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Pancreatic Ductal Adenocarcinoma

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This is the most common form of pancreatic cancer. In fact, it makes up more than 80 percent of diagnosed cases. A type of exocrine pancreatic cancer, PDAC grows from cells lining small tubes, called ducts, in the pancreas. These tubes carry the digestive juices, which contain enzymes, into the main pancreatic duct and then on into the first part of the small intestine, called the duodenum.

PDAC can grow anywhere in the pancreas, but are often found in the head of the pancreas.

Why Choose Sylvester Comprehensive Cancer Center?

Advanced care that improves outcomes. At our center, patients experience survival rates up to 14 percent higher than national averages for early- and late-stage pancreatic cancer. We provide more precise diagnosis and treatment for your exact cancer so you can experience the best possible outcomes and the least potential negative side effects.

One of few Pancreatic Cancer Research Institutes in the United States. You have increased access to leading-edge treatments and additional resources for patients and families.

Advanced radiation oncology tools. Sylvester is one of only five medical centers in the country with ViewRay™ — MRI-guided radiation therapy. Our RapidArc® radiotherapy system delivers intensity modulated external radiation therapy (IMRT). These tools lead to more efficient and effective treatments, shorter treatment times, pinpoint accuracy in tumor targeting, and less damage to surrounding healthy tissue.

More cancer clinical trials than any other South Florida hospital. If appropriate for your cancer and stage, our clinical trials provide you with easy access the very newest ways to treat and potentially cure your cancer.

Questions? We're here to help.

Our appointment specialists are ready to help you find what you need. Contact us today.

Treatments


Each new patient is presented at a multidisciplinary team conference of our pancreatic cancer experts. Your team of specialists will review all of your test results to recommend a personalized treatment plan. Your plan may include a combination of the following treatment options:

  • Surgery

    Surgical options are based on your specific case, and could include:

    • Whipple Procedure: The Whipple is the common surgery to remove cancer of the exocrine pancreas and the first section of the small intestine. It is formally known as pancreaticoduodenectomy.
    • Distal Pancreatectomy: The tail of the pancreas and the spleen are removed using small incisions.
    • Total pancreatectomy: During this procedure, your doctor removes the entire pancreas, gallbladder, spleen, and part of the stomach and small intestine. 
    • Palliative Pancreatic Surgery: This surgery may be recommended if imaging tests show the cancer is too widespread to be removed completely. These procedures include bypass and stent operations to help relieve pain and to allow you to eat more easily.
    • NanoKnife®  (Irreversible Electroporation - IRE): Sylvester is the first provider in Florida and one of only a handful in the world to provide this effective treatment for selected primary tumors considered inoperable. NanoKnife surgery is an advanced radiation therapy procedure occurring under computed tomography (CT) scan or ultrasound guidance. Done under general anesthesia, the procedure produces very little pain or side effects and requires only a brief hospital stay.
  • Radiation Therapy

    In this therapy, your doctor safely aims radiation at the cancer cells with pinpoint accuracy. The goal is to eliminate or shrink a tumor, either alone or in combination with surgery and/or chemotherapy. It can be delivered as external radiation from outside the body, or internally, with the radiation source implanted in the tumor.

  • Immunotherapy

    Also called biologic therapy, this type of therapy uses your own immune system to attack cancer cells. Your Sylvester oncologist will advise you if an immunotherapy clinical trial may be appropriate for your cancer.

  • Chemotherapy

    For chemotherapy, drugs are administered intravenously or by oral pill to kill cancer cells and/or to stop their growth. Chemotherapy also might be recommended before a surgery, to help reduce the size of the tumor.

    • If you need intravenous (infusion) chemotherapy, you can have it at the Comprehensive Treatment Unit (CTU) at Sylvester's main location in Miami, a 12,000-square-foot hospital that includes 33 recliners and 11 private rooms. If you prefer, you may have your infusion treatments at the Kendall, Plantation, Hollywood, Coral Springs, Coral Gables, and Deerfield Beach locations.
    • Cold cap therapy to minimize hair loss: Sylvester offers FDA-cleared cold cap therapy to minimize your hair loss during your chemotherapy treatments. Cold cap therapy works by cooling your scalp during treatment.

