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Pancreatic Cancer
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Pancreatic cancer involves cancer of the pancreas, which is an organ in the abdomen that lies along the underside of the stomach. The pancreas has two main uses-that of secreting enzymes used in the digestion of food and of making insulin to process the glucose you absorb in your system from your diet.
Pancreatic cancer is not a good cancer to have because many do not survive the cancer, even if it is detected in its earliest stages. The symptoms of pancreatic cancer can be vague initially, making it difficult for your doctor to diagnose until you have pain or unless the doctor is suspicious enough to do some abdominal testing. It is a rapidly growing cancer and is a leading cause of death from cancer.
The signs and symptoms of having pancreatic cancer vary with how severe the disease is. Unfortunately, signs and symptoms do not often occur until the disease has progressed and surgery is no longer possible. The typical symptoms include jaundice (yellowing of the eyes and skin), pain in the upper abdomen, pain that radiates to the back, weight loss, poor appetite, depression and blood clots in the body. If you have any of these symptoms, see your doctor for further evaluation.
The pancreas is a six inch long organ that looks like a pear. It secretes insulin and digestive juices. Pancreatic cancer is caused by mutations in the DNA of one or more cells in the pancreas so that the tissue that comes from these cells grows out of control. A tumor forms that eventually spreads beyond the border of the pancreas. The cancer that forms in the ducts of the pancreas is called adenocarcinoma. The majority of pancreatic cancers are considered adenocarcinomas. Cancer that forms in the insulin secreting cells is called an endocrine cancer. These are, in fact, not common at all.
Risk factors of pancreatic cancer include being older than age 60 years, being African American, being obese, having chronic pancreatitis or inflammation of the pancreas, having a family history of an increased cancer risk, having a family history of pancreatic cancer or having diabetes. Smokers have a higher risk of pancreatic cancer.
Complications of pancreatic cancer include jaundice, if the pancreatic cancer blocks the biliary ducts. This can be treated by inserting a tube or stent in the biliary ducts. You can have abdominal and/or back pain as a result of having advanced pancreatic cancer that pushes on the nerves in the abdomen. Radiation can shrink the tumor and can ease the pain. A bowel obstruction can occur if the pancreas presses on the small bowel, blocking the flow of food through the intestinal tract. Weight loss can occur because of nausea and vomiting or because the body can't process nutrients like it used to. Doctors can recommend pancreatic enzyme supplements to help digestion occur at a better pace and to keep you digesting your food better.
Doctors have several tools with which to diagnose pancreatic cancer. Ultrasound is available of the abdomen that can show the presence of a tumor within the pancreas. CT scan or MRI scan of the abdomen are good tests to show the size, shape and irregularities of the pancreas. An ERCP or endoscopic retrograde cholangiopancreatography uses a dye to shine the biliary ducts in the pancreas. It uses an endoscope to put dye into the pancreas and x rays show irregularities of the biliary ducts and pancreatic ducts. You can also take a biopsy at the time of the ERCP. There is also an endoscopic ultrasound device that can show the appearance of the pancreas using an ultrasound passed through an endoscope. A biopsy can also be done in an open procedure to see what's going on in a suspicious pancreas. It can completely diagnose the presence of pancreatic cancer.
The stage of the pancreatic cancer determines the success or failure in surviving the cancer; however, even those with stage I pancreatic cancer do not do well. Staging can be done using a laparoscope to look inside the abdomen, CT scan, MRI scan, X ray tests of the chest and tests to check for tumor markers in the blood. One tumor marker used in pancreatic cancer is CA19-9. The test is good but isn't always reliable. It can be used to test for what your prognosis is expected to be.
Treatment may involve surgery to remove the portion of the pancreas that contains tumor. One such surgery is called the Whipple procedure. It removes the head of the pancreas and the duodenum, the first portion of the small intestine. You can also have a distal pancreatectomy if the tail of the pancreas is affected. Radiation is used to shrink cancer cells. Chemotherapy is available for pancreatic cancer and is used when the tumor has spread to other body areas in a metastatic tumor. Targeted drug therapy is directed specifically at cancer cells and prevents their growth. It is usually used along with chemotherapy if the cancer is in its advanced stages.