Pancreatic
Cancer
What
is it?
The pancreas is a gland about
five inches long located behind the stomach.
It is surrounded by the liver, gallbladder,
and small intestine.
The pancreas has two main functions.
One is to produce digestive fluids needed
to neutralize stomach acids and break down food.
The second is to produce hormones, such as
insulin, that are needed to metabolize sugar.
Pancreatic cancer occurs when abnormal
(cancerous) cells grow in the tissues of the
pancreas. Ninety-five
percent of pancreatic cancers occur in the ducts
that carry pancreatic juices. A
rare type of pancreatic cancer, called
cystadenocarcinoma, begins in the cells that
produce insulin and other hormones.
Who
gets it?
Pancreatic cancer is the
fourth most common cancer in men and the fifth
most common in women in the U.S.
It occurs nearly twice as often in
men as women, but rarely develops before age 50.
It is
two to three times more common in heavy smokers
than in non-smokers. People who have chronic
pancreatitis are at a higher risk of developing pancreatic cancer.
Pancreatic
cancer is not contagious.
What
causes it?
While little is known about
the cause, the following factors may increase the risk of getting pancreatic cancer.
They include exposure to cancer-causing agents; cigarette
smoking; a high fat, low fiber diet; a diet high
in foods containing food additives; and diabetes.
Although the link has not been proven,
people who work with petroleum and certain
chemicals used in the dry cleaning industry should
follow the safety guidelines for handling these
chemicals.
What
are the symptoms?
Unfortunately, pancreatic
cancer usually causes no symptoms until the tumor
is large. At that point, the cancer has usually spread
(metastasized) to nearby lymph nodes, the liver,
or the lungs.
The first symptoms are usually abdominal
pain and weight loss.
Other symptoms depend upon the location of
the cancer. About
80% of pancreatic cancers occur in the “head”
of the pancreas.
This is the area closest to the common bile
duct. Jaundice,
which means the skin and whites of the eyes look
yellow, occurs when the bile duct becomes
obstructed. Other
symptoms include mid-back pain, nausea and
diarrhea, general weakness, itchy skin,
light-colored bowel movements, and slow digestion
of food. The
liver and gallbladder may be swollen.
About 20% of pancreatic cancers occur in the “tail” of
the pancreas.
These tumors usually block the vein that
drains the spleen, which enlarges the spleen and
the varicose veins around the stomach and
esophagus. Symptoms
include pain in the abdomen that usually gets
worse about 3 or 4 hours after a meal; back pain
that changes as you change position; loss of
appetite; and blood clots in the legs.
In the rare cases of pancreatic cancer (cystadenocarcinoma)
that affect the hormone-secreting portion of the
pancreas, the pancreas will produce too much
insulin or other hormones. Symptoms may include
weakness or dizziness, chills, muscle spasms, or
diarrhea.
How
is it diagnosed?
Because early symptoms of
pancreatic cancer are difficult to detect and are
often ignored, it can be difficult to diagnose. Your
doctor will take a complete medical history.
It is important to explain any recent
symptoms, such as any abdominal pain, or sudden
changes in appetite, diet, or weight. Your
doctor will closely examine your abdominal area,
feeling for any masses in the area of the
pancreas. Blood
tests will show the effects of cancer, such as
anemia or high blood sugar level, and rule out
other liver diseases that can also cause jaundice.
If you have pancreatic cancer, diagnostic
tests can help the doctor determine how far the
cancer has progressed, which is called
“staging.”
Common diagnostic tests include ultrasound scans, computed
tomography (CT) scans, and endoscopic retrograde
cholangiopancreatography (ERCP).
ERCP is an x-ray technique that provides a
close look at the pancreatic duct.
During the test, the physician can take a
tissue sample (biopsy) to be studied for cancer
cells. Sometimes
a biopsy must be done during surgery.
One type of surgery is called laparoscopy.
A laparoscope is a thin, lighted tube
that is inserted into the abdomen through a small
incision. In
addition to a biopsy, the doctor can identify the
location and extent of the disease.
In certain cases, a laparotomy may be
necessary. With
this surgical technique, the doctor makes a larger
incision so he or she can examine the organs in
the abdomen.
What
is the treatment?
Most symptoms of pancreatic
cancer are not noticed until the disease has
progressed significantly.
At that point, treatment is aimed at
improving quality of life by controlling symptoms.
However, patients who develop signs and
symptoms of pancreatic cancer early may be cured
with surgery if the cancer has not spread.
The most common surgery is called the
Whipple procedure, where the surgeon removes the
head of the pancreas, the duodenum, part of the
stomach, and other nearby tissue. Another
type of surgery is a total pancreatectomy.
This procedure removes the entire pancreas,
the duodenum, common bile duct, gallbladder,
spleen, and nearby lymph nodes. You may also
require chemotherapy to destroy cancer cells and
radiation therapy to shrink the tumor.
Because pancreatic cancer affects the production of
pancreatic enzymes and insulin, you may also need
to take medication to replace these enzymes and
hormones. Many
people seek new treatment methods through clinical
trials (research studies).
You should always consult your doctor
before taking part in these types of studies.
Self-care
tips
Because early detection is
important in the treatment of pancreatic cancer,
report any sudden weight loss, digestive problems,
weakness, and lack of energy to your doctor.
If you have been diagnosed with pancreatic
cancer, follow your doctor’s recommendations for
diet, rest, and medical treatment.
While the exact cause of pancreatic cancer
is not known, you can lower your risk by eating a
high fiber, low fat diet; exercising regularly;
and avoiding smoking.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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