Pancreatic Head Cancer

Patients with uncinate-process pancreatic head cancer have poorer overall survival and have a higher incidence of systemic and locoregional recurrence. The cancer is rare and has a high rate of metastasis. The disease often has no early symptoms, and most patients do not survive the disease for more than six months. The 5-year survival rate for patients with resected tumours is 5%.
Although this is the only curative treatment for pancreatic head cancer, the survival rate is poor even after the procedure. A resection is only curative in about twelve to twenty per cent of patients, and the survival rate in non-qualifying patients is as low as one per cent. The key to successful surgery is a negative retroperitoneal soft-tissue margin. Patients considered a good candidate for pancreatic head cancer should undergo radiation therapy before surgery.
A multi-detector CT scan of the pancreas can be used to differentiate malignant tumours from benign cysts. Fine-needle aspiration biopsy cannot differentiate benign cystic tumours from malignant ones, and if the cancer is enhancing rapidly, it may be an endocrine tumour. Patients with non-detected pancreatic head cancer have a better prognosis than those with ductal tumours.
While a preoperative biopsy is not always required, an accurate diagnosis of pancreatic head cancer is essential for patients with unresectable cases. An accurate diagnosis will allow for a frank discussion of treatment options and possible complications. If surgery is not an option, a non-operative procedure such as pancreaticoduodenectomy should be performed as soon as possible. It is best to consult a pancreatic cancer expert if the mass is suspected of being cancerous.