Pancreatic Cancer Surgery Q&A w/ Dr. Stauffer on September 4

what is the difference between the new trials with the KRAS inhibitors and the RMC-6236?

Are there any new treatments for the mutation KRAS G12V?

Would you recommend any surgery/nanoknife for metastatic pancreatic cancer in the tail, stage IV?

Stage IV with Mets to liver considering histotripsy or nanoknife. Since oligometastaic, would surgery be better option? I am progressing (shrinking) with chemo at 4months of Flu.

Wife will complete 12 Folfirinox treatments. It has not determined if she is stage 3 or 4. Oncologist has delayed biopsy indicating Folfirinox would be the treatment for either stage. Suspicious spots on liver but no biopsy until full chemo is completed. What is your opinion of NanoKnife for either stage 3 or 4 (liver involvement) and is SBRT a better approach than conventional radiology after completion of chemo?

I have adenocarcinoma pancreatic CA, stage 1b, Whipple done 6/10, and have completed 8/12 chemo cycles. Surgeon said there were no attachments or invasions, CA was encapsulated within the mass, nothing in my lymph nodes. But the CA may still come back?

I am writing from Antalya, Turkey. I underwent distal pancreatectomy and liver resection surgery on August 4. The surgery went smoothly, and I am currently resting. What do you recommend following this surgical procedure? My oncologist suggested chemotherapy. What do you think? Thank you.

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I am a 75 year old female diagnosed Sept. 3, 2024, a year a go. I have adnocarcinoma 7 cm long. My Dr. considers me stage 4 with no cancer anywhere else but in the celiac axis, the body and tail. With the 3 scans the tumor has shrunk .5 inches. Dr. said inoperable and I will not servive this. I was on Gemsar and Abraxane but am now off the Abraxane because of side effects. I am now on Gemsar and nothing else. As of right now I am the same as I was a year ago. Dr. said eventually the tumor may reject the chemo. I was told I was getting chemo only for quality time. I am in Palliative Care. (I am hoping this is where you post for Dr. Stauffer)

Thank you for your question, and I understand how difficult and complex this situation must feel. Your oncologist is correct that the initial treatment course would typically be the same regardless of final staging. The goal is to assess how the disease responds to systemic chemotherapy before making decisions about local therapies like surgery or radiation. I recommend continuing to work closely with your oncology team at a high-volume pancreatic cancer center to fully explore and understand your options. Best wishes to you and your family.

Yes, we use NanoKnife for a very select group of patients. However, this is uncommon, as we prefer an aggressive, margin-negative resection when technically feasible.

Sometimes we offer novel techniques such as irreversible electroporation (IRE) and intraoperative radiation therapy (IORT) as complements to resection.

Both IRE and IORT target cancer cells after the tumor removal and require a radiation oncologist to be in the operating room, something unique to Mayo Clinic.

Thank you for reaching out, and I’m glad to hear that your surgery went smoothly. It sounds like you’ve already made it through a significant step in your treatment.

Following a distal pancreatectomy, the typical next step often involves considering adjuvant chemotherapy. I would recommend continuing to work closely with your oncology team to plan your next steps in terms of the best treatment approach.