Pancreatic cancer is caner that begins in your pancreas. Your pancreas is an organ in your abdomen that is positioned horizontally behind the lower portion of your stomach. The purpose of your pancreas is to secrete enzymes that aid in the digestion process as well as hormones that help to regulate the metabolism of your body’s sugars.
Pancreatic cancer often has a grim prognosis, even if the cancer is diagnosed early. It is important to remember that pancreatic cancer is rarely detected in its early stages. Pancreatic cancer generally spreads quickly. Due to rapid spreading and the rare ability to diagnose pancreatic cancer in its early stages, pancreatic cancer is often to be considered a leader in deaths when it comes to death caused by cancer. Many of the signs and symptoms of pancreatic cancer do not appear until the cancer is in its advanced stages. This makes surgical removal of the diseased portion of the pancreas nearly impossible.
The Function of Your Pancreas
Your pancreas is approximately a half a foot in length and has a pear-like shape, but is turned on its side. The pancreas plays a very important role in the digestive process. Your pancreas helps to secret hormones, such as insulin, which helps your body to process the sugars you consume. The pancreas also produces digestive juices, which makes it easier for your body to digest food.
Causes of Pancreatic Cancer
Doctors and medical researchers are unclear as to what specifically causes pancreatic cancer as of 2011. Pancreatic cancer occurs when the cells of your pancreas develop genetic mutations. These genetically mutated cells grow uncontrollably and continue to flourish as the regular, healthy cells of your pancreas die off. The accumulation of mutated cells can form tumors in your pancreas.
Risk Factors for Developing Pancreatic Cancer:
While cancer does not discriminate and can strict individuals of all ages, sexes, healthy or unhealthy, there are certain factors that can increase your chances of developing pancreatic cancer. These risk factors may include:
- Older age (specifically over the age of 60)
- Being of African American decent
- Those who are overweight or obese
- Chronic bouts of pancreatitis (inflammation of the pancreas)
- Being a diabetic
- Family history of pancreatic cancer
- A family history of genetic syndromes that can increase your risk of developing cancer of any kind. These genetic syndromes can include Lynch syndrome, familial atypical mole-malignant melanoma, BRCA2 gene mutation or Peutz-Jeghers syndrome.
Types of Pancreatic Cancer
The types of cells found in a biopsy of the pancreas can best determine the type of pancreatic cancer as well as the best form of treatment based on the type of cancer cells as well as the progression of the disease. Types of pancreatic cancer can include:
- Adenocarcinoma. Adenocarcinoma is a type of pancreatic cancer that occurs when cancer cells form in the ducts of the pancreas. Cells that line the ducts of your pancreas are responsible for helping your body to make digestive juices. A vast majority of pancreatic cancers are diagnosed as adenocarcinoma. However, these tumors may also be referred to as exocrine tumors.
- Endocrine cancer is also another form of pancreatic cancer. However, this type of tumor is very rare and is hardly diagnosed. Endocrine cancer occurs when cancer cells form in the hormone producing cells of the pancreas.
Stages of Pancreatic Cancer
Oncologists assign staging to pancreatic cancer based on how advanced the disease is. Cancer staging can run from stage I to stage IV. Stages are as follows:
- Stage I Pancreatic Cancer. If you are going to be diagnosed with pancreatic cancer, this is the best diagnosis to receive. At this point, the cancer is still confined to your pancreas.
- Stage II Pancreatic Cancer. Stage II cancer has spread beyond just your pancreas and now affects the nearby tissues and organs. Surrounding lymph nodes may be affected as well.
- Stage III Pancreatic Cancer. Stage III cancer indicates that the cancer has spread beyond your pancreas and its surrounding structures. The cancer may now affect the blood vessels and the lymph nodes around the pancreas.
- Stage IV Pancreatic Cancer. This is the most advanced form of pancreatic cancer. If you have been diagnosed with stage IV pancreatic cancer, the cancer has spread to distant sites of your body. This can include your lungs, liver and peritoneum (the lining of your abdominal organs).
