800-826-HOPE (4673)

Pancreatic Cancer


Here at City if Hope, we take an integrated approach to fighting pancreatic cancer. Our multidisciplinary team of world class specialists can answer your questions, address your concerns, and deliver a personalized treatment plan with the most innovative, leading-edge therapies available anywhere.

If you or a loved one has been diagnosed with pancreatic cancer, or if you've been told you're at high risk for developing the disease, talk to us.

Request a Consultation

If you have been diagnosed with pancreatic cancer or are looking for a second opinion consultation about your treatment, you may request an appointment online or contact us at 800-826-4673 (HOPE). Please visit Making Your First Appointment for more information. 

City of Hope has one of the most experienced pancreatic cancer programs in the United States. We are designated a comprehensive cancer center by the National Cancer Institute, and for more than a decade, U.S. News & World Report has named City of Hope one of the top cancer hospitals in America.

Highlights of our pancreatic cancer treatment program include:

  • Minimally invasive, robotically assisted surgery and procedures, such as ablation and embolization
  • Ultraprecise radiation therapy, including helical TomoTherapy
  • Unique chemotherapy and targeted therapy regimens
  • Targeted drug combinations for greater effectiveness and fewer side effects
  • Pioneering drug research and clinical trials
  • Palliative treatments to reduce symptoms and improve quality of life

What is pancreatic cancer?

Your pancreas is small, only about six inches long, but it plays an important role in your digestive system.

Located deep within the abdomen, the pancreas produces insulin to help regulate your blood sugar level and aids in breaking down the foods you eat.

Pancreatic cancer develops when cells in the pancreas begin to grow uncontrollably. There are two types of pancreatic cancer tumors, exocrine and endocrine. Exocrine tumors are more common, while endocrine tumors are rare and make up less than 5 percent of all pancreatic cancer.

What increases your risk of pancreatic cancer?

A risk factor is something that increases your likelihood of getting a disease. This could be a behavior, a health condition, a hereditary trait — anything that affects your chances of developing an illness.

Pancreatic cancer has several risk factors associated with it — some of which you change and others you cannot.

Risk factors you have control over include:

Smoking: According to the American Cancer Society, 20 to 30 percent of pancreatic cancer cases are thought to be brought on by smoking.

Obesity: Being overweight or obese boosts your chances of developing pancreatic cancer.

Risk factors you cannot control are:

Age: The older you get, the more likely you are to receive a pancreatic cancer diagnosis. Nearly all cases occur in people over 45 years of age.

Race and gender: African-Americans and men have a somewhat higher chance of getting pancreatic cancer.

Inherited genetic syndromes: It is possible that pancreatic cancer runs in some families. Genetic syndromes like Lynch, Peutz-Jeghers and Von Hippel-Lindau can all cause pancreatic cancer. Abnormal BRCA1 or BRCA2 genes passed down from parent to child also increases your likelihood of developing pancreatic cancer.

If you are high risk due to hereditary factors, there may be genetic testing options available to you. Talk to your doctor to assess your needs and evaluate the best course of action.

Certain illnesses: If you suffer from diabetes, chronic pancreatitis or cirrhosis of the liver, you may have a higher chance of getting pancreatic cancer.

What are the symptoms of pancreatic cancer?

You might not exhibit symptoms of pancreatic cancer until it has advanced, so it is important to know your body and be vigilant about any changes you experience that cause alarm.

Some symptoms associated with pancreatic cancer are:

Yellowing of the eyes and skin (jaundice)

  • Dark-colored urine
  • Unexplained weight loss
  • Itchy skin
  • Belly and back pain
  • Blood clots
  • Nausea and vomiting
  • Loss of appetite
  • Irregular stools

How is pancreatic cancer detected?

The pancreas is located deep within the body, making it difficult to detect early tumors during a routine physical exam. Additionally, there are no reliable screening options for pancreatic cancer, so it tends to be diagnosed at later stages when the cancer has grown and spread. At City of Hope, our knowledgeable and skilled team will work with you to ensure that your cancer is detected, diagnosed and staged using the latest methods.

How is pancreatic cancer diagnosed?

