Pancreatic, Liver and Bile Duct Cancer Program at Providence Cancer Institute of Orange County
At Providence Cancer Institute of Orange County, you have access to all the potential therapies you need – whether you have pancreatic cancer, liver cancer or another related cancer diagnosis.
From our pancreatic cancer screening program to innovative technologies and treatments like histotripsy, we’re dedicated to getting you the most advanced care possible.
Pancreatic, Liver and Bile Duct Cancer Program at Providence Cancer Institute of Orange County
At Providence Cancer Institute of Orange County, you have access to all the potential therapies you need – whether you have pancreatic cancer, liver cancer or another related cancer diagnosis.
From our pancreatic cancer screening program to innovative technologies and treatments like histotripsy, we’re dedicated to getting you the most advanced care possible.
Our Approach to Pancreatic, Liver and Bile Duct Cancer Care
Our pancreatic, liver and bile duct cancer program partners you with an expert team, including gastroenterologists who specialize in cancers near the gastrointestinal (GI) tract.
Additionally, our oncology nurse navigators are always available to answer your questions and support you before, during and after treatment.
We focus on both treating and preventing cancer. Through our pancreatic cancer screening and prevention program, we screen for multiple cancer types to see if you’re facing increased risks. That way, we can find cancer early when it’s easier to treat.
A variety of convenient services are available to you. We offer a walk-in genetics clinic, multiple clinical trial research options, support groups and more.
Cancer Conditions We Treat
We focus on treating patients with these related cancers:
- Bile duct cancer
- Gallbladder cancer
- Liver cancer, also called hepatocellular cancer
- Pancreatic cancer
Meet Our Expert Cancer Team
At the Providence Orange County Cancer Institute, our multi-disciplinary team is committed to providing expert care to every patient. We work together to deliver a personalized approach to prevention and treatment, supporting you at every stage. With our collaborative expertise, you receive dedicated guidance and compassionate support throughout your journey.
Testing and Diagnostics
Our care team uses many tools to provide a diagnosis and learn which therapies will work best to treat your cancer type based on your individual needs.
An abdominal ultrasound, also known as an abdominal sonogram, is a diagnostic imaging technique that uses high-frequency sound waves to create an image of your internal organs. Your care team can use this imaging to detect, diagnose and treat conditions that affect the abdominal region.
An endoscopic ultrasound (EUS) is a non-invasive diagnostic procedure that helps us inspect and diagnose conditions within the gastrointestinal tract, as well as nearby organs. Like an endoscopy, EUS involves an endoscope – a thin tube with a camera on the end inserted into the mouth or rectum – along with an ultrasound transducer.
The ultrasound transducer uses soundwaves so that your care team can view organs like the pancreas, which is often hard to see because of its position in the body. This imaging helps evaluate the size and status of growths, like tumors or cysts.
A biopsy is a procedure used to remove a tissue sample from the body. The extracted tissue is examined by interventional specialists to determine the presence or cause of a disease.
Liver biopsies are often performed to determine the cause of abnormal liver function, swelling of the liver or jaundice. They are also used to evaluate the effects of liver cancer and cirrhosis of the liver.
A biopsy is a procedure to remove a tissue sample from the body. The extracted tissue is examined by interventional specialists to determine the presence or cause of a disease. When it comes to the pancreas, biopsies are often used to evaluate the presence and stage of pancreatic cancer.
A pancreas biopsy can help assess how a tumor is affecting your pancreas’ natural function, allowing your doctor to determine the next treatment steps. It’s performed during an endoscopic ultrasound using a fine needle. The ultrasound carefully images the pancreas while the fine needle extracts the tissue sample.
Our program uses genetic testing along with additional blood tests, imaging or ultrasounds to check for cancer and pancreatic cysts that could increase your cancer risk.
Typically, we recommend regular screenings for patients with a higher risk due to family history or other factors:
- If you’re not sure about your risk for pancreatic cancer, genetic testing and genetic counseling can help determine the risk level for you or others in your family.
- If you already have a cancer diagnosis, genetic testing can help us understand the genetic makeup of your tumor, so we can take a more targeted approach to your treatment.
Regular screenings help us find any changes and possible signs of cancer early.
We offer a walk-in genetics clinic for your convenience, as well as scheduled appointments with genetic counselors.
