Borderline Resectable Pancreatic Cancer

With over 20 years as a leading liver and pancreas surgeon in Baltimore, Maryland, Dr. Fraiman has helped numerous patients facing borderline resectable pancreatic cancer.

If you or a love one have been diagnosed with borderline resectable pancreatic cancer, Dr. Fraiman may be able to help you too.

Treatment for Borderline Resectable Pancreatic Cancer Now Possible

Localized pancreatic cancer involving the superior mesenteric artery, superior mesenteric vein, or portal vein “borderline resctable” has previously been viewed as inoperable or an unresectable disease.

Recent data incorporating multimodality therapy, in combination with Whipple surgery — that includes portal vein/superior mesenteric vein resection — has shown promising results, achieving long-term survival similar to those patients having a classically resectable disease.

Once patients are classified as “borderline resectable” based on imaging studies at the initial presentation, a multimodality approach to therapy can be planned in conjunction with a medical and radiation oncologist.

Patients typically receive induction chemotherapy, followed by radiation treatment. Surgery is performed for patients who exhibit no evidence of tumor progression or metastases during treatment.

The Whipple procedure is performed in conjunction with resection and reconstruction of the portal/superior mesenteric vein. Below are two videos that demonstrate this surgical approach.

What Is Borderline Resectable Pancreatic Cancer?

Approximately one-third of patients with locally advanced pancreatic cancer will be borderline resectable. Borderline resectable cancers are those that can be completely removed by surgery based on the results of CT scan imaging and other tests.

Signs and Symptoms of Borderline Resectable Pancreatic Cancer

Some of the symptoms and signs of borderline resectable pancreatic cancer include:

  • Jaundice
  • Nausea and vomiting
  • Stomach and back pain
  • Poor appetite and weight loss
  • Blood clots
  • Diabetes

Treatments for Borderline Resectable Pancreatic Cancer

Here are the treatment options for borderline resectable pancreatic cancer. Our multidisciplinary team will decide your treatment based on your individual needs and work with you to ensure a successful recovery:

1. Chemotherapy

Chemotherapy is usually the first treatment for borderline resectable pancreatic cancer. It is administered to try and shrink the tumor before other treatments can be introduced.

Chemotherapy may be given alone or in combination with radiation therapy (chemoradiation). After this treatment, the surgeon will reassess the tumor by using a CT scan to find out whether it has shrunk.

2. Radiation Therapy

Radiation therapy is often given along with chemotherapy. It is also typically given to patients whose tumor responds to chemotherapy treatment. It is not administered first because it is unlikely to shrink the tumor on its own. Tumors that continue to grow during chemotherapy are treated as advanced tumors and may require additional treatments.

3. Surgery

Our surgeons will perform surgery if CT scans show that the tumor has shrunk in size and can now be completely removed. The type of surgery done will depend on the size, location and the number of tumors. Surgery is often the only chance for a complete cure from borderline resectable pancreatic cancer. Surgical options include:

  • The Whipple Procedure is used to remove tumors that are found in the head of the pancreas. In this procedure, the surgeon will take out the head of the pancreas, the first part of the small intestine, part of the bile duct, the last part of the stomach and the duodenum.
  • Distal Pancreatectomy may be used to take out tumors found in the body or tail of the pancreas. In this procedure, the surgeon will remove the body and tail of the pancreas along with the spleen.
  • Total Pancreatectomy may be used only if the tumor has to be removed completely. It’s very difficult to recover from this surgery, so it is not used as often. Total pancreatectomy removes the whole pancreas, the duodenum, the spleen, the pylorus and the bile duct.

Surgery Recovery Period

Patients usually stay in the hospital for up to seven days after successful surgery, followed by two to three months of recovery at home. If you’re looking for the best surgeon in Baltimore area, contact Dr. Fraiman.

He has over 20 years of experience and comes staffed with a dedicated and multidisciplinary team of physicians and nurses that provide the highest level of care possible. As an expert in treating borderline resectable pancreatic cancer, Dr. Fraiman is just the surgeon you want by your side for the best chance of complete cure.

Contact Our Pancreas Specialists Today

For more information regarding borderline resectable pancreatic cancer or a consultation with Dr. Fraiman or one of our pancreas specialists, please feel free to get in touch by completing our contact form. We will get back to you as soon as possible.

Dr. Fraiman – leading pancreas surgeon in Baltimore, MD – describes the technique of Whipple surgery with portal vein resection for borderline resectable pancreatic cancer.
Watch as Dr. Fraiman performs a Whipple procedure with portal vein resection.