Pancreatic Cancer

What is the pancreas?

The pancreas in a six inch oblong gland, that is located just behind the stomach. There are two types of glands that make up the pancreas, the exocrine and the endocrine glands. The exocrine gland produces enzymes that aid in the digestion of fats, proteins and carbohydrates from the foods you eat. The endocrine gland secretes insulin and other hormones that help to regulate the metabolism of blood sugars in the body.

What is pancreatic cancer?

The most common form of pancreatic cancer is exocrine tumors.

Approximately 95% of all exocrine tumors are called adenocarcinoma. Adenocarcinoma most often form in the duct of the exocrine pancreas, but it can sometimes be formed in the cells that make up the enzymes. Exocrine tumors are in most cases fatal, due to the fact that when the tumor is extremely small, it is hard to detect. By the time a diagnosis is made, the cancer has spread to other parts of the body.

Adenosquamous carcinomas, squamous cell carcinomas, and giant cell carcinomas are less common forms of exocrine pancreas tumors.

Endocrine pancreas tumors are a rare form of pancreatic cancer. This type of tumors are called islet cell tumors, with many subtypes involved, depending on which hormone producing cell it starts in. These tumors typically grow slower and are often found early. Islet tumors are often treatable even after the cancer has spread.

Who is at risk for pancreatic cancer?

There is no known cause for pancreatic cancer. However there are many known risk factors, which can contribute to this disease. Many people will develop pancreatic cancer, that have no risk factors. On the other hand, many people who have risk factors, will not develop pancreatic cancer. If you are concerned that you may have any of the risk factors listed below, talk to your Doctor. He/she will be able to answer any concerns.

1. More men than women are diagnosed with pancreatic cancer. 
2. Most pancreatic cancer is diagnosed in people over the age of 60. 
3. The risk for pancreatic cancer will triple, if anyone in your immediate family has had the disease. 
4. Chronic pancreatitis may increase the risk. 
5. African Americans are at a greater risk of developing pancreatic cancer. 
6. If you have diabetes, you are at a greater risk. 
7. Smokers are at a 50% to 75% greater chance of developing pancreatic cancer, than those who do not smoke. 
8. Those who have a diet high in fat content are at risk. 
9. Exposure to some chemicals could increase your risk of pancreatic cancer.

What are the symptoms of pancreatic cancer?

Often there are no symptoms of pancreatic cancer until the disease in the advanced stages. Once the symptoms start to appear, they will include the following.

1. Upper abdominal and upper back pain. 
2. Jaundice, which is a yellowing of the skin and the whites of the eyes and may include dark colored urine. 
3. Weight loss. 
4. Decreased appetite. 
5. Upset stomach and vomiting. 
6. Depression.

How is pancreatic cancer diagnosed?

There are many tests that your doctor may perform in order to diagnose pancreatic cancer. These include, but are not limited to the following.

1. A physical examination to look for signs of jaundice. Your doctor may examine your abdomen by feeling for changes or excessive water buildup around the pancreas, gall bladder or liver. 
2. Lab tests such as blood, urine and stool samples to check for abnormalities. 
3. An ultrasound to create images of your pancreas or other internal organs. 
4. CT scan which uses x-ray images, usually used with a type of dye that is injected into a vein This dye helps to enhance the pancreas images. 
5. MRI which creates an image of the pancreas by using a magnetic field and radio waves. 
6. ERCP is where a small lighted tube is placed into the stomach, through the mouth, to the beginning of the small intestine. Then a catheter is placed inside the lighted tube and into the ducts of the pancreas. A small amount of dye is injected into the ducts and an x-ray is taken. 
7. A biopsy may be performed, by taking tissue samples of the pancreas and checking for cancer cells. The sample may be obtained by inserting a needle through the abdomen, into the pancreas.

Staging pancreatic cancer.

Once the doctor has diagnosed pancreatic cancer through a series of tests, the pancreatic cancer must be staged. This will determine how advanced the pancreatic cancer has become. Staging will help your doctor to determine the method of treatment you are most likely to benefit from. Tests that will help to determine which stage of pancreatic cancer you have include the following. 
1. Laparoscopy is where a lighted tube which is equipped with a video camera is inserted through a small incision into the abdomen. The video is observed by the doctor, to see if the cancer has spread to your abdomen. 
2. Blood tests to determine if your blood contains tumor markers termed CA19-9. The more your blood levels of CA19-9 are elevated, the more progressed your pancreatic cancer. 
3. Chest x-ray to see if the pancreatic cancer has spread to the lungs. 
4. MRI to see if the pancreatic cancer has spread to surrounding tissue. 
5. CT scan will help the doctor to see the pancreas and help him determinine if the pancreatic cancer has spread to other areas. 
6. A bone scan may be performed to determine if the cancer has spread to the bones.

The stages of pancreatic cancer.

Stage l: The cancer has not spread from the pancreas. 
Stage ll: The cancer has spread from the pancreas to surrounding tissue and organs. 
Stage lll: The cancer has spread from the pancreas to the surrounding tissue and organs as well as to the major blood vessels and possibly spread to the lymph nodes. 
Stage lV: The cancer has spread from the pancreas to other organs such as the liver, lungs and the lining of the abdomen that surrounds your internal organs.

What is the treatment for pancreatic cancer?

The method of treatment for pancreatic varies with each patient and what stage the cancer has progressed to. Other variables include the persons age and overall health. Following is a list of options that your doctor may discuss with you, in the treatment of pancreatic cancer.

1. Surgery is not always an option with pancreatic cancer. When surgery can be performed, the type of surgery depends on the position of the tumor. A part or all of the pancreas may be removed, along with the spleen, part of the small intestine, bile duct and part of the stomach. 
2. Radiation therapy uses high energy rays to destroy cancer cells. Radiation therapy is often combined with chemotherapy before or after surgery. This combination may be recommended instead of surgery, if surgery is not an option. 
3. Chemotherapy uses drugs to target cancer cells and destroy them. Chemotherapy is often combined with radiation therapy to treat cancer that has spread from the pancreas to other organs. 
Chemotherapy may be combined with targeted drug therapy, to treat individuals with advanced pancreatic cancer. 
4. Targeted drug therapy is a new form of pancreatic cancer treatment. These drugs block chemicals needed by cancer cells to grow and divide. They are usually combined with chemotherapy in people with advanced pancreatic cancer. 
5. Clinical trials are test studies to see how a new drug, surgery or treatment will benefit pancreatic cancer. Talk to your doctor before joining a clinical trial to see if it is right for your condition.

What is the prognosis for pancreatic cancer?

The prognosis of pancreatic cancer is not a good one. The key to survival is catching this deadly disease in it’s early stages. Sadly to say, most pancreatic cancer is not diagnosed until it has reached advanced stages. The overall average survival rate of pancreatic cancer for 1 year is 20% and the 5 year survival rate is 4%.