Tests


Our team of diagnostic experts will determine the molecular, genetic and biologic drivers of your pancreatic cancer. In addition to a complete medical history and physical examination, procedures for diagnosing pancreatic cancer may include:

  • Blood Tests

    Several types of blood tests can be used to help diagnose pancreatic cancer and determine treatment options. The most common blood tests performed are:

    • Tumor markers: A sample of blood is checked to measure the amounts of certain substances related to pancreatic cancers, such as CA 19-9 and carcinoembryonic antigen (CEA).
    • Hormone levels: This test looks for increased hormones made by different types of neuroendocrine tumors (NET).
    • Carcinoid tumor analysis: This analysis looks for serotonin in the blood which is made by pancreatic tumors.

  • Biopsies

    • Biopsy: You may have either a percutaneous (through the skin) biopsy using a thin needle to remove a small piece of the tumor or an endoscopic biopsy. 
    • Laparoscopy: This minimally invasive surgical procedure involves a small incision made in the abdomen to carefully explore the pancreas and surrounding area. 
  • Imaging studies

    • Computed Tomography (CT scan or CAT scan): This scan involves a series of detailed pictures using a computer linked to an X-ray machine
    • Magnetic Resonance Imaging (MRI): An MRI uses magnetic fields, not X-rays, to produce detailed images of the body. Our computers then combine the images to create a series of detailed pictures of areas inside your body.
    • Ultrasound (also called a sonogram): High-frequency sound waves create images of the pancreatic tissue. The images help us distinguish between a solid mass (possibly cancer) and a fluid-filled cyst (usually not cancer). The ultrasound may be done externally on the abdomen (transabdominal ultrasound) or internally, using an endoscope with an ultrasound device at the tip (endoscopic ultrasound).
    • Positron Emission Tomography (PET) Scan: For a PET scan, you are injected with a small amount of a radioactive form of sugar, which collects mainly in cancer cells. A special camera is used to create a picture of areas of radioactivity in the body.
    • Percutaneous Transhepatic Cholangiography (PTC): A small amount of contrast dye is injected into the liver and bile ducts. X-rays are taken to view potential pancreatic cancer.
    • Endoscopic Retrograde Cholangiopancreatography (ERCP): Your care provider will pass a long, flexible, lighted tube (endoscope) into the first part of the small intestine. Then, a catheter is advanced through the scope and a small amount of contrast dye is injected to highlight the pancreas as X-ray images are taken.

Accepted Insurances

Note: Health plans that are currently contracted with UHealth are listed below. However, please check with your insurance provider to verify that UHealth is part of your provider network.

