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Pancreatic Cancer

Alternative names: Pancreatic Carcinoma, Cancer of the Pancreas

What is pancreatic cancer?
What are the signs of pancreatic cancer?
What causes pancreatic cancer?
How does my doctor tell if I have pancreatic cancer?
How is pancreatic cancer treated?

What is pancreatic cancer?

Cancer is when abnormal cells grow and damage the tissues that make up the organs of the body. Pancreatic cancer is cancer that starts in the pancreas, the gland that makes insulin and other hormones, as well as enzymes for digestion. Pancreatic cancer is the fourth leading cause of cancer deaths in the United States . Most pancreatic cancers begin in the ducts that carry digestive juices to the small intestine.

What are the signs of pancreatic cancer?

In its early stages, pancreatic cancer causes no symptoms. But as the cancer grows, a person with pancreatic cancer may have:

  • Pain in the upper abdomen or upper back
  • Jaundice (yellowing) of the skin and whites of the eyes
  • Unusually dark urine
  • Bowel movements that are unusually light in color
  • Weakness
  • Loss of appetite
  • Nausea and vomiting

What causes pancreatic cancer?

As with other cancers, the exact cause of pancreatic cancer is unknown. Certain things increase a person's chances of developing pancreatic cancer:

  • Smoking - cigarette smokers are two or three times more likely than nonsmokers to develop pancreatic cancer
  • Diabetes
  • Obesity
  • A family history of pancreatic cancer, or a family history of colon or ovarian cancer
  • Chronic pancreatitis, or ongoing inflammation of the pancreas

How does my doctor tell if I have pancreatic cancer?

In addition to a physical examination, your doctor may perform one or more of these tests to check for pancreatic cancer:

  • Blood, urine, and stool sample tests to examine bilirubin levels . A tumor in a pancreatic duct will raise the level of this substance in your blood, urine, and bowel movements.
  • An abdominal ultrasound, which uses sound waves to create images of your internal organs
  • An endoscopic ultrasound allows your doctor to place an ultrasound probe inside the digestive (GI) tract, very close to an area where you might have problems. These images are far more detailed than those of a traditional ultrasound. You will be given medication to make you relaxed and drowsy, and will need someone to drive you home after the procedure.
  • An abdominal CT (Computed Tomography) scan, which will show any changes to your pancreas
  • Endoscopic retrograde cholangiopancreatography (ERCP) uses a thin, flexible tube with a tiny video camera on the end to find problems in the liver, bile ducts, and pancreas. The test uses X-rays and a liquid dye to locate gallstones, tumors, and other problems. In some cases, these problems can be treated at the same time.

A biopsy taken during the ERCP procedure will help a doctor check body tissue for signs of cancer cells. The doctor will take the tissue sample with a tiny needle. A pathologist will then study the tissue sample with a microscope to look for cancer cells.

How is pancreatic cancer treated?

Treatment for pancreatic cancer depends on the size of the tumor in the pancreas, and if the cancer has spread to other parts of the body.

Non-Surgical

Only about 20% of pancreatic tumors can be removed by surgery. In most cases, doctors will recommend a combination of radiation therapy and chemotherapy, or chemotherapy alone, to treat pancreatic cancer.

  • Radiation therapy damages cancer cells and stops them from growing through the use of high-powered rays. The treatment is usually given five days a week for five to six weeks. The patient does not need to stay in the hospital between treatments.
  • Chemotherapy uses drugs to kill cancer cells. Several different drugs may be used, and they may be taken orally or injected into a muscle. There are recovery periods between cycles of chemotherapy.

Surgery

  • In a Whipple procedure, the surgeon removes the widest part of the pancreas, and part of the small intestine, bile duct, and stomach
  • In a distal pancreatectomy, the surgeon takes out the part of the pancreas that contains the tumor, and often the spleen as well
  • In a total pancreatectomy, the surgeon removes the entire pancreas, part of the small intestine, a portion of the stomach, the common bile duct, the gallbladder, the spleen, and nearby lymph nodes
  • If a tumor is blocking the flow of digestive juices, the surgeon can create a bypass with a small mesh tube - called a stent - to keep the duct open. Sometimes this can be done with non-invasive surgery.

After surgery to remove a part or all of the pancreas, a patient will have trouble digesting food, and will need to follow a special diet. The patient will need to take pancreatic enzymes or hormones to replace the ones the pancreas used to create, and possibly insulin as well.

A doctor may recommend radiation therapy and chemotherapy to follow the surgery to remove a pancreatic tumor.

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