessels.

Surgery doesn’t help people with locally advanced pancreatic tumors live longer, so doctors usually won’t perform the operation.

Recurring cancer

If your cancer comes back during or after treatment, it’s known as recurring cancer. Sometimes recurring cancer can’t be operated on because it’s spread to other organs. For instance, when pancreatic cancer recurs, it commonly crops up in the liver first.

Your treatment options will depend on how much your cancer has spread and your overall health.

How is it diagnosed?

Pancreatic cancer is often diagnosed when the disease is more advanced because it doesn’t cause symptoms early on. By the time a person notices symptoms, the cancer may have already spread outside the pancreas.

Some tests that can spot pancreatic cancer include:

  • Imaging tests. CT scans, MRIs, ultrasounds, and PET scans are all used to help doctors see the cancer inside your body. Some of these tests involve first receiving an injection of an intravenous (IV) contrast, so doctors can see more of what’s going on.
  • Endoscopic ultrasound. With this procedure, your doctor will pass a thin tube down your esophagus and into your stomach to take images of your pancreas.
  • Biopsy. Sometimes your doctor might take a small piece of tissue from your pancreas to examine under a microscope. A biopsy can be performed through a needle or during an endoscopic ultrasound.
  • Blood tests. Your doctor might use a blood test to measure liver function, certain hormone levels, or certain proteins, such as cancer antigen (CA) 19-9. Pancreatic tumor cells release CA 19-9. This blood test isn’t always reliable, however.

These tests can help your doctor determine if you’re a candidate for surgery. But in some cases, they won’t show cancer that’s spread, and your doctor might find it when he opens you up to operate.

Treatment options

Even though surgery isn’t an option for inoperable pancreatic cancer, there are several available treatments. Some aim to attack the cancer, while others are used to manage your symptoms.

Chemotherapy

Chemotherapy uses special medications to kill cancer cells. It can be delivered as an injection or an oral pill. In people with inoperable pancreatic cancer, chemotherapy is usually used to control the growth of cancer and improve survival. Sometimes, different chemotherapy combinations are given together. Here are seven helpful things to know about chemotherapy.

Radiation

Radiation uses high-energy beams to kill cancer cells. It’s sometimes given along with chemotherapy. Some medical centers offer newer forms of radiotherapy that target tumors more precisely, such as CyberKnife or NanoKnife.

Targeted therapies

These treatments target only cancer cells, while leaving healthy cells alone. Some targeted therapies, such as trastuzumab (Herceptin) and cetuximab (Erbitux), may help people with advanced pancreatic cancer. They’re sometimes combined with traditional chemotherapy.

Biological therapy

These treatments are given to prompt your immune system to fight the cancer in your body. They’re being studied to treat pancreatic cancer tumors and can be used alone or in combination with chemotherapy.

Other procedures

Some procedures can help control specific symptoms. For example, your doctor might recommend inserting a small stent in your body to relieve symptoms of a blocked bile duct, which might include nausea and vomiting.

Novel treatments through clinical trials

Clinical trials are available to test novel treatments for inoperable pancreatic cancer. Being involved in a clinical trial could give you access to new therapies that you might not otherwise be given.

Talk to your doctor if you think you’d like to participate in a clinical trial. You can also visit ClinicalTrials.gov/ to search for studies in your area.

Outlook

When providing a prognosis, your doctor might give you information on five-year survival rates. This refers to the percentage of people who live at least five years after being diagnosed. According to the American Cancer Society, people with stage 4 pancreatic cancer have a five-year survival rate of about 1 percent.

Pancreatic cancer, in general, has the highest death rate of all major cancers. Only 9 percent of people with this cancer will survive more than five years.

People with pancreatic cancer who can have surgery typically live longer than those who don’t. While the best hope for survival is surgery to remove the cancer, it’s not an option for many. That’s why treatments are available to help you manage symptoms.

It’s important to remember that survival rates are based on population-level data. They won’t tell you what will happen in your specific situation. As newer ways to detect and treat pancreatic cancer are being discovered, these statistics may change in the future.

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