Radiation with chemo for pancreatic cancer after whipple procedure?

There are many reasons why treatment is offered after successful surgery:
1) Recurrences happen quicker/more often when no further therapy done
2) Anatomically, the pancreas is a difficult organ to remove and get good clean tissue margins around the tumor; the amount of normal tissue around a tumor might be non-existent to vanishingly thin, hence chance for local recurrence is high.
3) Pancreas cancer has a striking predilection for spread to the liver, one of the reasons chemo is offered (the other: it makes the radiation work better). It may have already spread at the time of surgery and not be apparent by any test.

Chemo and radiation can cause cancer in small numbers of patients. It is a trade-off, but one we feel is worth it. The truly tiny risk of future treatment-induced cancer against the overwhelming likelihood of recurrent pancreas cancer and near-certain death seems worth it to me (and to nearly all patients).

As for Renee’s moronic answer, treatment is based on randomized controlled trials which have demonstrated the following:
1) GITSG study from 1985 showed small benefit in survival in chemoradiotherapy + surgery over surgery alone. This study was small however.
2) Subsequent EORTC (European) group failed to confirm findings in similar study. However this study included patients other than pancreas cancer, which may have raised to survival for surgery-only patients, and hence erasing any difference between the 2 treatment arms.
3) ESPAC 1 trial compared surgery alone versus chemoradiotherapy after surgery versus chemo alone after surgery versus chemoradiotherapy + more chemo after surgery: This study showed a benefit only for chemo after surgery, but this study has been widely criticized by experts because of results analysis and major non-adherence to protocol by patients. The Europeans though were the major participants in these trials, and they tend to rely on the last study’s results more heavily.

Current trials suggest gemcitabine chemotherapy after surgery may have survival benefits.

What is best is not known; clinical trial participation should be encouraged whenever possible to help sort out best therapy. However, prognosis is poor with surgery alone, and there is data to support "some" other therapy after surgery. Chemo is widely regarded as beneficial, radiation a little less clear, though in my opinion remains a standard of care for many.

I hope that helps.

God bless and best wishes

Chemo is not a good option. It could be the medical profession is trying to get more money out of you. Yes, cancer is likely to come back later in life. Chemo does nothing to cure the cancer just "rid" of it temporally.

I was dianosed with Pnacreatic Cancer in late september 2009, I had the whipple procedure on the 14th of Dec 2009.
I started chemo at the end of April 2010, and I found that even drinking as much fluid as I could (2 ltrs was reccomended) daily, I still found that the Chemo was building up in my body. Loss of appetite, aches in all joints,
and a general feeling of total sickness, not nausea just unable to cope with the Chemo. I visited my Oncologist yesterday who tried very strongly to get me to continue with the chemo, but he was unable to convince me to keep up with the treatment.
I have decided to go off the chemo,( gem zar), not because it is no good but because I found that i wa unable to cope with the treament.
Have I done the right thing, I’m not sure, but I needed quality, not constant aches and pains. I can only hope that my personal resolve and inner strength get me through