A PET scan is a nuclear imaging procedure that uses a combination of computer technology and a radioactive imaging agent called a tracer to produce clear, high-resolution images of the body and its various functions in real-time and in 3D. They allow doctors to evaluate a wide range of conditions – including brain disorders such as Alzheimer’s disease and a variety of cancers – and provide more accurate diagnoses, targeted treatments and better outcomes for our patients.
Services and Treatments
Each treatment plan is unique, personalized to your cancer type and individual needs. Your care team collaborates with you and discusses your treatment plan in detail, which may include a combination of therapies.
Medical oncology uses systemic therapies that travel through the bloodstream to treat cancer that has spread to other areas of the body or has a high risk of spreading. Sophisticated genetic analysis allows some of these therapies to target specific DNA mutations that cause cancer cells to develop and grow.
Adjuvant chemotherapy is treatment given after your main therapy, often surgery, to help destroy any cancer cells that may still be in the body. The goal is to lower the chance of cancer recurrence.
Anti-VEGF therapy represents a family of medications that interfere with the formation of blood vessels in cancerous tumors. Through this interference, they help control tumors by starving them of their blood supply.
Commercial clinical trials represent research studies sponsored by the pharmaceutical industry. These trials may include new non-FDA-approved drugs, FDA-approved drugs being used in a non-FDA-approved cancer or a new novel combination. These trials are often used to obtain FDA approval for the new treatment.
Cooperative group (NCTN) clinical trials are studies designed by a consortium of leading national cancer researchers. The goal of these studies is to test the newest and most cutting-edge innovations.
Participants in clinical trials may receive treatments not yet available to everyone. They also receive extra follow-up care in addition to their standard care. Taking part in the search for new and better cancer treatments can be personally satisfying, as participants become part of the advancement of medicine.
Every clinical trial has inclusion and exclusion restrictions that a patient must meet before enrolling in the trial. Before you decide to take part, doctors and clinical trial coordinators tell you all the known risks.
Immunotherapy boosts or restores the body’s natural defenses. Cellular therapies, stem cell transplants and biologic therapies use your own cells to fight disease and support recovery.
Molecularly targeted therapy uses drugs – including oral and intravenous (IV) biologics – to target specific molecules that allow cancer to grow. This therapy enables personalized treatment for patients, especially those who carry certain genetic mutations or abnormalities.
You receive neoadjuvant chemotherapy before your main treatment to help improve outcomes. Starting treatment earlier can sometimes shrink a tumor, make surgery less complex or lower the risk of cancer spreading. For some patients, it may also help reduce long-term side effects or lower the risk of complications, especially if lymph nodes are involved.
Surgical therapies involve an operation or procedure to remove cancer from the body. Surgery may be the main treatment for some invasive cancers, but it’s only one part of the entire treatment plan.
Laparoscopic liver resection is a minimally invasive procedure where up to half of the liver is surgically removed through a laparoscope – a thin rod with a tiny camera and high-intensity light – leaving the remainder of the organ in place.
Liver ablation is a treatment that uses heat or energy to slow or destroy cancerous growths in the liver.
Liver transplant is a surgical procedure to replace a diseased liver with either a portion of or an entire donated liver.
A liver transplant has the potential to effectively restore liver function, improve quality of life and eliminate the need for ongoing cancer treatments. However, using a liver transplant as a treatment option for liver cancer depends on various health factors, patient eligibility and donor organ availability.
This advanced procedure requires a sophisticated facility and equipment, along with highly specialized physicians.
A pancreatectomy is the surgical removal of part or all of the pancreas to treat cancer or severe disease. It may be done laparoscopically using small incisions for faster recovery, or as an open procedure for complex cases.
In a total pancreatectomy, the entire pancreas is removed, along with the gallbladder, part of the small intestine and sometimes the spleen. This surgery requires lifelong insulin and enzyme support but may relieve symptoms and improve quality of life.
Open liver resection is the surgical removal of a tumor from the liver through an incision in the abdomen. The diseased part of the liver is also removed.
Robotic-assisted surgery is a new way of performing minimally invasive procedures, incorporating techniques that allow a surgeon to operate through several small incisions, or ports, about the size of a dime. Robotic-assisted surgery uses technology proven to effectively treat a wide range of conditions with less pain, faster recovery and reduced risk of complications following surgery.
