Inoperable Pancreatic Cancer
Inoperable pancreatic cancer is a cancer tumor that because of its location and/or stage rules out surgery as a treatment. Many pancreatic tumors are inoperable by the time they are discovered. This occurs because they have usually already advanced to a late stage. Early stages of pancreatic cancer do not display specific symptoms, so the tumors grow unnoticed until they are large enough or have spread to enough areas that they begin causing things such as abdominal pain, high blood sugar, and jaundice to name a few. In fact, only about 15 to 20 percent of tumors can still be surgically removed at the time of diagnosis. And only 30 percent of people who can undergo the surgery live longer than 5 years.
Most pancreatic cancer is deemed inoperable because it has invaded neighboring blood vessels, metastasized or spread to organs, or grown directly into surrounding structures. It is still technically possible to operate on the pancreas, but by this time surgery on the pancreas is almost pointless and carries far more risks than it does benefits.
The initial location of the pancreatic cancer tumor has an influence on whether or not surgery will be an option. A tumor can grow on the head, body, or tail of the pancreas. If it is occurs on the head, its symptoms appear early, thus doctors may catch it before it spreads. But if it is on the body or tail, it usually does not display symptoms. So by the time the tumor is found, it has spread to its neighbors.
Another sign of whether or not you have inoperable pancreatic cancer is where the cancer has spread. For instance, if it is only in the lymph nodes around the pancreas, the spread is considered locoregional and is operable, or resectable. But if the cancer is found in other areas, it is usually inoperable (unresectable), though surgeons must make the final decision.
One such place is the lymph nodes. If the cancer has moved into the lymph nodes of the liver or even more distant nodes, it is probably unresectable. The same is true if the cancer has invaded the liver, which is common with tail and body tumors. The liver's complexity and role make surgery impossible, and the fact that the cancer has spread makes the surgery futile.
A structure called the Ligament of Treitz near the pancreas is another target for cancer spread. The ligament isn't really a ligament but a thin muscle. It circles the small intestine at the duodenum and jejunum's intersection. Then it wraps behind the pancreas to anchor and to the spine and diaphragm.
The celiac plexus is a distance above the pancreas but still an appealing site for cancer. The plexus is a nerves network around the aorta. Even if surgery here would be useful, the amount of nerves would make it very dangerous.
Two types of blood vessels called the superior mesenteric vessels and the portal vein also make cancer inoperable when it has invaded. The superior mesenteric brings blood to and from the bowels. It is related to the pancreas and so may spread or carry the tumor. The portal vein runs adjacent to the pancreas and connects to the liver. Cancer in the vein may be considered operable depending on the malignancy's spread.
Though cancer that has spread to the above areas may signal inoperable pancreatic cancer, remember that only surgeons can make the final call. Surgery is by far the most common treatment and is probably the best chance at a cure for the disease.