Sunday, March 3, 2024

Is Chemo Necessary After Whipple Surgery

Where Is The Whipple Procedure Performed

Whipple Operation Hospital Stay & Recovery | Roswell Park Patient Education

The Whipple procedure is a complex operation with a high risk of major complications. It takes a lot of skill and experience to perform the surgery and manage any complications. To get the best outcome, youll want to have a very experienced surgeon and be in a hospital that performs at least 15-20 Whipple procedures each year.

Chemotherapy After Surgery To Remove The Cancer

You should be offered chemotherapy after surgery to remove the cancer , to try to reduce the chances of the cancer coming back. There are three types of chemotherapy that may be used:

The type of chemotherapy you are offered will depend on how you are feeling and what your doctor thinks will be best for you.

You should be given time to recover properly from your surgery before starting chemotherapy, as you need to be well enough for six months of chemotherapy. Chemotherapy may start up to 12 weeks after your surgery.

Pancreatic cancer and surgery to remove it can cause problems with digestion, including weight loss, losing your appetite, and changes to your poo. If you have any problems after surgery, speak to your doctor, nurse or dietitian to make sure these dont delay the chemotherapy. A dietitian is an expert in diet and nutrition.

What Should I Expect After The Whipple Procedure

The Whipple procedure is a significant surgery. Recovery from the procedure will take some time.

Youll have pain for a while after your Whipple procedure. During your hospital stay, your care team will manage your pain and watch for signs of infection or other complications. Youll be on a clear, liquid diet for a few days until your healthcare providers feel that youre ready to introduce solid foods. As soon as you feel up to it, you should start doing lung exercises and moving about your room just be sure to call a nurse or physical therapist for help getting up so you dont fall.

Also Check: New Prostate Cancer Treatment In Germany

Am I Too Old For The Whipple Procedure

While there is no age limit for the Whipple procedure, age-related issues and conditions may impact a patients medical course and outcome. The geriatric oncology experts in the Specialized Oncology Care & Research in the Elderly clinic assist our oncologic surgeons in evaluating older patients considering the procedure.

Who Should Perform The Whipple Procedure

Thread by @ebtapper: " How do we provide a prognosis of ? A Let

The Whipple procedure can take several hours to perform and requires great surgical skill and experience. The area around the pancreas is complex and surgeons often encounter patients who have a variation in the arrangement of blood vessels and ducts.

After the Whipple procedure was introduced, many surgeons were reluctant to perform it because it had a high death rate. As recently as the 1970s, up to 25% of patients either died during the surgery or shortly thereafter.

Since then, improvements in diagnosis, staging, surgical techniques, anesthesia, and postoperative care have reduced the short-term death rate to less than 4% in patients whose operation is performed at cancer centers by experienced surgeons. At some major centers, the reported death rate is less than 1%. But the rate may still be above 15% in patients who are treated at small hospitals or by less experienced surgeons.

Because the Whipple procedure continues to be one of the most demanding and risky operations for surgeons and patients, the American Cancer Society says it’s best to have the procedure done at a hospital that performs at least 15 to 20 pancreas surgeries per year. The organization also recommends choosing a surgeon who does many such operations.

Recommended Reading: Chem-x Stars And Stripes

Chemotherapy For Advanced Pancreatic Cancer

When surgery is not possible you may have chemotherapy. The aim is usually to shrink the cancer, relieve symptoms and help you to live for longer. This is called palliative chemotherapy. You may have treatment with a single chemotherapy drug. Or you may have 2 or 3 combined.Common treatments are:

You and your doctor can talk about the type of chemotherapy that is most suitable for you. For example, FOLFIRINOX is a combination of three drugs and can cause more side effects.

What Can I Expect From Chemotherapy

Chemotherapy not only weakens and destroys cancer cells at the site of the tumor, but throughout the body as well. Unfortunately, this means that chemo can unintentionally harm the development of normal cells like your hair, nails, mouth, and digestive tract.

Chemo can be used at any stage of cancer. It can be used for advanced cancer. It also can be used once the cancer has been removed. It destroys any cancer cells possibly left behind. This can help prevent the cancer from coming back. If you are going to have surgery, your doctor may recommend that you have chemo and radiation before the surgery to shrink the tumor.