The Whipple procedure is one of the most advanced and effective surgeries for pancreatic and neuroendocrine cancers. This complex operation removes tumors along with surrounding tissue and nearby blood vessels to help stop the spread of cancer and improve long-term outcomes.
Radiation is effective in killing cancer cells and shrinking tumors. It can be used alone or in combination with other cancer treatments.
Image-guided radiation therapy delivers high-dose radiation, guided by imaging, directly to tumors. It provides precise and accurate cancer treatment while preserving healthy tissue and potentially keeping the side effects that you experience to a minimum.
IMRT and VMAT are advanced types of radiation therapies:
- IMRT uses advanced technology to manipulate the radiation beams to conform to the shape of a tumor.
- VMAT is a subtype of IMRT in which the machine actively delivers radiation beams while moving in an arc around the patient.
The arc-based therapy provided via VMAT delivers high doses of radiation to more focused areas, reducing side effects, toxicity and harm to vital organs and the overall treatment time.
Learn more about intensity-modulated radiation therapy (IMRT)
Radiopharmaceuticals (Y-90) is a group of treatments delivered by a catheter and consisting of millions of microscopic, radioactive microspheres that are infused into the arteries that feed the tumor. Y-90 microspheres are delivered into the arteries and can be used to treat cancer that has spread, or metastasized, to the liver. These particles become embedded into the cancer cells and deliver the radiation directly to the cancer site. Two commonly used agents are Theraspheres and Sir Spheres.
The advantage of this treatment is that the radiation penetrates only a short distance, so the risk to the organ is very low while the radiation dose to treat the cancer is very high.
Both SABR and SBRT deliver high-dose radiation to a specific area with very precise targeting through special immobilization and imaging techniques. These therapies can include stereotactic radiosurgery (SRS) systems like CyberKnife, which delivers precisely targeted radiation using a robotic delivery system with sub-millimeter accuracy. SABR and SBRT are often outpatient procedures, so you could go home the same day.
SGRT/SIGRT uses real-time beam guidance and surface-recognition technology to target tumors, reducing side effects and harm to vital organs. This therapy can be used in conjunction with IMRT and VMAT to help guide your positioning during treatment and account for any involuntary movement, making it less invasive and potentially more comfortable for you.
3DCRT uses 3D planning and CT imaging to better target tumors and cancerous areas and improve the outcome of radiation treatment. It also limits the damage to healthy tissue, potentially decreasing risks like infection and minimizing side effects.
Learn more about three-dimensional conformal radiation therapy (3DCRT)
Additional therapies may also be part of the treatment plan for a small number of patients.
Histotripsy is a revolutionary treatment for both cancerous and non-cancerous liver tumors, as well as metastatic cancer that has spread to the liver. This FDA-approved procedure uses high-energy ultrasound waves that convert to sonic beams and destroy liver tumors – without a single incision or needle.
Histotripsy has shown a 95.5% success rate in clinical trials, and multiple tumors can be treated in a single therapy session. It can be used to effectively treat liver tumors in patients who aren’t candidates for open surgery or have been told their liver tumor is inoperable.
Interventional radiology is a minimally invasive procedure guided by radiologic imaging. It may be used to implant a port, or vascular access device, to obtain diagnostic material, remove fluid from the chest or abdomen or deliver treatment locally.
TACE is a minimally invasive procedure – primarily used to treat liver cancer – that uses imaging guidance to directly deliver chemotherapy drugs to a tumor via embolic agents. The embolic agents are injected into the blood vessel feeding the tumor, which cuts off the blood supply and keeps the chemotherapy drugs within the tumor.
This procedure helps patients with advanced stages of cancer or those who aren’t good candidates for surgery.
Histotripsy: A Breakthrough Liver Cancer Therapy
Histotripsy is a revolutionary treatment for both cancerous and non-cancerous liver tumors, as well as metastatic cancer that has spread to the liver. This FDA-approved procedure uses high-energy ultrasound waves that convert to sonic beams and destroy liver tumors – without a single incision or needle.
Patient Resources & Support
Get a second opinion from our world-class cancer experts, so that you can make important decisions about your treatment plan and move forward with confidence. Our web page will walk you through the next steps and let you know how to prepare for your appointment.
