Pancreatic Cancer
Robotic pancreatectomy when appropriate, and multidisciplinary care
A pancreatic cancer diagnosis is one of the hardest a patient can receive, and the first conversations often leave more questions than answers. Dr. Papenfuss is a fellowship-trained surgical oncologist who specializes in pancreatic surgery at Advocate Health St. Luke's Medical Center, a high-volume referral center in Milwaukee that draws patients from across Wisconsin and the Upper Midwest. His team performs 80 to 100 pancreatic operations each year.
What it is
The pancreas sits behind the stomach and makes digestive enzymes and insulin. Most pancreatic cancers are adenocarcinomas that start in the ducts of the gland. Less common types include neuroendocrine tumors, which often grow more slowly, and cystic tumors, some of which are precancerous and can be removed before they turn into cancer. Because the pancreas is deep in the abdomen, symptoms such as jaundice, back pain, weight loss or new diabetes often appear late.
How it is treated
Surgery offers the only chance of cure, but the order of treatment matters. Many patients receive chemotherapy first to shrink the tumor and treat cancer cells that imaging cannot see, then surgery, then more chemotherapy. The operation depends on where the tumor sits:
Pancreaticoduodenectomy for tumors in the head of the pancreas: removal of the pancreatic head, the first part of the small intestine, the bile duct and gallbladder, with reconstruction of the digestive tract.
Distal pancreatectomy, often with removal of the spleen, for tumors in the body or tail.
Vascular reconstruction when the tumor touches major veins, which allows surgery for some patients who were told they were inoperable elsewhere.
Dr. Papenfuss performs robotic pancreatectomy when appropriate, which can mean smaller incisions, less pain and a faster return to chemotherapy. The approach is chosen for each patient based on the tumor, not the other way around.
Dr. Papenfuss's approach
Every pancreatic cancer patient is presented at a multidisciplinary conference with medical and radiation oncologists, gastroenterologists, radiologists and pathologists before a plan is set. He is a high-volume pancreatic surgeon, Program Director of the Complex General Surgical Oncology Fellowship, and serves as a robotic surgery proctor for Intuitive Surgical. Pancreatic cysts and neuroendocrine tumors are followed closely so that surgery happens when it is needed and not before.
When to get a second opinion
If you have been told your tumor is inoperable, borderline resectable, or involves blood vessels, a second opinion from a high-volume pancreatic surgeon can change the plan. Out-of-town patients can start with a records review.
Call 414-649-3240 or request a consultation.
This page is general information, not medical advice for any individual patient.