The side effects chemo causes depend on the type of chemotherapy you receive and how many cycles you receive. The most common side effects of chemo are:

  • Nausea and vomiting
  • Sores inside your mouth
  • Numbness in your hands and feet
  • Diarrhea, loose stool
  • Increased urgency to have a bowel movement or urinate

When chemotherapy is given at a lower dose, these side effects are less common. This sometimes happens when radiation is necessary too. If you experience side effects, call your physician right away. It is better to address side effects right away because there are numerous drugs available to help manage side effects.

Also Check: Docetaxel Prostate Cancer Life Expectancy

What Is Radiation Like What Happens

Radiation can be delivered in three ways:

  • External-beam radiation therapy: With external-beam radiation therapy, the radiation comes from outside your body. It is targeted at a specific area of the body. This therapy usually consists of daily treatments over several weeks. A machine called a linear accelerator is the most common machine used to give external-beam radiation. The most common type of external-beam radiation is three-dimensional conformal radiation therapy . This uses computer software to direct the radiation to a very precise area of the body. There are many other forms of external-beam radiation therapy. Your radiologist will know which is right for you.
  • Internal radiation therapy : With internal radiation therapy, a radiologist places radioactive material inside the body. These seeds give off radiation to destroy nearby cancer cells. The seeds may be placed inside the body with needles, catheters, or minor surgeries. Some of the seeds are permanent, and some are temporary. The permanent seeds stop giving off radiation over time. They do no damage by remaining in the body.
  • Systemic radiation therapy: With this type of therapy, the patient swallows or receives injections of a radioactive substance. This substance helps destroy cancer cells throughout the body. Radioactive iodine, a specific type of systemic radiation, is commonly used for thyroid cancer. Other types of systemic radiation may be used for hematological cancers.
  • What Causes Ampullary Cancer

    What is the Whipple procedure? – UChicago Medicine

    Experts arent sure what causes ampullary cancer. However, we know that cancer begins when cells develop mutations in their DNA. These abnormal cells start to multiply and grow out of control.

    There are certain factors that can increase your risk of developing ampullary cancer. These risk factors include:

    Don’t Miss: Where Is The Pain With Pancreatic Cancer

    What To Expect After The Whipple Procedure

    Youll likely stay in a hospital for about 8 to 10 days after the procedure so your healthcare team can monitor you for complications. Theyll also run tests to see if they removed all of the cancer.

    You may experience pain from the surgical incisions. Pain is usually initially controlled with medications administered through a spinal catheter or IV. Once you can resume eating, youll likely be given oral pain medications.

    Youll slowly be able to start drinking and eating again several days after the procedure. If you develop delayed stomach emptying, you may need to feed through tubes for several weeks.

    Many people undergo chemotherapy or radiation therapy after recovering from surgery.

    It can take anywhere from a few months to a year to feel relatively normal again. Many people take pancreatic enzymes to help digest food. You may have to make permanent dietary changes.

    You can expect to lose a significant amount of weight after the procedure. Youll doctor will likely want to perform a checkup within 3 weeks, and then in regular intervals.

    Why Should I Choose Uchicago Medicine For My Whipple Surgery

    Studies show that hospitals performing a high volume of Whipple procedures achieve a lower mortality rate than hospitals that perform few pancreatic resections. The American Cancer Society recommends patients have the Whipple operation at a hospital that does at least 15 to 20 of these surgeries a year. Surgeons at UChicago Medicine perform as many as five times that many Whipple procedures annually.

    Recommended Reading: Best Lotion For Chemo Skin

    Chemotherapy For Pancreatic Cancer

    Chemotherapy may be used at any stage of pancreatic cancer to kill cancer cells. Chemotherapy drugs are usually administered in cycles, with alternating periods of treatment and recovery. They may be given alone or in conjunction with radiation therapy or surgery.

