Pancreatic Cancer
Introduction
Anatomy
When you eat, the exocrine gland in your pancreas produces digestive enzymes and bicarbonates. They travel through the pancreatic duct to your small intestine. Your small intestine breaks down the liquefied food from your stomach even further so that your body can absorb the nutrients. The enzymes break down the proteins, carbohydrates, and fats in the food that you eat. The bicarbonates protect your small intestine from the irritating digestive acids produced by the stomach. The remaining waste products from the small intestine travel to the large intestine.
Causes
Endocrine cell tumors are less common. They may also be referred to as islet tumors. Although some endocrine tumors may be cancerous, the majority of them are not.
Symptoms
Diagnosis
A doctor can begin to diagnose pancreatic cancer by reviewing your medical history and conducting some tests and a physical examination that focuses on the abdominal area. Imaging tests may be used to help identify the cancer and to see if it has spread.
Computed tomography (CT) scans and magnetic resonance imaging (MRI) scans are used to take pictures of the pancreas and internal organs. Positron emission tomography (PET) scans use a radioactive sugar substance that cancer cells absorb. The substance makes the location of pancreatic cancer and spreading cancer appear on the photos. CT and PET scans may be used together to help stage cancer and identify early cancers. An ultrasound is an imaging test that uses sound waves to create a picture of the internal organs. An angiography is used to see if a tumor is blocking the blood flow in your pancreas.
An endoscopic retrograde cholangiopancreatography (ERCP) uses a probe that is inserted through the mouth into the stomach. An ERCP uses a dye to view the pancreas, bile ducts, and nearby structures. An endoscope is a thin tube with a light and a viewing instrument at the end of it. After you are sedated, the tube is passed through your mouth and into your small intestine. An endoscopic ultrasound (EUS) is a similar device which uses sound waves to create a picture of your pancreas and surrounding structures. A biopsy forceps may be passed through the EUS to take a sample of the tissue to be examined under the microscope.
Blood tests are used to evaluate your pancreas and liver functioning. A biopsy may be used to determine if the cells in a suspected area are cancerous or not. A biopsy entails obtaining a tissue or fluid sample for examination. A laparoscopy, also referred to as keyhole surgery, involves inserting a thin instrument into the abdomen to identify the size of a tumor and whether it has spread.
If you have pancreatic cancer, your doctor will assign your cancer a classification stage based on the results of all of your tests. Staging describes the cancer and how it has metastasized. Cancer that has spread from its original site to other parts of the body is termed metastatic cancer. Staging is helpful for treatment planning and recovery prediction.
There is more than one type of staging system for cancer, and you should make sure that you and your doctor are referring to the same one. Generally, lower numbers in a classification system indicate a less serious cancer and higher numbers indicate a more serious cancer. The stages may be subdivided into classifications that use letters and numbers.
Treatment
Surgery may be used to remove pancreatic tumors. A Whipple procedure, a pancreaticoduodenectomy, is a surgery that removes the head of the pancreas, sections of the stomach and small intestine, common bile duct, gallbladder, and regional lymph nodes. The pancreas and common bile duct are reattached to the small intestine. Another type of surgery may be used for people with a bile obstruction. Surgery and the placement of a biliary stent may be used to relieve an obstruction or blockage.
Radiation therapy uses high energy X-rays to kill cancer cells and shrink tumors. Radiation therapy may be received before a surgery to reduce the size of a tumor. It may be received after surgery to help prevent the cancer from returning. Radiation therapy and chemotherapy may be used to treat cancer that has spread.
Chemotherapy uses drugs to kill cancer cells. It may be used alone to treat early stage pancreatic cancer or in combination with other treatment methods. Chemotherapy may be combined with targeted therapy drugs for people with advanced pancreatic cancer.
The experience of cancer and cancer treatments may be a very emotional experience for you and your loved ones. It is important to embrace positive sources of support. Some people find comfort in their families, friends, co-workers, counselors, and faith. Cancer support groups are a helpful resource where you can receive support, information, and understanding from people with similar experiences. Ask your doctor for support groups near you.
Prevention
Am I at Risk
Risk factors may increase your likelihood of developing pancreatic cancer, although some people that develop pancreatic cancer do not have any risk factors. People with all of the risk factors may never develop the disease; however, the chance of developing pancreatic cancer increases with the more risk factors you have. You should tell your doctor about your risk factors and discuss your concerns.
Risk factors for pancreatic cancer:
_____ The risk of pancreatic cancer increases with age. The majority of pancreatic cancers occur in people that are over age 55._____ Men experience pancreatic cancer more frequently than women.
_____ African Americans experience the most cases of pancreatic cancer.
_____ Smoking is a significant risk factor for pancreatic cancer.
_____ Researchers believe that there might be a link between eating a lot of red meat, pork, or processed meats, such as bacon or sausage, and pancreatic cancer.
_____ People that are very overweight or obese have a higher risk of pancreatic cancer.
_____ Diabetes increases the risk of pancreatic cancer.
_____ Chronic pancreatitis, a long-term inflammation of the pancreas, is a risk factor for
pancreatic cancer.
_____ Exposure to certain chemicals, such as bug spray, dyes, or gasoline products may increase the risk of pancreatic cancer.
_____ It appears that some types of pancreatic cancer may be inherited. If your family members have had pancreatic cancer, ask your doctor about your risk. Genetic tests or tumor marker tests may be used to help show if you have a high risk of developing pancreatic cancer.
Complications
Advancements
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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.
The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on February 16, 2022. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.
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