Download Cancer of the Pancreas

Cancer of the Pancreas
The pancreas is a gland about 6 inches long that is located deep in the abdomen, between the stomach and the spine. The liver, intestines, and other organs surround the pancreas. The pancreas makes insulin and other hormones. These hormones enter the bloodstream and travel throughout the body. They help the body use or store the energy that comes from food. The pancreas also makes enzymes that help digest food. When cancer of the pancreas spreads outside the pancreas, cancer cells are often found in nearby lymph nodes. Sometimes cancer of the pancreas spreads to the tissue that lines the abdomen (peritoneum).
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Risk Factors
The exact causes of cancer of the pancreas are not known. These factors can increase the risk:
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Family History – The risk triples if a person’s mother, father, sister, or brother had the disease. A family history of colon or ovarian cancer also increases the risk.
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Tobacco Use – Smokers are 2 to 3 times more likely than nonsmokers to get pancreatic cancer.
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Diabetes – Occurs more often in people who have diabetes.
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Age – Risk increases with age and most people who develop this cancer are over age 60.
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Gender – It is more common in men than in women.
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Race – African-Americans are more likely than Asian-Americans, Hispanic-
Americans or Caucasians 
Chronic Pancreatitis – May also increase the risk.
Symptoms Symptoms do not usually occur in the early stages of pancreatic cancer. As the cancer grows, symptoms may include:
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Pain in the upper abdomen or upper back
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Yellow skin and eyes (jaundice)
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Dark urine
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Weakness
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Loss of appetite
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Nausea and vomiting
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Weight loss
Diagnosis
Physical Exam
The doctor will examine the skin and eyes for signs of jaundice. The abdomen will be checked for enlargement and abnormal buildup of fluid.
Lab Tests
Blood, urine, and stool samples may be obtained to check for bilirubin and other substances. Bilirubin passes from the liver through the gallbladder to the intestine. If the common bile duct is blocked by a tumor, the bilirubin cannot pass through normally. Blockages may cause the level of bilirubin in the blood, stool, or urine to be very high.
CT Scan (Computed Tomography)
A CT scan uses a computer linked to an X-ray machine that takes detailed pictures of the pancreas and other organs and blood vessels in the abdomen.
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Endoscopic Ultrasound
A gastroenterologist passes a thin lighted tube (endoscope) down your throat into your stomach and the first part of the small intestine. An ultrasound probe at the end of the tube sends out sound waves that produce a pattern of echoes as they bounce off organs. A computer makes a picture of the pancreas from these echoes as the probe is slowly pulled back through the intestine and the stomach. The picture can show a tumor in the pancreas. It can also show how deeply the cancer has invaded the blood vessels.
ERCP (Endoscopic Retrograde Cholangiopancreatography)
A gastroenterologist passes an endoscope through the mouth, down the throat and into the stomach and the first part of the small intestine. A smaller tube (catheter) is inserted through the endoscope into the bile ducts and pancreatic ducts. Dye is injected through the catheter and an X-ray is taken. The X-ray can show any narrowed or blocked ducts, which may be the result of a tumor.
Biopsy
Tissue is removed for microscopic examination to check for cancer cells.
Treatment
In most cases the aim of treatment is to control tumor growth and relieve symptoms. Methods of treatment may include:
Surgery
Surgery may be used alone or along with radiation therapy and chemotherapy. The surgeon may remove all or part of the pancreas. The extent of surgery depends on the location and size of the tumor, the stage of the disease, and the patient’s health.
Radiation Therapy
Radiation therapy uses high-energy rays to destroy the cancer cells in the treatment area. It can also be used to relieve pain and other problems caused by the cancer.
Chemotherapy
Chemotherapy is the use of drugs to destroy cancer cells. It can also be used to help reduce pain and other problems caused by the cancer. Clinical Trials
Many doctors encourage patients to think about taking part in a clinical trial. A clinical trial is one of the final stages of a long and careful cancer research process. Studies are done with cancer patients to find out whether promising approaches to cancer prevention, diagnosis, and treatment are safe and effective. Please note – if
you are involved in a clinical trial, you will receive at least the best standard treatment and will never receive a placebo for your actual cancer treatment.
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Palliative Care
When a cure or control of the disease is not possible, palliative therapy can be started. Palliative care aims to improve quality of life by controlling pain and other problems related to this disease.
Pain Control
Pain is a common problem for people with pancreatic cancer. The tumor can cause pain by pressing against nerves and other organs. Pain can be relieved or reduced in several ways:
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Pain Medication
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Radiation can help relieve pain by shrinking the tumor.
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Nerve block – An injection into the area around certain nerves in the abdomen can block the feeling of pain
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Surgery – Certain nerves can be cut to block pain.
Nutrition
Eating well during cancer treatment means getting enough calories and protein to prevent or control weight loss, maintain strength, and promote healing.
Cancer of the pancreas and its treatment may make it hard for patients to digest food and maintain a proper blood sugar level. Patients may need to take insulin or other medications such as Creon, to replace the enzymes and hormones made by the pancreas that help in the digestion of your food. Your health care provider can advise you on ways to maintain a healthy diet.
If eating is not possible, liquid nutrition may be provided through a feeding tube placed directly into the stomach. Follow-up Care
Follow-up care after treatment for cancer of the pancreas is important, in order to ensure that any changes in health are found. Patients should report any health problems to their doctor as soon as they appear.
Rev. 4.2007, Rev. 3/10, 1/13
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