We talked to people who had surgery for pancreatic cancer. Their experiences are described here.
Some people we talked to had surgery to remove the cancer from their pancreas. If this kind of surgery works it can cure the cancer. Most people felt lucky that surgery was possible and that surgery was the only option. However, a few people weren’t sure it was right and took a little while to decide. Some had felt worried before the operation.
The Whipple’s procedure
The Whipple’s operation is for cancer in the head or neck of the pancreas, that hasn’t spread. During this operation surgeons usually remove:
- part of the stomach
- part of the duodenum (the first part of the small intestine)
- the head of the pancreas
- the common bile duct
- the gall bladder
Some people we spoke to had a pylorus-preserving pancreatoduodenectomy, in which all these organs were removed except for the stomach.
Vicky had a rare type of pancreatic cancer called a a neuroendocrine tumour. Before her Whipple’s operation the doctor did an embolisation procedure. Embolisation blocks an artery (blood vessel that carries blood to an organ) to stop blood flow. Vicky’s doctors blocked an artery going to her tumour and reduced the blood supply to the tumour. The aim was to shrink the tumour and to lower the chance of a bleed during the Whipple’s operation.
People said that their Whipple’s operation took up to nine hours. The operation is done under general anaesthetic. Most people told us that they had an epidural injection as well, to help control the pain. They also had various tubes put in (such as a catheter, drains, feeding tubes or I.V.s).
Recovery from the Whipple’s Procedure
After the operation, people went into the intensive care unit for a few days. They were very drowsy and didn’t know what was happening around them. People talked about the relief they felt to have survived such major surgery. Some said they felt very ‘safe’ in the intensive care unit because the staff were reliable. Lesley had her own nurse and called the nursing care ‘fantastic’.
Most people said that pain was well controlled by the epidural or by a morphine pump. However, some had bad side effects from morphine or tramadol (such as nausea or dizzy spells). They described their time in intensive care as ‘very painful’.
At first people could sip only a little water. After a while they started to eat small amounts of food.
After a few days in intensive care people moved back to the main ward. Some felt nervous about that because the nurses were very busy. They were worried that they wouldnt get the attention they needed. However, one man said he had a ‘sense of achievement’ because he trusted the staff and everything was going well.
Once back on the ward, if recovery went according to plan, a nurse or doctor removed the drains and catheter and gradually stopped intravenous fluids. As people became stronger they were encouraged to get out of bed and to shower. Physiotherapists helped with mobility and strengthening exercises. Eating was often difficult at first, but people gradually learned what they could and couldn’t eat.
Some people had problems after the operation, including nausea, vomiting, infections and hernias. Vicky had a paralytic ileus (inactivity of the bowel), and so had to go home with her JPEG feeding tube in place. One woman had unexplained bleeding from the bottom.
Most people we interviewed went home after two to four weeks (it can be as short a stay as a week). Some were in hospital for longer than four weeks. Before people went home, the nurses usually took out the stitches or staples that held the incision together. Lesley had 67 staples.
People were happy to be home but still felt very weak and tired, and needed painkillers. Some people had wound infections which needed regular dressing by the district nurse. May developed a wound infection and went back to hospital for a few days. Some people’s GP also visited or phoned.
One man decided to sleep downstairs for the first two months because he found it hard to climb the stairs. Ann had lost two stone in weight and needed to rest several times a day. She also had headaches which worried her. Fred had a lot of pain along the line of his incision.
Others recovered more quickly and became mobile, walking a little further each day. Tony, for example, recuperated at home for two or three weeks and then felt well enough to do a little gardening and painting.
Weeks after surgery many people still felt exhausted at times but gradually felt strong enough to resume normal activities, enjoy life and go on holiday. A few went back to work. Others had to retire, partly because they needed further treatment, such as chemotherapy. Recovery can take several months and for some people up to a year.
Distal pancreatectomy
Some people we spoke to had cancer in the tail or in the body of the pancreas rather than its head. They had an operation called a distal pancreatectomy. Two people had their spleen removed too and needed to take antibiotics long term due to the resulting loss of immunity. Peter (Interview 36), who had a neuroendocrine tumour, also had part of his tumour removed from the portal vein.
After surgery these people also went to the intensive care unit before returning to the ward. Like those who had had a Whipple’s operation, they had intravenous fluids, drains and a catheter, and a large incision.
After one or two weeks in hospital they went home. Some people recovered fairly quickly but others took many weeks. Davinder, for example, was very weak and tired when she got home and needed help with personal care for three weeks. She also needed special equipment to help her get in and out of bed. She had to go back to hospital twice because of urinary and abdominal (tummy) infections.
Some people could not have surgery to remove the cancer. Instead they had surgery to stop symptoms like jaundice or sickness.