To diagnose pancreatic cancer, doctors first assess your personal and family health histories, in addition to your risk factors and symptoms. You must also undergo a physical exam and one or more of the following tests:


To conduct a biopsy, a small piece of the pancreas is removed and analyzed by a pathologist to determine if there is cancer present.

Blood tests

Blood tests may be conducted to detect elevated levels of certain substances known as tumor markers. Liver function tests may also be useful in identifying pancreatic cancer.

Imaging Tests

Computed tomography (CT) scan: The pancreas shows up rather clearly in a CT scan, so this test is commonly used to diagnose pancreatic cancer. It can also help show if cancer has spread throughout the body.

Positron emission tomography (PET) scan: For a PET scan, patients are first injected with a small amount of radioactive sugar solution. When this solution reaches the organs being evaluated, a special camera creates images of the areas where radiation is being emitted from the body. This test is often done in combination with a CT scan.

Abdominal ultrasound: The initial imaging test a patient undergoes is usually an ultrasound. This type of test uses sound waves to create images of potential pancreatic cancer tumors. Abdominal ultrasounds require no radiation and are noninvasive.

A doctor or ultrasound technician simply moves a wand-like instrument over your abdomen to capture the echoes that bounce off your internal organs. Those echoes are converted into images with the help of specialized computer programs.

Endoscopic ultrasound (EUS): This type of ultrasound provides more detailed images than an abdominal ultrasound, as it allows for closer access to the pancreas. During the procedure, and thin tube fitted with a light at the end is inserted into the mouth or nose, down through the throat and stomach and into the small intestine. If a tumor is found during an EUS, a small needle can be inserted through the endoscope to take a biopsy.

Endoscopic retrograde cholangiopancreatography (ERCP): During this procedure, an endoscope is inserted down the throat, passed through the stomach and into the small intestine. Next, a small amount of dye is dispensed, outlining the bile and pancreatic ducts. X-rays can then pick up on the dye and reveal any visible abnormalities.

Magnetic resonance cholangiopancreatography (MRCP): Similar to a MRI, this test takes thorough pictures of the pancreatic and bile ducts. Unlike the ERCP, it is noninvasive and does not use radiation.

Percutaneous transhepatic cholangiography: For this test, doctors use a needle to inject dye into the liver, outlining the pancreatic and bile ducts. X-rays can then detect any duct blockages or other issues.


Pancreatic cancer is often diagnosed at an advanced stage and can require aggressive treatment. To receive the best care possible, it is important to seek out a multidisciplinary team of medical experts to create an individualized treatment plan tailored to your needs.

At City of Hope, you are treated as a valued individual. Our entire team works together to bring you precise, state-of-the-art surgical, radiation, drug and other therapy options that will deliver the best outcome for you.

Our pancreatic cancer treatments include:


When possible, our surgeons will take a minimally invasive approaches to remove pancreatic cancer, such as laparoscopic surgery (using miniaturized operation instruments inserted through a thin tube) and robotically assisted surgery (using a specially-designed robot equipped with miniature surgical tools) and advanced imaging systems, giving the surgeon superior visualization and greater control at the tumor site.

Some pancreatic cancer surgeries include:

  • The Whipple procedure. This is the most common pancreatic cancer surgery, which removes portions of the pancreas, small intestine, gallbladder, surrounding lymph nodes and in some cases, the stomach.
  • A total pancreatectomy. If your cancer has spread but is still contained to the pancreas, a total pancreatectomy may be an option for you. During this procedure, your surgeon removes the entire pancreas and usually your spleen.
  • The distal pancreatectomy. Less common than other pancreatic cancer operations, a distal pancreatectomy may be a possibility if the cancer is located on the tail of your pancreas only. In this operation, a surgeon removes the tail of your pancreas and usually your spleen as well.

Surgeries on the pancreas are complex and require a highly skilled and experienced surgical team. At City of Hope, our doctors are experts at performing these intricate procedures.


Pancreatic cancer is often treated with chemotherapy (anti-cancer medicines that kill all fast-growing cells in the body).

You may get chemotherapy to try to shrink a tumor before surgery, to try and kill any remaining cancer cells after surgery or if you do not qualify for surgery.

To learn more, visit our chemotherapy treatment page here.

Radiation Therapy

Using advanced imaging techniques, our radiation team can accurately locate and target pancreatic tumors for treatment, ensuring maximum impact against cancer cells while minimizing exposure to surrounding normal tissues.

At City of Hope, these techniques include respiratory gating and four-dimensional computed tomography, both of which account for organ and tumor movements during breathing.

For more information on City of Hope’s leading-edge radiation therapy techniques, visit our Radiation Therapy and Gastrointestinal Cancers page.

City of Hope’s renowned physicians and researchers utilize the latest in technology and innovation to treat cancer, coupled with our enduring belief in providing unparalleled compassionate care.


Donald S. David, M.D., F.A.C.G.

Clinical Specialties

  • Gastroenterology

Medical Oncology

Joseph Chao, M.D.

Clinical Specialties

  • Medical Oncology
Vincent Chung, M.D., F.A.C.P.

Clinical Specialties

  • Medical Oncology
Marwan G. Fakih, M.D.

Clinical Specialties

  • Medical Oncology
Daneng Li, M.D.

Clinical Specialties

  • Medical Oncology
Dean W. Lim, M.D.

Clinical Specialties

  • Medical Oncology

Radiation Oncology

Yi-Jen Chen, M.D., Ph.D.

Clinical Specialties

  • Radiation Oncology


Susanne Gray Warner, M.D.

Clinical Specialties

  • Surgery
  • Liver Surgery
  • Pancreatic Surgery
  • Gallbladder and Bile Duct Surgery
  • Minimally Invasive Surgery
  • Robotic Surgery
  • General Surgery

Surgical Oncology

Yuman Fong, M.D.

Clinical Specialties

  • Surgical Oncology
Lily Lau Lai, M.D., F.A.C.S.

Clinical Specialties

  • Surgical Oncology
Laleh Melstrom, M.D., M.S., F.A.C.S.

Clinical Specialties

  • Surgical Oncology
  • Hepato-Pancreato-Billiary (HPB) Surgery
Gagandeep Singh, M.D., F.A.C.S.

Clinical Specialties

  • Surgical Oncology
  • Liver and Pancreatic Surgery
  • Liver Cancers and Metastases
  • Biliary Tract Cancers
  • Gallbladder Cancer
  • Pancreas Cancer
Yanghee Woo, M.D.

Clinical Specialties

  • Surgical Oncology
  • Robotic Surgery
  • Minimally Invasive Surgery

At City of Hope, we offer access to drug, surgical and other clinical trials aimed at improving survival rates and enhancing quality of life.

In our latest research we are investigating a drug that dismantles pancreatic cancer cells' defense against chemotherapy, a DNA study examining genetic anomalies that may aid in early detection, and development of an improved support care program.

Browse through our clinical trials and research projects here.

Living with pancreatic cancer

When you come to City of Hope, you automatically gain access to an unparalleled array of support services to help you and your family cope with each challenge you come across in your pancreatic cancer journey.

We support you every step of the way, both during treatment and long after, helping you and your loved ones manage your recovery.

We can help with all of these concerns, and more:

  • Poor appetite and trouble eating/drinking
  • Managing pain, fatigue, nausea
  • Adjusting to new diet and lifestyle habits
  • Your emotional, social and spiritual well-being
  • Palliative care
  • Staying healthy and active
  • Healthy cooking and eating
  • Healing arts
  • Caregiver skills
  • Dealing with family, work and school stress
  • Navigating the health care system

Learn more about these resources at our Living with Cancer or Supportive Care Medicine sites. For more information about the supportive care programs we offer, please contact the Sheri & Les Biller Patient and Family Resource Center at 626-218-2273 (CARE).

Support the Pancreatic Cancer Program

It takes the help of a lot of caring people to make hope a reality for our patients. City of Hope was founded by individuals' philanthropic efforts more than 100 years ago. Their efforts − and those of our supporters today − have built the foundation for the care we provide and the research we conduct. It enables us to strive for new breakthroughs and better therapies − helping more people enjoy longer, better lives.

For more information on supporting this specific program, please contact us below.

Joe Komsky
Senior Development Officer
Phone: 626-218-6291
Email: [email protected]


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