Pancreatic Cancer and the Whipple Procedure


Few cancers are as serious as pancreatic cancer.  Often showing no symptoms in its early stages, pancreatic cancer is usually detected long after it has metastasized to nearby organs, sometimes going as far as to enter the bloodstream.

Most patients diagnosed with pancreatic cancer receive a grim outlook on their chances of survival.  Even if detected early, those with pancreatic cancer face a long road ahead in terms of recovery.

In order to have the best shot at beating this deadly cancer, most pancreatic doctors will recommend surgery.  Removing all of the disease is one of the only ways a patient with pancreatic cancer will survive.

Today we will look at what both endocrine and exocrine cancers are and why leading pancreatic surgeons in the Baltimore area are likely to perform the Whipple Procedure on any patient diagnosed with pancreatic cancer.


Types of Pancreatic Cancer

Pancreatic cancer develops when abnormal cells within the pancreas begin to grow uncontrollably into tumors.  There are two types of cells in the pancreas – the endocrine cells and exocrine cells.

  • Endocrine cells. These produce gastrointestinal enzymes and hormones, such as insulin and glucagon, into the bloodstream for transportation to other parts of the body.
  • Exocrine cells. These produce and secrete substances, such as pancreatic juice, into the small intestine (rather than directly into the bloodstream) to help with the digestive process.

Since there are two types of cells in the pancreas, two types of cancer are possible.


Endocrine Pancreatic Cancer

This type of pancreatic cancer is the least common and is most often benign.  Tumor growth affects the endocrine cells in the pancreas, specifically where insulin and other important hormones release into the bloodstream.

One unique feature of endocrine tumors is that they sometimes function to produce hormones of their own that release into the bloodstream.  This causes unusual symptoms but again, are most often benign.


Functional Endocrine Tumors

Functional endocrine tumors in the pancreas fall into one of these categories:

  • This is a tumor producing gastrin in the pancreas.  Gastrin is a hormone that signals the stomach to release an acid to help digest food.  If a gatsrinoma develops, both gastrin and stomach acid levels rise causing ulcers and diarrhea.
  • This is a tumor producing insulin in the pancreas.  Insulin helps control the amount of sugar in the bloodstream and helps push sugar into cells so the body can use it for energy.  Insulinomas can throw this balance off but are typically slow growing and benign.
  • This is a tumor producing glucagon in the pancreas.  Glucagon increases the amount of glucose (or sugar) in the bloodstream when levels are low.  Too much glucose in the bloodstream causes high blood sugar.

Two-thirds of pancreatic endocrine cancers are not functioning, meaning they do not produce hormones of their own.


Exocrine Pancreatic Cancer

The majority of pancreatic cancers develop in the exocrine cells of the pancreas.  In fact, over 95% of pancreatic cancer falls under the category of exocrine cancer.  Further, more than 8 out of 10 exocrine pancreatic tumors are adenocarcinomas, meaning they begin forming in the cells lining the pancreatic duct.

Two rare types of pancreatic cancer require surgery involve cystic tumors and cancer of the acinar cells.

  • Cystic Tumors. These tumors create a cyst of fluid to form in the pancreas.  Although many of them are benign, some are very dangerous and require your Whipple procedure surgeon to remove them.
  • Cancer of the acinar cells. Acinar cells are near the end of the pancreas and are responsible for producing pancreatic juices.  When these cells are affected by cancerous cells, again the Whipple procedure is usually the best treatment option.


Pancreatic Cancer and the Whipple Procedure


Since pancreatic cancer is so difficult to diagnose, often turns up in its late stages, and has a poor long-term prognosis, surgery is usually the best solution for trying to battle this nasty cancer.

The most common surgical option for treating pancreatic cancer is the Whipple procedure.  Performed by an experienced Whipple procedure surgeon, such as Baltimore’s finest, Dr. Fraiman, this surgical treatment of pancreatic cancer offers the best chances at a positive outcome.

During the Whipple procedure, the head of the pancreas, the gallbladder, and the bile duct, as well as parts of the stomach and small intestine are removed.


Other Surgical Alternatives

Unfortunately, when it comes to treating pancreatic cancer, your Whipple surgeon will most likely explain that there are no good alternative surgical options.

Although total removal of the pancreas is sometimes an option, there are many complications, both pre- and post-surgery that can make things worse for someone who has pancreatic cancer:

  • Pancreatic cancer affects the digestive process causing many patients to be too malnourished to be a good candidate for a total pancreatectomy.
  • Removing the entire pancreas removes the body’s natural insulin producer, which leads to diabetes if not carefully monitored forever.
  • The metabolic damage that results is far worse than what results from a Whipple procedure operation.


Whipple Procedure Success

Despite being the best treatment option for pancreatic cancer, the Whipple procedure does not come without its own set of complications.

In fact, it takes a very experienced and knowledgeable Whipple surgeon to think about performing such a highly complex surgery.

In addition, it takes a dedicated and multidisciplinary team of highly trained physicians and assistants to help perform a successful Whipple procedure on a patient.  After all, there is not just the surgery to think about when it comes to treating pancreatic cancer.  There is perioperative care, therapists, nutritionists, and more that play a role in a patient’s Whipple procedure aftercare.

In the end, a specialized pancreatic surgeon and a well-coordinated team are what it takes to meet the task of beating pancreatic cancer.  And, with the prognosis being so grim despite having the best medical care available, it is important that patients with pancreatic cancer enlist the help of the very best.

If you are looking for the very best Whipple surgeon in the Baltimore area, contact Dr. Fraiman at the Liver and Pancreas Center today.  He has over two decades of experience and comes staffed with physicians and assistants that provide the highest standard of care possible.

As an expert treating pancreatic disease, as well as a Whipple procedure professional, Dr. Fraiman is just the type of pancreatic surgeon you want fighting this battle by your side.