Pancreatic Cancer

 

 

OVERVIEW

Pancreatic cancer occurs when malignant cells form in the tissues of the pancreas, a six-inch gland of the gastrointestinal system that lies behind the stomach and in front of the spine. The pancreas' two main functions are to produce digestive juices that break down food and to produce hormones, such as insulin and glucagon, that help control blood sugar levels. About 95 percent of pancreatic cancer begin in the gland's exocrine cells, which produce digestive juices. Cancer can also develop in the gland's endocrine cells.

In 2007, the American Cancer Society estimates that 37,000 men and women will be diagnosed with pancreatic cancer. It is a particularly deadly cancer because, due to the gland's position deep inside the body, it can be difficult to detect and is often diagnosed at a late, advanced stage when treatment options are limited. Pancreatic cancer is the fourth deadliest cancer for both men and women in the United States.

The Cancer Center features the following for patients with pancreatic cancer:

  • board-certified gastroenterologist, surgical oncologist and medical oncologists who are highly skilled in the latest technologies and techniques to diagnose, treat, and manage pancreatic cancer
  • state-of-the-art diagnostic technology and imaging studies
  • clinical trials to investigate new medications and treatment methods
  • a full range of support services

board-certified  and radiation oncologists who are skilled at treating gallbladder cancer
complex surgical procedures
sophisticated diagnostic testing and imaging studies
clinical trials to investigate new medications and treatment methods
a full range of support services

DIAGNOSTIC SERVICES

Your doctor may use several different approaches to diagnose pancreatic cancer. The Cancer Center offers:

  • CT scan
  • chest X-ray
  • MRI
  • PET scan
  • endoscopic ultrasound
  • laparoscopy
  • tissue biopsy
  • fine needle aspiration biopsy
  • ERCP (endoscopic retrograde cholangiopancreatography, an endoscopic test to view the small intestines, bile ducts, and pancreatic ducts)
  • PCT (percutaneous transhepatic cholangiography using dye to show bile duct blockages)

 

RISK FACTORS

Risk factors for pancreatic cancer include:

  • smoking
  • long-standing diabetes
  • chronic pancreatitis
  • certain hereditary conditions, such as hereditary pancreatitis, multiple endocrine neoplasia type 1 syndrome, hereditary non-polyposis colon cancer, and von Hippel-Landau syndrome

 

SYMPTOMS

Pancreatic cancer can be difficult to detect and diagnose early for a number of reasons:

  • Because the gland lies deep inside the body, tumors in the pancreas cannot be easily seen nor felt by a physician.
  • There are often no noticeable symptoms in the early stages of the disease.
  • When symptoms are present, they are the same symptoms of many other types of problems. These symptoms include jaundice, abdominal pain or pain in the middle to upper back, unintended or unexpected weight loss, digestive problems, gallbladder enlargement, blood clots or fatty tissue abnormalities, diabetes mellitus, or problems with sugar metabolization.

 

TREATMENT SERVICES

A combination of treatment methods may be used to treat pancreatic cancer. These may include surgery, radiation therapy, and chemotherapy. There are also several palliative care treatments that may be used to treat pain that may result when a tumor presses on nerves or other organs near the pancreas. Palliative treatments include oral and injectable medications, cutting the nerves, radiation therapy, and chemotherapy.

Surgery

There are a number of surgical procedures used to treat pancreatic cancer. These surgeries are complex procedures and should only be performed by a surgical oncologist who is highly experienced in the procedure. At The Cancer Center, we have several surgical oncologist who specialize in treating only cancers of the digestive system, including pancreatic cancer. Surgical procedures to treat pancreatic cancer include:

  • the Whipple procedure (removal of the head of the pancreas, gallbladder, part of the stomach, part of the small intestine, and the bile ducts)
  • total pancreatectomy (removal of the whole pancreas, part of the stomach, part of the small intestine, the common bile duct, the gallbladder, the spleen, and nearby lymph nodes)
  • distal pancreatectomy (removal of the body and tail of the pancreas and the spleen)

If the cancer has spread and is at an advanced stage, one of the following palliative surgical procedures may be used to treat pain or other side effects:

  • surgical biliary bypass (to create a new pathway for bile to go around cancer that is blocking the small intestine)
  • endoscopic stent placement (placing of a stent to drain bile in an area where cancer has blocked the bile duct)
  • gastric bypass (sewing the stomach directly to the small intestine to allow the patient to eat if the tumor is blocking the flow of food from the stomach)

Radiation Therapy

External beam radiation therapy may be used to shrink tumors before surgery, to kill remaining pancreatic cancer cells after surgery, or to relieve pain by shrinking tumors that cannot be removed entirely.

Chemotherapy

Chemotherapy may be used to treat pancreatic cancer that has spread to areas outside the gland. It may also be used in combination with radiation therapy to shrink tumors that cannot be removed entirely.

Palliative Treatments

There are several palliative treatments that can be used to treat pain that may result when a tumor presses on nerves or other organs near the pancreas. These include oral medications, medications injected into the area around the affected area, cutting the nerves to block the feeling of pain, and radiation therapy to relieve pain by shrinking the tumor.