Cancer of the Pancreas

What is pancreatic cancer?

Cancer of the pancreas is an abnormal growth of the cells in the pancreas. The pancreas makes juices to help the small intestine digest food. The pancreas also makes hormones, such as insulin and glucagon. The hormones go directly into the bloodstream to help the body use and store the energy it gets from food. The pancreas is located behind the stomach.

How does it occur?

Exactly what causes most cases of pancreatic cancer is not known. Most cases of pancreatic cancer occur in older adults. Some things that increase the risk of this disease are:

smoking
diabetes
chronic pancreatitis.

Rarely, some families have inherited conditions that are also risk factors for pancreatic cancer.

What are the symptoms?

Pancreatic cancer has been called a silent disease because it usually does not cause symptoms early on. When symptoms do appear, they may be so vague that they may be ignored or appear to be some other disease.

Some symptoms of pancreatic cancer are:

yellowing of the skin and eyes, called jaundice
pain in the upper or middle belly and mid-back
unexplained weight loss
loss of appetite
tiredness.

How is it diagnosed?

This cancer usually cannot be detected early, unlike other cancers such as breast and colon cancer, because the pancreas is tucked away, deep in the abdomen. It can be hard to diagnose. Your health care provider will ask about your symptoms. You will have a physical exam. Your provider may feel a hard lump in your belly. Your liver or gallbladder may be swollen.

Tests you may have are:

blood tests
CT scan of the abdomen
endoscopic ultrasound (A thin, flexible, lighted tube is inserted through the mouth into the stomach. It is then used to bounce high-energy sound waves off the organs to create a picture of the organs and help determine the extent of the cancer.)
a needle biopsy (the removal of cells or tissues for lab tests with a thin needle inserted through your skin and into the pancreas after your skin has been numbed with an anesthetic)
laparoscopy (a surgical procedure for looking inside the belly and possibly taking a sample of tissue for tests)
a procedure called ERCP (endoscopic retrograde cholangiopancreatography).

An ERCP is a common procedure used to look at the liver, gallbladder, bile ducts, and pancreas. After you are given a sedative, a specialist in digestive problems will pass an endoscope through your mouth, esophagus, and stomach into the first part of the small intestine. From this point the tube can be passed into the bile ducts near the gallbladder or the ducts connecting the small intestine with the pancreas. A sample of tissue can be removed (a biopsy) with tiny tools passed through the scope. The tissue sample will then be tested in the lab.

How is it treated?

The treatment depends on how advanced the cancer is and your general health. Parts or all of the pancreas and possibly other organs, such as the gallbladder can sometimes be removed. Other types of operations may help relieve symptoms if the cancer cannot be removed. For example, bypass surgery may help to relieve obstruction of the bile duct and stomach.

You may have surgery to try to cure the pancreatic cancer, or your health care provider may recommend chemotherapy and radiation therapy.

Your provider may give you other treatments to help with pain, such as injecting medicine into the area around affected nerves or cutting the nerves to block the feeling of pain.

How long will the effects last?

Cancer of the pancreas is very hard to control. Symptoms of pancreatic cancer usually are not recognized until late in the course of the disease, when surgery will not be able to cure the cancer. However, sometimes pancreatic cancer is diagnosed early and cured with surgery. When a cure is not possible, treatment can improve the quality of your life by controlling symptoms and complications of this disease.

How can I take care of myself?

In general, focus on controlling your symptoms. The following may be helpful:

Follow your health care provider's advice about diet.
Eat small, frequent meals instead of large meals.
Take pancreatic enzyme pills if your provider prescribes them. These pills replace the enzymes usually made by your pancreas and carried with the juices through the duct of the pancreas into the small intestine to help digest your food. If your duct is blocked by the cancer, taking these pills will help your digestion.
Get enough rest.
Take pain medicines as prescribed by your provider when you need them. Do not delay or avoid taking prescribed drugs.
Your medicines may make you drowsy. Don't drive or perform tasks that require you to be alert if you are drowsy.
Discuss your symptoms and concerns openly with your provider.
Ask your provider to recommend a counselor to help deal with your concerns and feelings.

How can I prevent pancreatic cancer?

Since the causes of pancreatic cancer are unknown, there is no reliable way to prevent it. General cancer prevention guidelines include eating a healthy diet, maintaining a healthy weight, and avoiding smoking and alcohol.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File CNC3535F.HTM Release 9.0/2006