    According to the American Cancer Society, the following chemotherapy drugs may be used to treat pancreatic cancer:

    • Irinotecan liposome

    If the patients health is strong enough, two chemotherapy drugs may be used together to fight pancreatic cancer. They may be given intravenously or by mouth. Chemotherapy is very powerful and can lead to a wide range of side effects, including hair loss, nausea and vomiting, changes in appetite and fatigue.

    Life Expectancy After Whipple With Pancreatic Cancer

    Oncologist Searching and Reading Digitally across India

    Hi there, my dad is 65 years old was diagnosed with pancreatic cancer stage 3. My sister and I talked to the doctor before surgery, they suspected cancer. After Whipple surgery we got news that dad’s hystology results are ready, he has pacreatic cancer, 3.5 cm with 2 lymph nodes out of 22. He is recovering from the surgery right now, it has been a month. Eating well but always so so tired and sleepy. We want to bring him to live with us, we live in the US, it is a long flight and we don’t know what to expect next few month. Does anyone here went though Whipple surgery and pancreatic cancer at this stage, what is your experience, what is the life expectancy? I pray we have few months with dad here, he just got his first grandson from me and my sister is due in June. We hope dad will have a chance to see them. We have an appointment with oncologist next week, I am not sure if chemo worth it at this stage

    Hello LiyaShake

    I’m sorry to hear about your Dad’s diagnosis and all that he has been through. It’s good to hear that he is recovering from the surgery although it’s to be expected that he is tired.

    It’s difficult for us to say what your Dad’s prognosis maybe but hopefully the appointment with the Oncologist next week will give you the answers needed so that your Dad can make decisions about his future and the possible move.

    Best wishes,

    You May Like: What Is The Difference Between Radiation And Cyberknife

    Pancreatic Cancer Research And Clinical Trials

    UT Southwestern is enrolling patients in three pancreatic cancer clinical trials.

    Ourresearchers are studying how a drug that inhibits a specific receptor called tyrosine kinase AXL can make chemotherapy more effective. We will collect biopsies from patients to help us discover why treatments do and dont work. The study is a multicenter project, and it is open and enrolling patients. Explore the trial.

    In another exciting study, we are investigating whether immunotherapy medications that dont work well alone against pancreatic cancer might be effective in shrinking tumors when combined. Preliminary data are promising. Learn more.

    We are also enrolling patients in a trial to determine whether warfarin, a drug most commonly used as a blood thinner, can be combined with chemotherapy to improve overall survival. Learn more.

    What To Expect During The Whipple Procedure

    On the day of your surgery, your surgeon and anesthesiology team will answer any last-minute questions in the preoperative area. Youll then be taken to the operating room where youll be given an intravenous line into your arm. You may also receive a spinal injection and local nerve block injections around your abdomen to minimize pain.

    Youll be put to sleep with medications administered through the IV. A urinary catheter will be inserted into your bladder to drain urine.

    The surgery usually takes about 5 to 7 hours to complete. During the procedure,

  • The surgeon will make a central incision or several small incisions in your abdomen.
  • They will then remove part of your pancreas, duodenum, bile duct, gall bladder, and possibly part of your stomach depending on the technique being used.
  • The remainder of your pancreas will be attached to your small intestines and your small intestines will be reattached to your stomach.
  • Read Also: Whats The Cure For Cancer

    For Two Years After Treatment David Felt Well And He Went Back To Work Then He Developed

    So what happened after that?Did you have a CT scan every time you went back?And then what happened?And did they take X-rays or?Okay, and they referred you?Can you tell us what a PET scan is like please?And whats it like in the room when its being done?And this radioactive substance, how does that get into you, did you say?Right.Did they do a CT scan then?This is 2009?Oh dear.Oh dear.

    Two Years After Her Surgery And Chemotherapy Ann Had Bowel Problems Again She Also Had

    Chemo, radiation, surgery combo boosts survival for pancreatic cancer patients with veins involved

    EMBED CODEIt was comfort food rather than you felt that other foods would upset you?

    David had a Whipples operation, then chemotherapy and radiotherapy. After his treatment he felt very well for two years. Then he started to feel unwell again. He felt sick, off his food and had diarrhoea. He had CT scans and blood tests but they looked normal. David felt ill for over a year. Eventually he had more CT scans and a PET scan and this time the doctors could see that his cancer had come back.

