About Pancreatic Cancer

The pancreas is a small gland in the upper abdomen, behind the stomach. It helps break down food by releasing digestive enzymes, and secretes hormones (especially insulin) to control blood sugar levels.

Most pancreatic cancers start in the cells that produce digestive enzymes. As these tumors grow, they can invade nearby organs – the bile duct, intestine or stomach – as well as nearby blood vessels. Cancer cells can also break away and spread to lymph nodes and other, distant organs, such as the liver.

In the United States, over 40,000 people are diagnosed with pancreatic adenocarcinoma every year. It is the fourth-leading cause of cancer death. Unfortunately, because this cancer does not cause symptoms in its early stages, the diagnosis is usually only made after it has spread beyond the pancreas. 

Risk Factors

  • Smoking
  • Older age
  • Race: African Americans are more likely to develop pancreatic cancer than Causasians, Hispanics or Asians.
  • Genetic factors: about 10% of patients with pancreatic cancer have some inherited risk for this disease. These genetic syndromes include familial atypical multiple mole melanoma syndrome, familial breast cancer, and Peutz-Jeghers syndrome. Patients with a family history of pancreatic cancer are also at increased risk of developing the disease.
  • Obesity
  • Diabetes
  • Chronic pancreatitis

Symptoms

Patients do not usually have symptoms in the early stages of pancreatic cancer.

Some symptoms that may occur include:

  • Unintentional weight loss
  • Jaundice (yellowing of the eyes and skin), which may be associated with itching, dark urine and whitish stools
  • Severe pain in the upper abdomen and / or back.

Keep in mind that these symptoms can be caused by other health problems that are more common than pancreatic cancer.

Diagnosis & Staging

USA Mitchell Cancer Institute provides comprehensive, compassionate and personalized care for all patients with pancreatic cancer.

Diagnostic tests may include

  • Blood tests (liver function tests, tumor markers)
  • Imaging (CT scans, magnetic resonance imaging (MRI), endoscopic ultrasound)
  • Biopsy (either endoscopically or percutaneously) may be required.

Pancreatic cancer can be assigned one of the following four stages:

  • Stage I – The tumor is smaller than 2cm and is completely contained within the pancreas.
  • Stage II– The tumor has grown outside of the pancreas, but has not invaded a major blood vessel. There may be spread to nearby lymph nodes, but not to distant sites.
  • Stage III – The tumor has grown into major blood vessels.
  • Stage IV – The cancer has spread to other parts of the body, such as the liver or the peritoneum (inner lining of the abdomen).

Treatment

Your treatment will likely include a combination of different therapies. Our multidisciplinary approach to pancreatic cancer ensures that surgeons, medical oncologists and radiation oncologists discuss you and your cancer before treatment starts. This allows selection of the optimal combination and timing of various therapies.

Surgery

When a pancreatic tumor can be removed safely, an operation is the best chance to improve survival.

  • The Whipple procedure, also known as pancreatoduodenectomy, is the most common type of operation for pancreatic cancer. This operation is for tumors in the head (right side) of the pancreas.  It involves removal of the head of the pancreas, the first part of the small intestine (known as the duodenum), the lower portion of the bile duct, surrounding lymph nodes, gallbladder and sometimes part of the stomach. The remaining pancreas, stomach and bile duct are then re-connected to the small intestine to enable digestion. Although this operation is complex, it is safe and effective for many patients.
  • Distal pancreatectomy is the operation to remove a tumor in the left side of the pancreas (body and tail). It may also require removal of the spleen. This operation is often performed laparoscopically.

Chemotherapy

Chemotherapy (also called systemic therapy) is a drug or combination of drugs that are given to kill cancer cells wherever they are in the body. In pancreatic cancer, chemotherapy has been shown to improve survival. It can be given to patients in conjunction with radiation, before or after an operation, or to treat patients whose cancer has spread to organs beyond the pancreas.

Radiation Therapy

Radiation therapy is often used in combination with surgery and chemotherapy. By shrinking tumors, it can allow an operation to be performed, it can be used after an operation has removed the tumor, and it can also be used to relieve pain when the tumor cannot be safely removed.

Managing Symptoms

Controlling symptoms of cancer and side effects of therapies is a critical part of your treatment. We aim to not only extend your survival but maintain your quality of life.

Related Links

Pancreatic Cancer Home Page
http://www.cancer.gov/cancertopics/types/pancreatic/

Pancreatic Cancer Action Network
http://www.pancan.org/

Lustgarten Foundation for Pancreatic Cancer
http://www.lustgarten.org/home

NCCN Guidelines
http://www.nccn.org/patients/guidelines/pancreatic/index.html

Mitchell Cancer Institute
http://www.usahealthsystem.com/mci

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