Inoperable Pancreatic Cancer: What treatment options are there?

Hi @anto1nette, I moved your post to this existing discussion with other members for whom surgery was not an operation as a treatment for their pancreatic cancer. It sounds like you’re not getting the information in the way that you need it from your husband’s care team. Have you considered meeting with an oncology social worker?

Here’s a blog written by the oncology social work team at Mayo Clinic. They describe best
- How an Oncology Social Worker Can Help https://connect.mayoclinic.org/blog/cancer-education-center/newsfeed-post/how-an-oncology-social-worker-can-help/

Among other things, a social work can answer questions as well as help you interpret your husband’s diagnosis, treatment options, and how to prepare for what is to come and what you can expect. As the article states, they can be a vital bridge between you and your medical team.

@anto1nette You don't mention where your husband is receiving treatment or if you have gotten a second opinion. Pancreatic surgery is highly specialized and if the doctors you've seen aren't extremely experienced with pancreatic surgery they might not see a surgical path possible. Other specialists might be more optimistic and surgery might become more viable after completing chemo. Many pancreatic patients receive chemo in order to improve enough for surgery. Good luck.

There are three highly experienced surgeons in NYC for second opinions regarding the Whipple procedure when vasculature is involved. At the Pancreas Center of Columbia Presbyterian Mefical Center is Chief of Surgery of that Department Dr. John Chabot who is noted for doing very difficult and challenging procedures.

At MSKCC is Dr. Michael D’Angelica and others.

NYU Langone Medical Center is Dr. Christopher Wolfgang who was previously at John’s Hopkins.

A study done at Massachusetts General Hospital and published in May 2019 showed that an older drug for treating high blood pressure called Losartan when combined with chemotherapy could be repurposed to shrink tumors away from vasculature. Sixty-one percent of study participants went on to having the Whipple. LetsWinPC.org featured a patient that participated in the study. I personally know of a patient that had this drug regimen that resulted in the tumor being reduced away fro the vasculature and went on to have the Whipple.

Losartan
https://news.harvard.edu/gazette/story/2019/05/mass-general-trial-shows-novel-protocol-improves-pancreatic-cancer-outcomes/

My wife's surgery was by Chris Wolfgang while he was at JHH. He is a wonderful person and a phenomenal surgeon. We were blessed that our Florida gastro was a JHH alum and made the arrangements immediately upon diagnosis. 9 rounds of folfirinox before surgery.

No comment on what options there are without surgery that’s what article was about?

The article addressed the situation where patients were initially classified as not being surgical candidates. By repurposing an FDA approved drug Losartan, 61% of the study participants were able to have Whipple surgery after treatment-that was the sole purpose of the article and it accomplished its objective.

Here are options for non-resectable patients either because the tumor is in a difficult location such as significant involvement of vasculature or metastatic spread-
https://www.healthline.com/health/inoperable-pancreatic-cancer#diagnosis

My husband has a large tumor that has vascular involvement and was told here in OKC that it is inoperable. Am I understanding that they tried surgery then was not able remove the tumor after they got in there?

University of Michigan attempted the surgery but after they opened me up the surgeon realized he could not remove the tumor because of vein involvement.
I then went to Mayo Clinic for a second opinion and Dr. Truty did the surgery and was able to reconstruct the vein.

@kware53, how are you and your husband doing? What treatment did they offer your husband? Did you consider a second opinion?