Pancreatic Cancer

What is the Pancreas?

The pancreas is a gland about six inches long that is shaped like a thin pear lying on its side. It has two main functions in the body:

• To make juices that help digest (break down) food.
• To make hormones such as insulin and glucagon that help control blood sugar levels. Both of these hormones help the body use and store the energy it gets from food.

What is Pancreatic Cancer?

Pancreatic cancer is a disease in which malignant (cancer) cells form in the tissues of the pancreas. Cancer happens when a group of abnormal cells (a malignant tumor) grows in an uncontrolled way, often spreading through an organ, or to other parts of the body. When cancer cells form in the pancreas, they are most often found in its ducts – which produce digestive enzymes. This type of cancer is called pancreatic adenocarcinoma, more simply referred to as “pancreatic cancer.” Though rare, cancer cells can also form in the hormone-producing cells of the pancreas, which is referred to as islet or pancreatic neuroendocrine cancer.

Risk Factors

• Smoking.
• Being very overweight.
• Having a personal history of diabetes or chronic pancreatitis.
• Having a family history of pancreatic cancer or pancreatitis.
• Having certain hereditary conditions such as:
  • Multiple endocrine neoplasia type 1 (MENl) syndrome. 
  • Hereditary nonpolyposis colon cancer (HNPCC) also known as Lynch syndrome. Von Hippel Lindau syndrome. 
  • Peutz Jeghers syndrome. 
  • Hereditary breast and ovarian cancer syndrome. 
  • Familial atypical multiple mole melanoma (FAMMM) syndrome. 
  • Ataxia telangiectasia. 

Signs and Symptoms

There are usually no signs or symptoms of pancreatic cancer until the disease has reached late stages. Once symptoms do occur, they are often vague and treated as symptoms of other conditions. They include:

• Upper abdominal and/or back pain
• Jaundice (yellowing of skin and eyes)
• Loss of appetite
• Weight loss
• Nausea/vomiting
• Darkened urine
• Light colored stools

Since many other diseases and conditions may cause similar symptoms, it’s important to see your doctor right away if you experience any of the above.

Diagnosis

If pancreatic cancer is suspected, your doctor may perform one of more of the following diagnostic tests:

• Physical exam and health history: An exam of the body to check general signs of health including checking for signs of disease such as lumps or anything else that seems unusual
• Tumor marker test: A procedure in which a sample of blood, urine, or tissue is checked to measure the amounts of certain substances called tumor markers, which are linked to types of cancer
• MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body
• CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body taken from different angles
• PET scan (positron emission tomography scan): A procedure in which a small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body
• Abdominal ultrasound: An ultrasound exam used to make pictures of the inside of the abdomen
• Endoscopic ultrasound (EUS): A procedure in which an endoscope is inserted into the body usually through the mouth or rectum
• Endoscopic retrograde cholangiopancreatography (ERCP): A procedure used to X-ray the ducts (tubes) that carry bile from the liver to the gallbladder and from the gallbladder to the small intestine
• Percutaneous transhepatic cholangiography (PTC): A procedure used to x ray the liver and bile ducts
• Laparoscopy: A surgical procedure to look at the organs inside the abdomen to check for signs of disease
• Biopsy: Removing a tissue sample for laboratory testing

Prognosis Factors

The prognosis and treatment options depend on the following: 

• Whether or not the tumor can be removed by surgery
• The stage of the cancer (the size of the tumor and whether the cancer has spread outside the pancreas to nearby tissues or lymph nodes or to other places in the body).
• The patient's general health.
• Whether the cancer has just been diagnosed or has recurred (come back).

Pancreatic cancer can be controlled only if it is found before it has spread and when it can be completely removed by surgery. If the cancer has spread, palliative treatment can improve the patient's quality of life by controlling the symptoms and complications of this disease. 

Treatment Options

Five types of standard treatments are used:

• Surgery 
• Radiation therapy
• Chemotherapy 
• Chemoradiation therapy 
• Targeted therapy 

• Treatments for pain caused by pancreatic cancer
• Guidance on special nutritional needs brought on by the disease

Clinical Trials