Pancreatic Cancer Surgery

Nearly 2,000 people with pancreatic cancer in all stages of disease seek treatment from our cancer experts every year. Over 300 of them undergo curative surgery at Mayo Clinic in Rochester, Minnesota, so you can feel confident you are in expert hands

Pancreatic cancer typically is not caught until it has reached an advanced stage. Historically, most people with advanced pancreatic cancer whose tumors have grown outside the pancreas to involve critical blood vessels (veins and arteries) have been told their cancer is inoperable and incurable.

We have changed that.

We developed a unique and aggressive approach to treating pancreatic cancer and now offer life-saving treatment to more patients than ever before. We have redefined who is a candidate for surgery, increased survival rates and made more cures possible.

Most people with tumors that involve critical veins and arteries come to us after being told elsewhere that their cancer was inoperable. Mayo Clinic is one of the few centers in the world with highly specialized surgeons who routinely perform surgeries involving blood vessel reconstruction. In addition, we have the most experience with minimally invasive pancreatic cancer surgery.

Our pancreatic cancer team has found that customized treatment plans including personalized chemotherapy followed by radiation and complex surgery with blood vessel reconstruction can lead to excellent outcomes and a positive impact on long-term survival.  

Our advanced treatment options include a wide range of surgeries, chemotherapy, radiation, immunotherapy, combination therapies and promising clinical trials. Based on your unique goals, we will help you choose what treatment is right for you.  

Accurate pancreatic cancer staging is critical to receiving the right treatment. As part of your initial evaluation at Mayo Clinic, you will have access to state-of-the-art imaging technology and molecular diagnostic tools, many of which are not available anywhere else in the world. Through this comprehensive assessment combined with our specialized knowledge of this disease, you can be confident you are getting the most accurate diagnosis and staging with the most appropriate treatment recommendations. 

Time is critical with an aggressive pancreatic cancer. We are dedicated to getting you an appointment quickly. Your multidisciplinary team of pancreatic specialists will guide you through a comprehensive diagnostic and staging evaluation with a custom treatment plan. In some cases, this can be done with a condensed 1-to-2-day appointment itinerary. 

Your team of pancreatic cancer specialists includes surgeons, radiologists, medical and radiation oncologists, endocrinologists, nutritionists and more. They work together on your case and help you choose the best treatment plan for your needs.     

Mayo Clinic is recognized as one of the leading centers for pancreatic cancer treatment. Our many clinical trials provide more options and hope for people with pancreatic cancer. 

If you have been told curative surgery is not an option because of where your tumor is located or because of blood vessel involvement, a second opinion from the pancreatic cancer team at Mayo Clinic could expand your treatment choices and increase your long-term survival. We are revolutionizing the standard of care for pancreatic cancer and offering potentially curative treatment options to people who have been told they have none.  

Treatment innovations for pancreatic adenocarcinoma.

We're finding that patients with more advanced tumors, who typically would have survival of less than a year, using our protocol and our aggressive procedures, we can extend that to five years, on average, but many patients beyond that. The traditional approach is a patient has some symptoms. They get a CAT scan. There's a mass. There's no evidence of spread.

They would go to the operating room immediately to try to take the tumor out. And invariably, they would either leave some cancer behind, or the patient would have a complication after surgery, and they wouldn't get any chemotherapy, and the cancer would come back quite rapidly, and so a completely pointless exercise.

So now what happens, a patient comes in, and as long as they're not metastatic-- meaning no spread of cancer anywhere-- and then regardless of the involvement of the blood vessels, they have to grow appropriate staging. So not only do they get CT scans, we have special types of PET scans that we get to better identify where the tumor is and how active it is, a variety of different blood tests that can look for circulating cancer within their blood.

We also stage their abdomen, take a look in the abdomen to see if there's any microscopic cancer cells. And then they go through an extensive duration of chemotherapy to kill all the cancer that we can't see-- that's the specific thing-- not just what we can't see, because we know most people have cancer cells elsewhere in their body.

After we do the chemotherapy, we have to prove that what we're giving is effective. So we use the PET scans and all these blood markers to prove that the chemo we're giving is particularly effective. At that point, we move on the radiation therapy to treat not only the main tumor, but the surrounding structures. And then after that, we come up with a pretty aggressive operative plan to remove the entire tumor and all the at-risk tissues, and then put that patient back together in a livable manner with a good quality of life.

Maybe even 10 years ago, we were saying, if the tumor's touching major vessels, we really shouldn't even try to remove it. Now we're seeing, well, the tumor's touching major vessels, but the patient has had a good response to chemotherapy. We should remove the vessels, too, and reconstruct the vessels, and do what we can to rid them of their disease.

Those operations do carry much higher risk in terms of complications, et cetera, and therefore, if I'm going to put a patient through a higher risk procedure, I need to look them in the eye and say, hey, this operation makes sense long term. And therefore, we have to treat them, prior to surgery, appropriately. That's the critical thing. The operation has a benefit to that patient.

We do have much better chemotherapy than we've had in the past. For about two decades, we've only had one single drug that had very poor response rates. Now we have combinatorial chemotherapy, several different regimens, that have tripled the response rate and doubled the survival for patients with pancreas cancer. So we're utilizing those much more effectively.

As the chemotherapy is taking effect, patients start to feel better oftentimes, and they might be able to eat more. They might be able to have less pain, and thus, can regain some strength with more energy. And that actually can sometimes help get them to a better state for surgery. In the past, the typical survival rate for patients diagnosed with pancreas cancer was less than 20% at five years.

If we treat patients with that multi-modality approach-- meaning as aggressive as possible with chemotherapy, surgery, and sometimes radiation-- we can potentially get a much better five-year survival rate.

The one thing, particularly from a surgical point-of-view, that we have the greatest evidence for is the volume and outcome relationship, meaning the more types of procedures a surgeon or an institution does, the better their outcomes are, in terms of complication rates, long-term survival, et cetera. That has been shown time and time again. So you definitely want to be treated at a center that does this at a very high volume and is very comfortable with that.

Get Personalized Cancer Treatment From the Experts Revolutionizing Pancreatic Cancer Care

Making the inoperable, operable.

Count on our expert team to provide accurate cancer staging and prompt treatment.

We are your partner throughout your journey, during treatment and after.

Gain access to the latest, innovative clinical research trials.

When it's time to find answers, you know where to go.

Contact us to request an appointment.

Treatment innovations for pancreatic adenocarcinoma.

Mayo Clinic Comprehensive Cancer Center is designated by the National Cancer Institute as a comprehensive cancer center.

Mayo Clinic Comprehensive Cancer Center is nationally accredited by the American College of Surgeons' Commission on Cancer (CoC).