Mapping Progress in Pancreatic Cancer Surgery: Continuing to Move the Needle

In this second episode of OncChats: Mapping Progress Made in Pancreatic Cancer Surgery, Horacio J. Asbun, MD, and Domenech Asbun, MD, both of Baptist Health South Florida, share examples of efforts that have moved the needle forward in pancreatic cancer surgery, and note potential areas of opportunity.

HA: There is no question that pancreas surgery today is very different than [what it was] before, but I do agree with you. Despite [the fact] that the surgery has improved, the outcomes of the procedure, in terms of overall prognosis, have not. You still need surgery [to achieve] curative results; without surgery, patients are not cured. But [for] those [in whom] we do surgery, the overall prognosis has not changed for several years. That’s when, as you said, chemotherapy and other modalities play a significant role.

DA: Absolutely. I want to also add that it’s nice to see that a lot of these changes have [improved] outcomes after surgery, [in terms of] morbidity and mortality; some of [these changes] have actually increased survival. But there’s also an increase in quality of life [QOL]. When a patient has a very serious diagnosis, even one that may be terminal, QOL is even more important in some ways because it has a very big impact on that patient’s life. As such, it’s nice to see those [kinds of] advances.

HA: Absolutely. You’re absolutely right. We have seen that, for example, with distal pancreatectomy, meaning left-side pancreatectomy and non-Whipple [procedures]. I cannot say this officially, of course, [but] it’s almost like, why don’t we do palliative surgery for those patients? Because they’re not going to have the infiltration of the celiac trunk, they’re not going to have the amount of pain, and yes, they may succumb to the disease anyway, but [with] the distal pancreatectomies, when done by experienced people through a minimal access approach, the results are so good that palliation may play a role. Who knows?

DA: Right, and [for] those surgeries [that] we do with 4 ports and no drains people are usually home in a few days. So, it’s a different approach to treating cancers [compared with] knowing that they would be in the hospital for 2 weeks as almost a mandatory prescription.

Check back next Wednesday for the next episode in this series.