Symptoms of Pancreatic Cancer
The signs and symptoms of pancreatic cancer may vary from person to person. In most cases, pancreatic cancer symptoms are not apparent until the end stages of the disease. Symptoms of pancreatic cancer may include:
- Jaundice (or yellowing the your skin as well as the whites of your eyes)
- Upper abdominal pain that will often radiate to the back or may disguise itself as back pain.
- Weight loss
- Loss of appetite
- Blood clots
When To See Your Physician
You should visit your physician if you are experiencing unexplained weight loss, jaundice and abdominal pain. If you are experiencing other signs, symptoms or something does not feel right, you should also visit with your physician. Many diseases, cancers and other conditions have similar symptoms. You should not assume pancreatic cancer. Your doctor will check for other conditions as well as pancreatic cancer.
If your family doctor determines that you do have pancreatic cancer, you may be referred to:
- An oncologist
- A radiation oncologist
- A surgeon, who specializes in surgery of the digestive tract
Diagnosing Pancreatic Cancer
If your doctor suspects that you have pancreatic cancer, you may undergo a battery of tests. These tests can confirm diagnosis as well as determine how advanced the cancer may be. Tests may include:
- Ultrasound. An ultrasound tests uses high-frequency sound waves to help create an image of your pancreas.
- Ct scan (or computerized tomography). A CT scan is a high-powered x-ray that helps your doctor visualizes your pancreas. To make the image of your pancreas even clearer, your doctor may inject die into your veins.
- MRI (magnetic resonance imaging). An MR I uses high-powered magnetic and radio waves to help create images of your internal organs – including your pancreas.
- Endoscopic retrograde cholangiopancreatography (also referred to as ERCP). This test uses dye to help highlight the bile ducts of your pancreas. During the procedure, a thin, small, flexible tube (referred to as an endoscope) is slowly passed down your throat into your stomach and then into the upper portion of your intestines. Air is used to help inflate the intestines so that doctors are better able to see into the bile ducts of your pancreas. During this test, x-rays are often taken. Your doctor may also opt to collect a biopsy (of tissue or cells) during the ERCP procedure.
- Percutaneous transhepatic cholangiography (also referred to as PTC). During a PTC test, doctors use dye to help highlight your bile ducts. A thin needle is inserted into your pancreas to help inject the dye. X-rays are then taken. The use of special dye allows your doctor to get a better view of your pancreas.
- Endoscopic ultrasound (also known as EUS). During an EUS procedure, an ultrasound device creates images of your pancreas from inside of your body. An ultrasound device is inserted into your abdomen via an endoscope. During this test, the endoscope may also collect a sample of cells or tissues from your pancreas.
- Tissue biopsy. A tissue biopsy may be taken during an endoscopy procedure or during a small surgical procedure. The tissue sample is then analyzed under a microscope to help diagnose and determine the stages of pancreatic cancer.
Determining the Stage of Your Diagnosis
Once doctors have confirmed the presence of pancreatic cancer, doctors will then work to determine the severity of your condition. Determining the staging of your cancer is the best means in finding a treatment method. Methods used to stage pancreatic cancer can include:
- Imaging studies. Further CT scan, x-rays and MRIs can help determine the severity of your condition.
- Laparoscopy. Doctors will use a scope (or small video camera) to explore your insides. A laparoscopy procedure examines your pancreas as well as the surrounding organs and tissues. This way doctors can see if the cancer has spread. This type of procedure is performed in an operating room.
- Blood tests. Blood tests can be useful in staging pancreatic cancer. Your blood may be tested to help search for specific proteins (or tumor markers) shed by the cancer cells in your pancreas. The most commonly used tumor marker test for pancreatic cancer is known as CA10-0. Researchers indicate that a higher presence of this marker can indicate more advanced cancer. Other doctors may use this test to measure how your body is responding to cancer treatments.
