Alan Koffron, MD, fellowship trained hepatobiliary surgeon with University Surgical Associates, explains pancreatic cancer risks, warning signs you shouldn’t ignore, and advanced treatment options. 

Pancreatic cancer is largely a silent disease process and an elusive type of cancer that affects 60,000 Americans each year. A person’s average lifetime risk of developing pancreatic cancer is about 1 in 65. Risks for developing the disease include smoking, obesity, and a family history of the disease or pancreatitis.

While cancer tends to be more prevalent as we age, people in their 40s, 50s and 60s are more commonly diagnosed with pancreatic cancer. It’s most often found with computed tomography (CT) scans, endoscopic ultrasound (EUS) and magnetic resonance imaging (MRI). Unfortunately, these screening modalities are not 100 percent effective in finding small lesions, pre-cancer or early-stage cancers. For many people diagnosed – approximately 30 percent – the cancer has already spread before symptoms become noticeable.

“The first signs of pancreatic cancer are typically abdominal or back pain that doesn’t go away, or the skin becomes jaundiced or yellow. Other symptoms include nausea, diarrhea, bloating and stool changes, along with loss of appetite, elevated blood sugar, weight loss and general fatigue,” Dr. Koffron says. “Because pancreatic cancer is much easier to treat when it’s found early, it’s important to pay attention to your body’s signals and talk to your doctor if something’s not right.”


Pancreatic cancer is a complicated condition to treat, specifically because of the pancreas’ location deep within abdomen. Although it’s not a large organ, it’s nestled right next to the blood vessels that feed the other major organs and the lymph nodes that make insulin and digestive enzymes. Its location alone makes it a technically difficult surgery to perform.

“The hope for any cancer – including pancreatic – is to surgically remove it using safe but aggressive techniques. When the cancer is contained within the pancreas and hasn’t spread to surrounding tissue, surgery is the mainstay of treatment,” Dr. Koffron says. “For tumors that are larger and beginning to grow but haven’t spread to other organs, we often use neoadjuvant chemotherapy, which means chemo that’s administered before surgery. It’s used to shrink or slow the tumor’s growth so it becomes possible to remove. For individuals whose disease has spread outside of the pancreas, chemotherapy and radiation are used to prolong survival.”


Although we know pancreatic cancer treatment is complex, the diagnosis isn’t an automatic death sentence – particularly when you choose a surgeon with the experience and education needed to offer the very latest and most effective treatment options.

“It’s important for people to know that we have the most advanced cancer-fighting surgeries and treatments right here in Chattanooga. In the last 15 years or so, surgical fellowships that focus on the techniques and procedures of the liver and pancreas allow us to do very technically difficult operations on a routine basis,” Dr. Koffron says. “The outcomes are better when you seek care from a pancreatic cancer specialist at a high-volume center – meaning one that does more than 20 operations a year, which is what we do here at Erlanger. But more than that, you have access to a dedicated surgical and recovery care team and other cancer specialists who are all working together to fight your cancer and help you live a longer and healthier life.”

If you or a loved one has been diagnosed with pancreatic cancer, you have choices when it comes to your surgeon and your treatment options. For more information or to schedule an appointment, call 423-267-0466.  


Dr. Koffron is a fellowship trained multiple-organ transplant and hepatobiliary surgeon who specializes in liver and kidney transplant and advanced surgical treatment of conditions of the liver, pancreas and biliary system. He serves as Surgical Director, Erlanger Kidney Transplant Center. 

Dr. Koffron is certified by the American Board of Surgery and fellow of the American College of Surgeons. He sees patients at the USA Surgical Specialties Building. Click here to learn more about Dr. Koffron’s education and experience.