    Also Check: Best Gummies For Chemo Nausea

    What Are The Steps Of The Whipple Procedure

    The Whipple procedure can be summed up in a few steps:

  • A large incision will be made in your abdomen .
  • Your surgeon will remove the portion of your pancreas where the tumor is located along with the small bowel surrounding it , the lower section of the bile duct, the gall bladder and sometimes a part of your stomach.
  • Whats left of your pancreas and bile duct get attached to your small intestine.
  • The small intestine is then reattached to your stomach, ensuring that food can pass through the entire digestive tract.
  • Prognosis After The Whipple Procedure

    Overall, the five-year survival rate after a Whipple procedure is about 20 to 25%. Even if the procedure successfully removes the visible tumor, it’s possible that some cancer cells have already spread elsewhere in the body, where they can form new tumors and eventually cause death.

    The five-year survival rate is higher in node-negative patients than for node-positive patients.

    Regardless of node status, most patients receive chemotherapy, radiation, or both after surgery. However, cancer specialists have differing opinions on the best combination and the best drugs to use.

    Recent trials have shown improved outcomes with chemotherapy before surgery and with different chemotherapy regimens before and after surgery.Ã

    Show Sources

    Also Check: How To Help Someone With Cancer

    Signs Or Symptoms Of Cancer Returning

    Here people talk about the signs and symptoms they had when their pancreatic cancer returned. It may come back in the pancreas or spread to other parts of the body. A tumour formed by cells that have spread is a ‘secondary’ or metastatic’ tumour or a metastasis.

    Some people found out their cancer came back from a routine check-up. Other people had symptoms like they’d had before. People told us about:

    Treatment For Pancreatic Cancer

    Oncologist Searching and Reading Digitally across India

    Pancreatic cancer can be difficult to treat.

    The treatment you have will depend on:

    • the size and type of pancreatic cancer you have

    It may include surgery, chemotherapy, radiotherapy and supportive care.

    The specialist care team looking after you will:

    • explain the treatments, benefits and side effects
    • work with you to create a treatment plan that is best for you
    • help you manage any side effects, including changes to your diet to help you digest your food

    You’ll have regular check-ups during and after any treatments. You may also have tests and scans.

    If you have any symptoms or side effects that you are worried about, talk to your specialists. You do not need to wait for your next check-up.

    Read Also: Bcg Treatment For Bladder Cancer

    Ann Was Often Concerned About Tiredness During Her Remission Various Pains Were Investigated But

    EMBED CODEI was thinking, going back to talk about the one or two times during the course of the last year that, how youve dealt with thinking about it, every now and then thinking, This is it.And then maybe ending up with why you felt very sure this time, di- —— as you hadnt previous times. I mean there have, youve quite often said to me for instance that, I feel weary.What do you think, what do you think you meant by that?

    Adjuvant Therapy More Than 12 Weeks After Surgery Vs Surgery Alone

    On Cox MVA , adjuvant therapy more than 12 weeks after surgery was associated with improved survival compared with surgery alone. After Cox MVA, treatment interactions were observed in a node-positive disease subgroup, favoring the adjuvant therapy for OS compared with surgery alone . No treatment interactions were seen in other variables, including age, CDS, tumor size, pathologic T stages, surgical margin, duration of postoperative inpatient admission, unplanned readmission within 30 days after surgery, and time from diagnosis to surgery.

    A total of 655 propensity-matched pairs were constructed for adjuvant therapy initiated more than 12 weeks after surgery vs surgery alone. All variables were well balanced between these cohorts . The overall median follow-up was 41.9 months for the adjuvant therapy cohort and 33.6 months for the surgery alone cohort. The median OS was 21.1 months for the adjuvant therapy cohort and 15.5 months for the surgery alone cohort. Overall survival at 2 years was 47.2% and 38.0% for the adjuvant therapy and surgery alone cohorts, respectively .

    Recommended Reading: Chemo Cream Before And After

    Latest news
    Related news