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    Pancreatic cancer

    Pancreatic cancer; Cancer - pancreas

    Pancreatic cancer is cancer that starts inthe pancreas.

    Causes

    The pancreas is a large organ behind the stomach. It makes and releases enzymes into the intestines that help the body absorb food, especially fats. The pancreas also makes and releases insulin and glucagon. These are hormones that help the body control blood sugar level.

    There are different types of pancreatic cancers. The type depends on the cell the cancer develops in. Examples include:

    • Glucagonoma
    • Insulinoma
    • Islet cell tumor
    • VIPoma

    The exact cause of pancreatic cancer is unknown. It is more common in persons who:

    • Are obese
    • Have a diet high in fat and low in fruits and vegetables
    • Have diabetes
    • Have long-term exposure to certain chemicals
    • Have long-term inflammation of the pancreas (chronic pancreatitis)
    • Smoke

    Pancreatic cancer is slightly more common in women than in men. The risk increases with age. Family history of the disease also increases the chance of getting this cancer.

    Symptoms

    A tumor (cancer) in the pancreas may grow without any symptoms at first. This means the cancer is often advanced when it is first found.

    Symptoms of pancreatic cancer include:

    • Diarrhea
    • Dark urine and clay-colored stools
    • Fatigue and weakness
    • Increase in blood sugar levals (diabetes)
    • Jaundice (a yellow color in the skin, mucous membranes, or white part of theeyes) and itching of the skin
    • Loss of appetite and weight loss
    • Nausea and vomiting
    • Pain or discomfort in the upper part of the belly or abdomen

    Exams and Tests

    The doctor will perform a physical exam and ask about your symptoms. During the exam, the doctor may feel a lump (mass) in your abdomen.

    Blood tests that may be ordered include:

    • Complete blood count (CBC)
    • Liver function tests
    • Serum bilirubin

    Imaging tests that may be ordered include:

    • CT scan of the abdomen
    • Endoscopic retrograde cholangiopancreatography (ERCP)
    • Endoscopic ultrasound
    • MRI of the abdomen
    • Pancreatic biopsy

    If tests confirm you have pancreatic cancer, more tests will be done to see if the cancer has spread. This is called staging. Staging helps guide treatment and gives you an idea of what to expect.

    Treatment

    Treatment depends on the stage of the tumor.

    Surgery may be done if the tumor has not spread or has spread very little. Along with surgery, chemotherapy or radiation therapy or both may be used.

    When the tumor has not spread out of the pancreas but cannot be removed, chemotherapy and radiation therapy together may be recommended.

    When the tumor has spread (metastasized) to other organs such as the liver, chemotherapy alone is usually used.

    With advanced cancer, the goal of treatment is tomanage pain and other symptoms. For example, if the tube that carries bile is blocked by the pancreatic tumor, a procedure to place a tiny metal tube (stent) may be done to open the blockage. This can help relieve loss of appetite, jaundice, and itching of the skin.

    Support Groups

    You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.

    Outlook (Prognosis)

    Some patients with pancreatic cancer that can be surgically removed are cured. But in most patients the tumor has spread and cannot be completely removed at the time of diagnosis.

    Chemotherapy and radiation are often given after surgery to increase the cure rate (this is called adjuvant therapy). For pancreatic cancer that cannot be removed completely with surgery or cancer that has spread beyond the pancreas, a cure is not possible. But chemotherapy can extend one’s life.

    When to Contact a Medical Professional

    Call for an appointment with your health care provider if you have:

    • Abdominal pain that does not go away
    • Back pain
    • Loss of appetite
    • Unexplained fatigue or weight loss
    • Other symptoms of this disorder

    Prevention

    • If you smoke, now is the time to quit.
    • Keepa diet high in fruits, vegetables, and whole grains.
    • Exercise regularly to stay at a healthy weight.

    References

    Drebin JA, Sun W, Metz JM, Furth EE. Carcinoma of the pancreas. In: Abeloff MD, Armitage JO, Niederhuber JE, et al., eds. Abeloff’s Clinical Oncology. 4th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 85.

    National Cancer Institute: PDQ Pancreatic Cancer Treatment. Bethesda, Md: National Cancer Institute. Date last modified 06/12/2013. Accessed September 24, 2013.

    National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Pancreatic Adenocarcinoma. Version 1.2013. Accessed September 24, 2013.

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              Review Date: 9/20/2013

              Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

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