Are you looking for a clinical trial, either for yourself or a patient? Currently, Providence Cancer Institute of Orange County is involved in over 100 ongoing clinical trials.
We offer comprehensive support services – including oncology nurse navigators, transportation services and financial counseling – to help you and your loved ones throughout your cancer journey.
Frequently Asked Questions
Pancreatic cancer is a different type of cancer than liver cancer. However, pancreatic cancer most commonly spreads to the liver, so the same type of cancer doctor usually specializes in both liver and pancreatic cancer.
Your doctor may refer you for different imaging and testing of your body tissue so that we can make a cancer diagnosis. Scans and pathology tests also help us look for changes, or mutations, in your cancer, which can tell us how to treat your specific cancer type.
It can take one to two weeks to receive pathology results, but these results are important for getting you the targeted treatment that serves you best.
Though not all cancers are genetic, genetic testing can be a helpful tool for understanding your cancer or additional cancer risks.
If you know that you have a higher cancer risk, you can:
- Receive regular screenings to catch cancer early, when it’s most treatable
- Be on the lookout for other cancer types, especially if you have a specific germline mutation
- Inform your family, so they can also be tested
If you already have a cancer diagnosis, genetic testing can help us determine what caused or contributed to your cancer, leading to a more targeted treatment plan.
Histotripsy is a revolutionary, noninvasive treatment for liver tumors. During the procedure, an interventional radiologist uses high-energy ultrasound waves that convert to sonic beams and destroy liver tumors without the need for incision.
Because histotripsy is noninvasive, it minimizes risk of infection, bleeding and other complications. This precise technology can effectively treat tumors in patients who aren’t candidates for open surgery or who have been told their liver tumor is inoperable.
Our institute is the proud home of the first hospital in California to provide histotripsy.
Not all cancer treatments include chemotherapy drugs. Your cancer care team will review your options in detail to find the best approach for your treatment.
If your treatment plan does include chemotherapy, you may experience certain side effects. Some of the most common chemotherapy side effects include:
- Anemia
- Easier bleeding and bruising
- Extreme tiredness
- Hair loss
- Inability to focus
- Loss of appetite
- Lowered immunity and increased infections
- Mood changes
Both liver and pancreatic cancer are complex and so is treatment, which can look different for everyone. Your oncology nurse navigator, along with your care team, can answer any questions you have about your personalized treatment plan.
Based on your needs, you may require additional pathology testing to check for genetic mutations. Then, you may have regular chemotherapy, targeted therapy, immunotherapy, surgery or radiation.
Yes, our support services at Providence Cancer Institute of Orange County include financial navigation to help ease your way through financial concerns and barriers.
Our staff can help you:
- Evaluate insurance health plans to ensure the right choices are made for your care
- Leverage available programs and services, such as co-pay assistance and patient assistance programs to help reduce financial barriers
- Optimize external assistance programs, such as patient financial support programs
Your oncology nurse navigator can refer you to a social worker, who can connect you with financial support as needed.
An oncology nurse navigator is a nurse or registered clinician who personally guides you from diagnosis through survivorship. They are your advocate, here to provide support and reassurance tailored to your needs – whether that's occasional conversations or daily check-ins.
Your navigator can coordinate your appointments, speak directly with your primary care physician, provide support to lower your stress, talk to your loved ones and help you access all the resources that you need.
Many people assume that if you’re joining a clinical trial, other treatment options have failed, but that’s not always the case. Your care team may know of clinical trials that offer promising, innovative therapy options that are best suited to treat your cancer type. Your participation in a clinical trial also offers a way to help others by advancing cancer research. If you’re curious, you don’t need to wait. Ask your care team as many questions as you need to, as soon as you’d like.
We’re proud to offer a variety of clinical trials with the most advanced types of therapies – right here in Orange County.
Not necessarily. Palliative care isn’t just hospice care. Palliative care offers additional support alongside your treatment, and it can start as soon as you’re diagnosed. It helps you define treatment goals, manage symptoms and improve your overall quality of life.
With palliative care, you get support managing pain, symptoms and side effects from your cancer treatment. Your palliative care team also helps you deal with physical and emotional stress, spiritual needs and more.
You have the option to incorporate palliative care into your treatment plan right from the start, which can help keep you comfortable and receive the extra support that you need.