  • Aetna WC
  • Aetna Affiliates/Signature Adm (ASA)
  • Aetna Behavioral Health
  • Aetna Elect Choice (EPO)
  • Aetna Florida Healthy Kids
  • Aetna HMO
  • Aetna Medicaid HMO
  • Aetna Medicare HMO
  • Aetna Medicare PPO
  • Aetna POS
  • Aetna PPO
  • Aetna UM Employee HMO 1
  • Aetna UM Employee HMO 2
  • Aetna UM Employee POS HRA
  • Aetna/Coventry Institutes of Excellence (IOE)
  • Amerigroup Florida Healthy Kids
  • Amerigroup Medicaid HMO
  • Argus Vision
  • AvMed Choice
  • AvMed HMO/POS
  • AvMed MDC and JHS Groups
  • AvMed Medicare HMO
  • AXIS
  • BCBS Blue Options Network Blue PPO
  • BCBS BlueCare HealthOptions HMO
  • BCBS BlueChoice PPC/PPO
  • BCBS Miami Dade Blue PPO Limited Benefits Plan
  • BCBS of Florida (All products except "SELECT" Plans)
  • BCBS of Florida (Commercial plans exclude HIX Select)
  • BCBS Traditional PHS/PPO
  • Beacon Health (ValueOption)
  • Beech Street PPO
  • Broward Health Medical Center
  • CarePlus Medicare HMO
  • Catholic Hospice
  • CCP/CMS Title XIX (Medicaid Enrolled in South Florida)
  • CCP/CMS Title XXI (Non Medicaid Enrolled in South Florida)
  • CCP/MMA (Broward County residents)
  • Charlotte County Sheriffs Office PPO
  • Cigna Affiliates
  • Cigna Behavioral Health
  • Cigna Dental HMO/PPO
  • Cigna EPO
  • Cigna HMO
  • Cigna Life Source (Intracorp is part of Cigna Lifesource)
  • Cigna MDCPS Jackson Sr. High
  • Cigna POS
  • Cigna PPO
  • Cigna Shared Administration
  • Clear Health Alliance SNP Medicaid HMO
  • Concordia Behavioral Health
  • CorVel WC
  • Coventry First Health WC
  • Coventry Health Care of Florida (HIP) HMO/POS
  • Coventry Health Care of Florida (HIP) PPO
  • Coventry Health Plan of Florida (Foundation) HMO
  • Coventry Health Plan of Florida (Foundation) POS
  • Coventry National PPO
  • Coventry Summit Medicare HMO
  • Coventry Vista Medicare HMO
  • Coventry First Health PPO
  • Delta Dental PPO
  • DentaQuest (ADI)
  • DIKLA
  • Dimension WC
  • Dimension Plus PPO
  • EHN PPO
  • EQUIAN (Health Systems International)
  • Europe Assistance/Global Corporate Solutions (Care Management Network)
  • eyeQuest
  • FCCI WC
  • Florida Healthcare Plan (Affiliate of BCBSFL)
  • Florida PACE (FPC)
  • Freedom Health Medicaid HMO
  • Freedom Health Medicare HMO
  • Gallagher Bassett WC (MDCPS & FCSRMC)
  • Global Excel Mgt PPO
  • Great West (Cigna) HMO/POS
  • Guardian Life PPO
  • HAA Preferred Partners
  • Health First Health HMO/POS
  • Health First Health Medicare HMO
  • Health First Health PPO
  • Health Net Veterans Choice HMO
  • Heritage Summit Healthcare WC
  • Humana Behavioral Health (LifeSynch)
  • Humana Dental/CompBenefits/OHS
  • Humana EPO
  • Humana HMO
  • Humana Medicaid HMO
  • Humana Medicare HMO
  • Humana National Transplant
  • Humana PPO
  • Humana Premier
  • iCare Health Solutions
  • Interlink Health Services
  • International Kids Fund (IKF)
  • League Medical Concepts Federal Inmates
  • Life Trac
  • Magellan Behavioral Health
  • Magellan Complete Care SNP Medicaid HMO
  • MDAbroad
  • Medica Medicare HMO
  • Medical Development In't (MDI)-Federal Inmates
  • Medicus
  • Metlife Dental PPO
  • MHNet Behavioral Network (MHNet)
  • Molina
  • Molina Market Place
  • Molina Medicaid HMO
  • Molina Medicare HMO
  • Morgan White International
  • MultiPlan PPO
  • Naphcare (Federal Prisoners)
  • National Healthcare Solutions Inc.
  • Neighborhood HealthPlan HMO/POS
  • Neighborhood HealthPlan PPO
  • North Broward Hospital District PPO
  • Olympus Managed Healthcare
  • Optum
  • Positive Healthcare SNP Medicaid HMO
  • Positive Healthcare SNP Medicare HMO
  • Prestige Health Choice Medicaid HMO
  • Prime Health Services WC
  • Quality Health Management
  • Religious Order of Jehovah's Witnesses PPO
  • Rockport Healthcare Group WC
  • Royal Caribbean Cruises PPO
  • Sanus Health Corporation
  • Seasons Hospice
  • Simply Healthcare Medicaid HMO
  • Solstice Dental HMO/PPO
  • Start Healthcare Network
  • Sunshine
  • Sunshine AMBETTER
  • Sunshine Healthy Kids HMO
  • Sunshine Medicaid HMO
  • Sunshine Medicare HMO
  • Tricare South Prime HMO
  • Tricare South Standard PPO
  • United Behavioral Health (UBH)
  • UnitedHealthcare Affiliates
  • UnitedHealthcare Healthy Kids HMO
  • UnitedHealthcare HMO/POS
  • UnitedHealthcare Medicaid HMO
  • UnitedHealthcare Medicare Nursing Home Plan
  • UnitedHealthcare PPO
  • University of Miami Athletic Dept PPO
  • VUMI
  • Wellcare/Staywell Healthy Kids HMO
  • Wellcare/Staywell Medicaid HMO
  • Wexford Health State Inmates
  • Worldwide Managed Care