Diagnosed with Cancer? Your two greatest challenges are understanding cancer and understanding possible side effects from chemo and radiation.  Knowledge is Power!

Learn about conventional, complementary, and integrative therapies.

Dealing with treatment side effects? Learn about evidence-based therapies to alleviate your symptoms.

Click the orange button to the right to learn more.

Chemo BEFORE Surgically Removing Pancreatic Cancer

Share Button

Neoadjuvant therapy (chemo before surgery) may improve overall survival in early stage pancreatic cancer patients. As always, the devil is in the details…

Pancreatic cancer (PCa) is one of the, if not the most difficult cancer diagnoses. According to the American Cancer Society, the average one year survival rate is 20% and the average five year survival rate is 7%. The Whipple surgical procedure is a pancreatic cancer survivor’s only real chance for a cure.

The main challenge with a diagnosis of pancreatic cancer is that approximately 80% of the time, PCa patients have cancers that have advanced too far for surgery to be possible. The study below speaks to the approximately 20% of those PCa patients who catch their cancer early enough to surgically remove it.

The study linked and excerpted below talks about neoadjuvant therapy for early stage PCa. Though the standard of care for early PCa is to undergo chemo after surgically removiing the pancreatic tumor, according to the article, about half of patients who have surgery are unable to undergo chemo. They experience complications from their surgery.

Further, the article may contain oncological jargon meaning phrases that average people don’t understand. One of the theoretical advantages of chemo before surgery is “downstaging of nodal disease,” This phrase means that preadjuvant chemotherapy may kill pancreatic cancer that has already spread beyond the tumor to the lymph nodes. It is the systemic spread of cancer that often causes a person’s cancer to relapse.

Two more therapies that are evidence-based but non-conventional. Pre-habilitation and Integrative Pancreatic cancer therapies. To learn more about pre-habilitation, please read the post highlighted in recommended reading below.


To learn more about therapies such as curcumin what research has shown can enhance the efficacy of conventional PCa chemo regimens such as gemcitabine/nab-paclitaxel, click now to go to the pancreatic cancer coaching program.

To learn more about pancreatic cancer, scroll down the page, post a question or a comment and I will reply to you ASAP.

Thank you,

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeaingCancer

Recommended Reading:

Emerging Role for Neoadjuvant Treatment of Resectable Pancreatic Cancer

SEVERAL STUDIES presented at the 2019 Gastrointestinal Cancers Symposium evaluated the benefits of neoadjuvant treatment in patients with pancreatic cancer—and in patients deemed fully resectable, not just “borderline” resectable.1-3…

Although the standard of care for resectable pancreatic ductal adenocarcinoma remains surgery followed by adjuvant chemotherapy, approximately 50% of patients are unable to receive adjuvant treatment due to postoperative complications.

Neoadjuvant chemotherapy, it is believed, has several theoretical advantages, including

  • early treatment of disease,
  • assessment of responsiveness to chemotherapy,
  • downstaging of nodal disease,
  • improved operability, and
  • greater achievement of negative surgical margins…

Prep-02/JSAP-05 demonstrated a significant survival benefit of neoadjuvant therapy, with a median overall survival of 36.7 months vs 26.6 months for upfront surgery.

  • The 2-year overall survival rate was 63.7% and 53.5%, respectively, and
  • all subgroups appeared to benefit from the neoadjuvant approach.
  • Lymph node metastases were significantly decreased in the neoadjuvant group (59.6% vs 81.5%).
  • There were no significant differences in operating time, bleeding events, operation method, and operating morbidity, and no patient died of a surgery-related complication in either group-

Based on the superior outcomes, Dr. Unno commented: “We believe that neoadjuvant chemotherapy could be a new standard for patients with resectable pancreatic adenocarcinoma.”

Hematologic grade 3 or 4 adverse events, primarily leukopenia and neutropenia, were frequently observed in the neoadjuvant group…

Davendra Sohal, MD, MPH, of the Cleveland Clinic, reported that 29% of enrolled patients were found, on central review, not to have resectable disease.2

  • The main reasons were venous involvement,
  • arterial involvement, and
  • the presence of metastatic disease.

Patients received 12 weeks of neoadjuvant chemotherapy with either modified FOLFIRINOX or gemcitabine/nab-paclitaxel followed by surgical resection or 12 weeks of identical chemotherapy postoperatively. The primary outcome was 2-year overall survival. The investigators are also assessing differences in tolerability between the two regimens…



Leave a Comment: