{"id":5330,"date":"2024-12-11T10:35:19","date_gmt":"2024-12-11T09:35:19","guid":{"rendered":"https:\/\/irccs.com\/patologie\/tumors-of-the-pancreas\/"},"modified":"2026-03-24T11:43:37","modified_gmt":"2026-03-24T10:43:37","slug":"tumors-of-the-pancreas","status":"publish","type":"pathology","link":"https:\/\/irccs.com\/en\/patologie\/tumors-of-the-pancreas\/","title":{"rendered":"Tumors of the pancreas"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\"><span  id=\"pathology\" class=\"h2_anchor\"><\/span>Pathology<\/h2>\n\n\n\n<p>Pancreatic cancer develops in the eponymous glandular organ, which is elongated, about 18-20 cm long and located deep in the abdomen, between the stomach and spine. The <strong>pancreas is divided into three parts<\/strong>: the &#8220;head&#8221; (the largest), the &#8220;body&#8221; (the middle part) and the &#8220;tail&#8221; (the thinnest, oriented toward the spleen). This organ produces key hormones, such as insulin and glucagon, which regulate sugar metabolism, and enzymes essential for digestion. Pancreatic cancer occurs when certain cells begin to multiply uncontrollably.<strong> <\/strong><\/p>\n\n\n\n<p>Globally, pancreatic cancer is among the top 12-15 cancers in terms of incidence, <strong>less frequent<\/strong> than cancers such as lung, breast, or colorectal, but stands out for its high mortality, mainly due to its often late diagnosis and therapeutic complexity.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Main types<\/h3>\n\n\n\n<p><strong>About 70% of pancreatic cancers develop in the head of<\/strong> the organ and are called <strong>ductal adenocarcinoma<\/strong> of the pancreas, which originates from the ducts that carry digestive enzymes.<\/p>\n\n\n\n<p>Less common tumors are <strong>neuroendocrine<\/strong> tumors, arising from islets of Langerhans cells, with different characteristics and treatments.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">The numbers in Italy<\/h3>\n\n\n\n<p>According to the <a href=\"https:\/\/www.registri-tumori.it\/cms\/pubblicazioni\/i-numeri-del-cancro-italia-2023\">AIRTUM <\/a>(Italian Association of Cancer Registries) registry, about 14,800 new diagnoses were registered in 2023 (men = 6,800; women = 8,000).<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"risk-factors\" class=\"h2_anchor\"><\/span>Risk factors<\/h2>\n\n\n\n<p><strong>The incidence of this malignancy is increasing significantly among men<\/strong>, particularly those older than 65 years.  <\/p>\n\n\n\n<p>Among the currently known risk factors, the main ones are:  <\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Cigarette smoking<\/strong>: active smokers have double to triple the risk of incidence compared with nonsmokers<\/li>\n\n\n\n<li>obesity<\/li>\n\n\n\n<li>Dietary and lifestyle habits: reduced physical activity, high consumption of saturated fat, low intake of vegetables and fresh fruits<\/li>\n<\/ul>\n\n\n\n<p>The risk of onset also increases in:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>heavy drinkers of alcohol<\/strong><\/li>\n\n\n\n<li>Workers exposed to <strong>chemicals<\/strong> such as benzidine, naphthylamine, some pesticides, DDT<\/li>\n\n\n\n<li>People with <strong>chronic pancreatitis<\/strong><\/li>\n<\/ul>\n\n\n\n<p>Finally, there is a <strong>genetic predisposition<\/strong> in a small percentage of cases: about 10% of pancreatic cancer patients have a previous similar case in the family. In some cases these are known genetic syndromes. In some cases, these are known genetic syndromes (such as (as Lynch syndrome, hereditary pancreatitis, or BRCA1 and 2 gene mutation).<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"symptoms\" class=\"h2_anchor\"><\/span>Symptoms<\/h2>\n\n\n\n<p>Diagnosis is often not immediate, as <strong>early-stage pancreatic cancer gives no symptoms <\/strong>and, even when present, they may be vague. Clearer symptoms, depending on the area of tumor onset, appear when the lesion has begun to spread to neighboring organs or obstructs the biliary tract; therefore,<strong> diagnosis is often made at an advanced stage<\/strong>.<\/p>\n\n\n\n<p>The most common symptoms are <strong>weight loss<\/strong>, difficulty in digestion, abdominal pain, nausea, vomiting, and<strong> jaundice <\/strong>(yellowish discoloration of skin and mucous membranes).  <\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"diagnosis-and-examination\" class=\"h2_anchor\"><\/span>Diagnosis and examination<\/h2>\n\n\n\n<p>If pancreatic cancer is suspected, some instrumental examinations can be performed: a <strong>CT scan with contrast medium<\/strong> to which an<strong>echoendoscopy<\/strong> (if possible with biopsy) is often associated.  <br>In the case of tumors with elevated bilirubin values, ERCP (endoscopic retrograde cholangiopancreatography) is also usually performed before diagnostic procedures.<\/p>\n\n\n\t<div id=\"block_69c26ad88956d\" class=\"accordion-block acf-block\">\n\t\t<div class=\"my-4 lg:my-6\">\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Echoendoscopy (EUS)<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p><span style=\"font-weight: 400;\">It is an examination that allows for a<\/span><b>high-resolution ultrasonography<\/b><span style=\"font-weight: 400;\"> (power of resolution about 1-2 mm) <\/span><b>of the walls of the esophagus, stomach, duodenal<\/b><span style=\"font-weight: 400;\"><strong>o.<\/strong> Echoendoscopy also has the ability to investigate, with high accuracy, some organs and districts closely adjacent to the digestive tract such as the pancreas, biliary tract, and mediastinum and to investigate the related vascular and lymph node stations.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">The examination is performed with an instrument similar to those used for traditional endoscopy: the<\/span><b>ecoendoscope<\/b><span style=\"font-weight: 400;\">, which has endoscopic viewing optics at its end, and a miniaturized ultrasound probe that allows evaluation of the gastrointestinal wall and adjacent organs and\/or districts.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">EUS is a second-level examination that can provide very detailed information that other, noninvasive diagnostic methods cannot.  <\/span><\/p>\n<p><b>Echoendoscopic examination of the upper digestive tract is very similar to gastroscopy<\/b><span style=\"font-weight: 400;\">  but requires a significantly longer lead time, which may vary depending on the indication or the need to perform a therapeutic operative procedure. For these reasons, the examination is performed with anesthesia assistance. In selected cases for particularly complex procedures, general anesthesia with orotracheal intubation may be necessary.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">The instrument is introduced through the mouth and conducted under direct endoscopic vision to the duodenum passing through the esophagus and stomach.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">For exploration of the upper digestive tract (esophagus, stomach, duodenum, biliary tract, pancreas, and mediastinum), it is necessary to have been fasting for at least 8 hours for solids and 2 hours for liquids  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">An operative procedure called needle aspiration (EUS-FNA-FNB) can be performed during echendoscopy : it consists of taking a minimal amount of material through dedicated needles that are inserted, under echendoscopic vision, into the organ tissue. The material is then sent for cytologic or histologic evaluation.  <\/span><\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Endoscopic retrograde cholangiopancreatography (ERCP)<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p data-start=\"209\" data-end=\"447\">ERCP is an <strong>invasive endoscopic examination<\/strong> performed at the <a href=\"https:\/\/irccs.com\/aree-mediche\/gastroenterologia-ed-endoscopia-digestiva\/\">Division of Gastroenterology and Digestive Endoscopy<\/a>. It allows the<strong> identification and resolution of causes<\/strong> that hinder the outflow of bile and pancreatic juices in the intestines.<\/p>\n<p data-start=\"449\" data-end=\"896\"><strong>The procedure is performed under narcosis, on an inpatient basis.<\/strong>  The patient is positioned prone, supine or on the left side, depending on technical requirements. A duodenoscope, a flexible probe equipped with a light and side camera that transmits images to a screen, is introduced through the mouth. The duodenoscope reaches the duodenum, where Vater&#8217;s papilla, a small orifice from which the bile and pancreatic ducts flow.<\/p>\n<p data-start=\"898\" data-end=\"1306\">Through an operative channel of the duodenoscope, instruments for diagnostic-therapeutic procedures are inserted. Initially, a cannula is introduced into the papillary orifice to inject a radiopaque contrast agent into the bile and pancreatic ducts. With X-rays, images of the filled ducts can be viewed on a radiology monitor to refine the diagnosis and plan the surgery.<\/p>\n<p data-start=\"1308\" data-end=\"1544\">This is followed by the therapeutic phase, which almost always involves a sphincterotomy: a small cut of the papillary orifice to allow access and necessary maneuvers. The procedure takes about 60 minutes and requires fasting for at least 12 hours.<\/p>\n<p data-start=\"1546\" data-end=\"1718\">Given the<strong>use of X-rays<\/strong>, all women of childbearing age must be certain that they are not pregnant; if in doubt, a test is performed before the procedure.<\/p>\n<p data-start=\"1720\" data-end=\"1763\">During ERCP, the following can also be performed:<\/p>\n<ul data-start=\"1764\" data-end=\"2302\">\n<li data-start=\"1764\" data-end=\"1845\">\n<p data-start=\"1766\" data-end=\"1845\"><strong data-start=\"1766\" data-end=\"1778\">Biopsies:<\/strong> taking small tissue samples for histological analysis<\/p>\n<\/li>\n<li data-start=\"1846\" data-end=\"1993\">\n<p data-start=\"1848\" data-end=\"1993\"><strong data-start=\"1848\" data-end=\"1888\">Biliary or pancreatic sphincterotomy:<\/strong> cutting the muscle that closes the ducts at the level of Vater&#8217;s papilla, to operate in the upstream ducts<\/p>\n<\/li>\n<li data-start=\"1994\" data-end=\"2302\">\n<p data-start=\"1996\" data-end=\"2302\"><strong data-start=\"1996\" data-end=\"2034\">Prosthesis (stent) placement:<\/strong> plastic or metal prostheses to recanalize narrowing or stenosis of the bile and pancreatic ducts. In the case of tumor stenosis, stents can be used preoperatively to resolve jaundice or as palliative therapy in inoperable patients<\/p>\n<\/li>\n<\/ul>\n<p data-start=\"2304\" data-end=\"2457\"><strong>ERCP is a complex procedure with possible complications<\/strong> such as acute pancreatitis (3.5%), hemorrhage (1.3%), perforation (0.1-0.6%), and infection (1-2%).<\/p>\n<p data-start=\"2464\" data-end=\"2562\"><strong data-start=\"2464\" data-end=\"2562\">In order to complete the diagnosis and staging of pancreatic cancer, they can also be performed:<\/strong><\/p>\n<ul data-start=\"2564\" data-end=\"2652\">\n<li data-start=\"2564\" data-end=\"2619\">\n<p data-start=\"2566\" data-end=\"2619\">CT scan of the abdomen and chest with contrast medium<\/p>\n<\/li>\n<li data-start=\"2620\" data-end=\"2652\">\n<p data-start=\"2622\" data-end=\"2652\">Cholangio-Magnetic Resonance<\/p>\n<\/li>\n<\/ul>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Analysis of tumor markers in blood<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p data-start=\"93\" data-end=\"330\">Through a blood test, it is possible to measure the amount of two particular <strong>proteins<\/strong>, called tumor markers, that may be produced by pancreatic cancer cells:<strong> CEA<\/strong> (Carcino-Embryonic Antigen) and <strong>CA19-9<\/strong>.<\/p>\n<p data-start=\"332\" data-end=\"621\">Their concentration in the blood <strong>correlates with the extent of the tumor<\/strong> and tends to increase with disease progression. When present, these markers are useful for assessing the severity of the tumor, monitoring its progress over time, and checking the effectiveness of the therapies taken.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Histological analysis<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p><span style=\"font-weight: 400;\">The diagnosis of the tumor is obtained by the<\/span><b>histologic examination performed by the anatomo-pathologist <\/b><span style=\"font-weight: 400;\">on the samples taken during echo-endoscopy or ERCP.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In tumor diagnosis, the pathologist describes the architecture as a whole (histologic type). The definition of histologic type has its own biological significance and is useful information for treatment planning purposes.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">The main types of pancreatic cancer are:  <\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>adenocarcinoma<\/b><span style=\"font-weight: 400;\">: the majority of pancreatic neoplasms belong to this histotype,<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>neuroendocrine carcinoma<\/b><span style=\"font-weight: 400;\">: This is a rarer tumor that requires different treatment than adenocarcinoma, <\/span> <\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>cystic tumors<\/b><span style=\"font-weight: 400;\"> (mucinous and serous),<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>IPMN<\/b> (intraductal mucinous papillary neoplasm).<\/li>\n<\/ul>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n\n\t<\/div>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"staging\" class=\"h2_anchor\"><\/span>Staging<\/h2>\n\n\n\n<p>Pancreatic cancer is classified according to four stages:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Stage I<\/strong>: The tumor is confined to the pancreas and has not spread to other organs or lymph nodes;<\/li>\n\n\n\n<li><strong>Stage II<\/strong>: The tumor has spread to adjacent organs, such as the duodenum or bile duct, with or without lymph node invasion and without artery invasion (celiac trunk or superior mesenteric artery);<\/li>\n\n\n\n<li><strong>Stage III<\/strong>: The tumor has infiltrated the arteries around the pancreas (celiac trunk or superior mesenteric artery);<\/li>\n\n\n\n<li><strong>Stage IV<\/strong>: The tumor has spread to distant organs (liver, lungs, bone, non-regional lymph nodes);<\/li>\n\n\n\n<li><strong>recurrent<\/strong>: a tumor is defined as such when it recurs after treatment. Recurrence can develop in the same site as the primary tumor or in another organ.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"therapies\" class=\"h2_anchor\"><\/span>Therapies<\/h2>\n\n\n\n<p>After the diagnosis is confirmed, specialists in the multidisciplinary team evaluate a number of factors to plan an <strong>individualized course of treatment<\/strong> for the patient. In addition to the type of tumor, its size, and whether it has spread to other parts of the body, the patient&#8217;s age, general health status, and medical history are also considered. The treatment plan is then <strong>discussed with the patient<\/strong>, proposing alternative choices in case of equivalent effectiveness.<\/p>\n\n\n\n<p><strong>For selected patients<\/strong> whose tumor has peculiar characteristics or for whom standard therapies had not proved effective, there is also the possibility of receiving experimental therapies within clinical trials conducted by the Institute&#8217;s researchers. In case this option is considered feasible by the multidisciplinary team, it will be proposed and explained to the patient with whom a shared decision will be made.<\/p>\n\n\n\t<div id=\"block_69c26ad8896cd\" class=\"accordion-block acf-block\">\n\t\t<div class=\"my-4 lg:my-6\">\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Surgery<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p><span style=\"font-weight: 400;\">Surgery is proposed when the tumor is still localized to the pancreas: in the case of patients with adenocarcinoma, this percentage is around 25%, higher in other histologic types. Surgical intervention differs depending on the location of the lesion:<\/span><\/p>\n<ul>\n<li><b>duodenocephalopancreasectomy<\/b><span style=\"font-weight: 400;\">: is indicated in pancreatic head tumors and involves en bloc removal of the head of the pancreas, duodenum, the last part of the stomach, gallbladder, and biliary tract.<\/span><\/li>\n<li><b>distal pancreasectomy<\/b><span style=\"font-weight: 400;\">: in case of lesions of the body or tail, these portions are removed en bloc with the spleen. <\/span> <\/li>\n<li><b>total pancresectomy<\/b><span style=\"font-weight: 400;\">: is the surgery by which the entire pancreas, a portion of the small intestine, part of the stomach, bile duct, gallbladder, spleen, and most of the regional lymph nodes are removed.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">These interventions can be performed <\/span><b>open<\/b><span style=\"font-weight: 400;\"> or, in selected cases, with <\/span><b>minimally invasive techniques <\/b><span style=\"font-weight: 400;\">such as <\/span><b>laparoscopy<\/b><span style=\"font-weight: 400;\"> or <\/span><b>robotics<\/b><span style=\"font-weight: 400;\">. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">In any case, these are complex operations, both in the demolition and reconstructive phases, burdened by a high rate of postoperative complications: for this reason, they must be performed in specialized centers with adequate volume and experience.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">If the tumor has spread to distant organs and is judged inoperable, the surgeon may still decide to intervene to relieve symptoms by performing procedures such as biliary bypass or gastric bypass.<\/span><\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Recovery after surgery: the ERAS protocol<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p><span style=\"font-weight: 400;\">In recent years, the ERAS (Enhanced Recovery After Surgery) philosophy has become increasingly popular, which allows the patient a  <\/span><b>faster recovery from surgical trauma<\/b><span style=\"font-weight: 400;\">  through a whole series of arrangements, including: adequate preoperative counseling with the patient, comprehensive prehabilitation, selective use of bowel preparation and naso-gastric tube, early removal of the bladder catheter, little or no use of intravenous morphine derivatives, the use of drugs that stimulate bowel motility, the use of peridural catheter (which releases analgesic drugs directly at the level of the spinal cord without the constipating effects of morphinics given by the venous route), early resumption of ambulation, and early introduction of fluids and food by mouth.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">All these arrangements resulted in a faster resumption of normal physiological and behavioral functions, shortening the hospital stay thus reducing complications, the risk of hospital infections and thromboembolic changes.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Upon discharge, you will be scheduled for a follow-up appointment. At that time, physicians will give the patient the result of the final histologic examination and schedule subsequent oncologic checkups (follow-up).  <\/span><\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Chemotherapy<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p><span style=\"font-weight: 400;\">Chemotherapy consists of the use of <\/span><b>particular cytotoxic drugs that aim to inhibit the growth and proliferation of cancer cells<\/b><span style=\"font-weight: 400;\">  To the point of causing his death. Indeed, one of the characteristics of cancer cells is uncontrolled proliferation, which&#8211;at the same time&#8211;makes them potentially more vulnerable to chemotherapy. However, some cells in our body physiologically proliferate quickly, which is why they can be damaged by chemotherapy, causing the so-called &#8220;side effects&#8221; that will be discussed later.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Chemotherapy drugs are administered through treatment cycles with varying cadence (daily, weekly, trisweekly), the duration of which depends on the drugs used but usually does not involve hospitalization with overnight stay.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In some cases, although there is a tumor judged by the surgeon to be potentially resectable, chemotherapy or chemo-radiotherapy treatment may need to be given before and\/or after surgery, referred to as peri-operative treatment. Not all patients are candidates for such treatment as the indication is dependent on stage and risk factors.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Peri-operative treatment can be of two types:<\/span><\/p>\n<ul>\n<li><b>adjuvant<\/b><span style=\"font-weight: 400;\">, or performed after surgery in order to reduce the risk of recurrence due to the possibility that some tumor cells too small to be visualized by the naked eye may have remained;<\/span><\/li>\n<li><b>neoadjuvant<\/b><span style=\"font-weight: 400;\">, i.e., before surgery, in order to make surgery less invasive and decrease the risk of local recurrence, particularly in those cases where there is tumor invasion of lymph nodes near the pancreas.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Standard treatment of advanced cancers involves the use of chemotherapy. In these cases, chemotherapy is primarily aimed at chronicizing the tumor disease.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Chemotherapeutic drugs generally used for the treatment of pancreatic cancer are:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">5-Fluorouracil (5FU) combined with folinic acid (intravenous route)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Gemcitabine (intravenous route)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Irinotecan (intravenous route)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Cisplatin (intravenous route)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Oxaliplatin (intravenous route)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Nab-Paclitaxel (intravenous route)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Capecitabine (oral route)<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">These drugs can be carried out <\/span><b>In combination with each other or used individually<\/b><span style=\"font-weight: 400;\">  or still sequentially in relation to the clinical picture. The oncologist evaluates several factors-the site affected by the tumor, the general condition, and the type of chemotherapy already received-before making the most appropriate treatment proposal.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Finally, numerous clinical trials are underway with the goal of identifying the most effective chemotherapy treatment for advanced cancers and the best way to administer these drugs. Still, molecules with a different mechanism of action than chemotherapeutic drugs, characterized by greater selectivity toward cancer cells and thus fewer side effects, are being tested. Therefore, in some cases, the oncologist might propose participation in taking part in a clinical trial.  <\/span><\/p>\n<p><b>Side effects of chemotherapy<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Reactions to chemotherapy vary from subject to subject and are usually time-limited in duration. Among the  <\/span><b>side effects <\/b><span style=\"font-weight: 400;\">most common we have nausea\/vomiting, skin rashes, reductions in red, white and platelet cells, fatigue, hair loss (alopecia).<\/span><\/p>\n<p><span style=\"font-weight: 400;\">To date, we have at our disposal numerous principals and drugs that can effectively prevent and treat almost all side effects. However, tolerance to chemotherapy is subjective, and it is not uncommon to adjust the dosages or timing of treatment to suit the patient&#8217;s characteristics.<\/span><\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Radiotherapy<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p><span style=\"font-weight: 400;\">Radiation therapy is a <\/span><b>localized therapy<\/b><span style=\"font-weight: 400;\">, non-invasive that, through the use of <\/span><b>high-energy radiation (ionizing radiation)<\/b><span style=\"font-weight: 400;\">, is able to damage and bring to necrosis neoplastic cells localized at the level of the treatment area, <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">Radiation therapy is commonly performed <\/span><b>on an outpatient basis<\/b><span style=\"font-weight: 400;\">, on a daily basis, excluding Saturdays, Sundays and holidays. The duration of each treatment generally varies between ten to twenty minutes and the number of sessions depends on several factors, both related to radiotherapy techniques and the stage of disease, and generally ranges from one to four to six weeks. Such treatment does not make one radioactive, and allows one to be in contact with other people without danger throughout the period.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Radiation therapy in pancreatic cancers can be used <\/span><b>alone or in combination with chemotherapy<\/b><span style=\"font-weight: 400;\"> depending on the presentation and stage of disease. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">Radiation therapy may be used <\/span><b>with stereotactic technique<\/b><span style=\"font-weight: 400;\"> (a highly complex technique involving the delivery of high doses per fraction with extreme precision in a small number of sessions), which <\/span><b>conventional<\/b><span style=\"font-weight: 400;\">, both preoperatively, postoperatively, and in cases of persistent disease after surgery.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Finally, radiotherapy can be used <\/span><b>for antalgic purposes and to reduce disease<\/b><span style=\"font-weight: 400;\"> where it is symptomatic (presence of pain, jaundice or other symptoms from infiltration of abdominal organs). <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">Among the <\/span><b>side effects<\/b><span style=\"font-weight: 400;\"> most common include nausea, gastrointestinal upset and fatigue (or asthenia).<\/span><\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n\n\t<\/div>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"ongoing-support\" class=\"h2_anchor\"><\/span>Ongoing support<\/h2>\n\n\n\n<p>At the Candiolo Institute, the doctors and nurses of the multidisciplinary team are available to provide the patient with all the support he or she needs to manage the various side effects he or she will face in the course of treatment.<\/p>\n\n\n\t<div id=\"block_69c26ad8897bc\" class=\"accordion-block acf-block\">\n\t\t<div class=\"my-4 lg:my-6\">\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Direct line to specialists<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p><!-- wp:paragraph --><!-- \/wp:paragraph --><!-- wp:paragraph -->The cancer patient is often a <strong>fragile patient<\/strong>, who needs help and support in his or her disease journey: when he or she experiences an ailment, whether related to the disease or a side effect of therapy, he or she should be able to receive a specialist&#8217;s opinion quickly, through a &#8220;fast track.&#8221;<\/p>\n<p><!-- \/wp:paragraph --><!-- wp:paragraph -->For this reason, at the Candiolo Institute there is an <strong>assistance service<\/strong> every day, Monday through Friday from 8 a.m. to 5 p.m.: just call the secretary of the Oncology Day Hospital (011.993.3775 ) reporting the need for an urgent consultation, and the patient is quickly contacted by his or her specialist doctor.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Continuing care and palliative care<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p>At the Candiolo Institute, specialists from different disciplines are available at Candiolo for patients who need or request them to offer:<\/p>\n<p><!-- \/wp:paragraph --> <!-- wp:list --><\/p>\n<ul class=\"wp-block-list\">\n<li style=\"list-style-type: none;\">\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>nutritional support<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><!-- \/wp:list-item --> <!-- wp:list-item --><\/p>\n<ul class=\"wp-block-list\">\n<li style=\"list-style-type: none;\">\n<ul class=\"wp-block-list\">\n<li>psychological support<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><!-- \/wp:list-item --> <!-- wp:list-item --><\/p>\n<ul class=\"wp-block-list\">\n<li style=\"list-style-type: none;\">\n<ul class=\"wp-block-list\">\n<li>physiotherapy<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><!-- \/wp:list-item --> <!-- wp:list-item --><\/p>\n<ul class=\"wp-block-list\">\n<li style=\"list-style-type: none;\">\n<ul class=\"wp-block-list\">\n<li>dressing of venous access devices<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><!-- \/wp:list-item --> <!-- wp:list-item --><\/p>\n<ul class=\"wp-block-list\">\n<li style=\"list-style-type: none;\">\n<ul class=\"wp-block-list\">\n<li>pain therapy<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><!-- \/wp:list-item --> <!-- wp:list-item --><\/p>\n<ul class=\"wp-block-list\">\n<li style=\"list-style-type: none;\">\n<ul class=\"wp-block-list\">\n<li>Management of other coexisting conditions.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Social work<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p><strong>Social work<\/strong><\/p>\n<p><!-- \/wp:paragraph --> <!-- wp:paragraph --><\/p>\n<p>The Social Service Department of the Candiolo Institute conducts <strong>information and orientation interviews for patients and their families <\/strong>on how to access services in the area and how to obtain welfare and social security benefits provided by law (disability, benefits for aids and prostheses, work leave, etc.).<\/p>\n<p><!-- \/wp:paragraph --> <!-- wp:paragraph --><\/p>\n<p>The service operates on Wednesdays and Fridays from 9 a.m. to 1 p.m. &#8211; Phone: 011.993.30<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Follow up<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p>With the conclusion of the course of treatment, the follow-up period begins during which, through a series of examinations and visits, the side effects of the therapies performed, their effectiveness, and the patient&#8217;s functional recovery are monitored.<\/p>\n<p><!-- \/wp:paragraph --> <!-- wp:paragraph --><\/p>\n<p>Follow-up examinations are especially important to intercept any recurrences early so that appropriate therapy can be intervened. For the patient, they are also a valuable opportunity for dialogue with their medical specialist.<\/p>\n<p><!-- \/wp:paragraph --> <!-- wp:paragraph --><\/p>\n<p>It is the same specialist doctor who schedules follow-up visits, in which the patient&#8217;s health condition is assessed and the required test reports are viewed.<\/p>\n<p><!-- \/wp:paragraph --> <!-- wp:paragraph --><\/p>\n<p><strong>Checkups are performed at scheduled intervals for the duration of 5-10 years <\/strong>and include examination, blood chemistry tests, CEA marker assay, Ca19.9, and CT chest and abdomen with contrast medium.<\/p>\n<p><!-- \/wp:paragraph --> <!-- wp:paragraph --><\/p>\n<p><strong>They have a shorter cadence at first (three to six months)<\/strong>, then gradually thin out over time (once a year). The frequency and type of examinations provided depend on the stage of the tumor and the treatments given.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n\n\t<\/div>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"interdisciplinary-group\" class=\"h2_anchor\"><\/span>Interdisciplinary Group<\/h2>\n\n\n\n<p>Every cancer requires, in all phases of disease management, a<strong> multidisciplinary approach<\/strong> that at the Candiolo Institute is guaranteed by a team of different specialists, belonging to the various clinical and surgical departments of the Institute: this team is called GIC (Interdisciplinary Care Group). The GIC ensures that<strong> each patient is taken care of throughout the diagnostic-therapeutic process<\/strong>, including prescribing and booking examinations and communicating with the patient and his or her family members. The GIC defines and shares a <strong>personalized care pathway<\/strong> for each patient, based not only on the type and stage of the tumor, but also on the patient&#8217;s own characteristics. The goal is to ensure that he or she has the best outcome both oncologically and functionally and the maintenance of a good quality of life.The Group also<strong> works closely with researchers<\/strong> at the Institute to ensure that patients have rapid access to the latest research-produced innovations in screening, diagnosis and treatment.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"clinical-divisions\" class=\"h2_anchor\"><\/span>Clinical divisions  <\/h2>\n\n\n\n<p>The diagnostic and therapeutic pathway for pancreatic cancer at Candiolo involves several clinical divisions, including:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/irccs.com\/en\/divisioni-cliniche\/oncologic-surgery\/\" type=\"medical-area\" id=\"5163\">Oncologic surgery<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/irccs.com\/en\/divisioni-cliniche\/gastroenterology-and-digestive-endoscopy\/\" type=\"medical-area\" id=\"5125\">Gastroenterology and digestive endoscopy<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/irccs.com\/en\/divisioni-cliniche\/anesthesia-and-resuscitation\/\" type=\"medical-area\" id=\"5185\">Anesthesia and resuscitation<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/irccs.com\/en\/divisioni-cliniche\/medical-oncology\/\" type=\"medical-area\" id=\"5169\">Medical oncology<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/irccs.com\/en\/divisioni-cliniche\/radiodiagnostics\/\" type=\"medical-area\" id=\"5101\">Radiodiagnostics<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/irccs.com\/en\/divisioni-cliniche\/nuclear-medicine\/\" type=\"medical-area\" id=\"5106\">Nuclear medicine<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/irccs.com\/en\/divisioni-cliniche\/radiotherapy\/\" type=\"medical-area\" id=\"5104\">Radiotherapy<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/irccs.com\/en\/divisioni-cliniche\/pathologic-anatomy\/\" type=\"medical-area\" id=\"5118\">Pathologic anatomy<\/a><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"clinical-studies\" class=\"h2_anchor\"><\/span>Clinical studies<\/h2>\n\n\n\n<p>Researchers at the Candiolo Institute are currently involved in <strong>several national and international projects<\/strong> on pancreatic cancers.  <\/p>\n\n\n\n<p>The clinical trials currently underway are:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>CTC Profiling Study<\/strong>: observational study dedicated to the analysis of circulating tumor cells and tissue biomarkers in patients with pancreatic neoplasia who are candidates for surgery and\/or systemic treatment<\/li>\n\n\n\n<li>There are also <strong>phase 2 and phase 3 randomized trials<\/strong>evaluating the use of standard chemotherapy in combination with monoclonal antibodies and\/or molecularly targeted therapies in patients whose tumor has specific molecular features (e.g., Claudin 18.2 positivity, BRCA gene mutations..).<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"why-choose-us\" class=\"h2_anchor\"><\/span>Why choose us<\/h2>\n\n\n\n<p>At Candiolo IRCCS Institute, every pancreatic cancer patient is followed in a highly specialized manner, thanks to the synergistic work of a dedicated Interdisciplinary Care Group (ICG).<\/p>\n\n\n\t<div id=\"block_69c26ad88981a\" class=\"accordion-block acf-block\">\n\t\t<div class=\"my-4 lg:my-6\">\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Clinical experience and tailored approach<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p><!-- wp:heading {\"level\":3} --><!-- \/wp:heading --><!-- wp:paragraph -->Due to the high number of cases treated each year, the Candiolo Institute is a national reference for taking pancreatic cancers. Our experience enables us to deal with even the most complex situations, always with a personalized approach built on the clinical and personal profile of each patient.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Imaging technologies and advanced diagnostics<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p>Establishing the treatment plan always starts with an <strong>accurate and timely diagnosis<\/strong>. Patients have access to state-of-the-art imaging technologies that allow accurate assessment of the extent of the disease.<\/p>\n<p><!-- \/wp:paragraph --> <!-- wp:paragraph --><\/p>\n<p>In addition, the Institute offers advanced and sophisticated laboratory investigations, including molecular and genomic analyses, which are critical for identifying biological features of cancer and guiding therapeutic decisions<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Minimally invasive surgical techniques and multidisciplinarity<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p>When indicated, surgery is performed with minimally invasive techniques (laparoscopic or thoracoscopic), which reduce operative trauma, promote faster recovery, and improve postoperative quality of life. Every treatment choice is defined within the GIC, ensuring a consistent and integrated approach.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Clinical research and access to trials<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p>As an IRCCS, the Candiolo Institute combines clinical practice with a strong vocation for scientific research. Patients can be evaluated for<strong><a href=\"#studi-clinici\">inclusion in active clinical trials<\/a><\/strong>, which represent a real chance to access innovative therapies not yet available in standard practice. Collaboration between care and research is a distinctive value that translates into concrete opportunities for the patient.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Care and support every step of the way<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p>The Interdisciplinary Care Group takes care of the person at every stage: from diagnosis to treatment to follow-up, with attention to nutritional support, psychological health, and reintegration into daily life. The organization of checkups, visits and treatment is designed to ensure continuity and serenity, always valuing the human dimension of care.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n\n\t<\/div>\n","protected":false},"featured_media":0,"template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-5330","pathology","type-pathology","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Tumors of the pancreas - Istituto di Candiolo<\/title>\n<meta name=\"description\" content=\"Pancreatic cancer: discover the diagnostic pathway and therapies of excellence offered by the Candiolo Institute, just a few miles from Turin.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/irccs.com\/en\/patologie\/tumors-of-the-pancreas\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Tumors of the pancreas - 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