Treatment Options for Pancreatic Cancer
Treatment options for pancreatic cancer are going to vary from person to person. Treatment plans are designed based on the stage of cancer as well as location of any tumors. Other factors that play a role in treatments are:
- Personal preference
- Your overall health
The primary focus of cancer treatment is to eliminate the disease. When eliminating the disease is not any option, doctors may focus on preventing the spread of cancer throughout your body. In very advanced stages, treatment options center around easing your symptoms and making patients more comfortable.
Treatment options can include:
- Surgery. Surgery is primarily an option for
patients with pancreatic cancer that is confined to the pancreas and has
not spread to blood vessels, lymph nodes, tissues and other organs
throughout the body. There are two surgical options for the treatment of
- Whipple procedure (also referred to as pancretoduodenectomy) by the medical community. During a Whipple procedure, surgeons remove the head of your pancreas as well as part of your small intestine, bile ducts, gall bladder and a portion of your stomach. Your surgeon will then reconnect the remaining portion of your pancreas, intestines and stomach – this will allow you to digest food. There are risks associated with this surgery including bleeding and risk of infections. Many individuals who have had the Whipple procedure report nausea and vomiting as well as difficulty emptying the stomach. You should expect a long recovery from a Whipple procedure. Recovery can include 10 days (if not more in the hospital) as well as several weeks of recover in the privacy of your own home.
- Surgery to remove tumors in the tail end of the pancreas as well as the body of your pancreas. This form of surgery is known as a distal pancreatedectomy. During this surgery, your surgeon will remove the diseased portions of your pancreas along with your spleen. Risks for this surgery include bleeding and infections.’
- Radiation Therapy. Your doctor may use radiation therapy by itself or in combination for chemotherapy or surgery as a treatment plan for pancreatic cancer. Radiation therapy involves high-energy beams of radiation targeted directly at your pancreas. This is used in an effort to destroy cancer cells. Many radiation therapy sessions are performed through the use of a machine outside of your body (also referred to as external beam radiation). However, radiation therapy can occur inside of your body (known as brachytherapy. Doctors can also use intraoperative radiation therapy to direct beans of radiation directly onto the pancreas. Side effects of radiation therapy often include fatigue and burning at the site of your radiation treatment.
- Chemotherapy. Chemotherapy is a combination of drugs used to help kill cancer cells as well as prevent the spread of cancer cells to other portions of your body. Chemotherapy is often taken intravenously, but may be taken orally. Chemotherapy will be commonly used if your cancer has spread beyond your pancreas. It can be used in combination with radiation therapy or surgery. Due to the harshness of chemotherapy drugs, there are a number of side effects that can occur. Side effects of chemotherapy can include: nausea, vomiting, constipation, fatigue, loss of appetite, weight loss, increased risk of infection, hair loss and mouth sores.
- Targeted Therapy. Targeted therapy uses drugs that are specifically designed to help attack abnormalities within cancer cells. Drugs help to block chemical signals sent to cancer cells that cause them to grow and divide. Targeted therapy is often used in conjunction with chemotherapy or to help manage the symptoms of individuals with end-stage pancreatic cancer.
- Clinical Trials. There are many clinical trials available for patients with pancreatic cancer. While clinical trials are not guaranteed to work, they offer new hope in the form of surgery, drugs and radiation treatments for patients who are not responding to the typical course of treatment for pancreatic cancer. It is important to note that clinical trials are conducted as safely as possible by can have serious as well as unexpected side effects. Clinical trials are closely monitored by the government and provide access to new treatment options for individuals with advanced stage pancreatic cancer. Clinical trials can include:
- Cancer vaccines. There are a number of trials underway to investigate the effectiveness of pancreatic cancer vaccines. Vaccines are designed to help enhance immune systems. By enhancing the immune system, a body may be better able to recognize pancreatic cancer cells and work to attack them. It is important to note that as of 2011, pancreatic cancer vaccines are still in the very early stages of development and testing.
- New drugs. New drugs and combinations of drugs are aimed at stopping the growth of cancer. Clinical trial targeted drug treatments work by stopping the growth of new blood vessels. These types of drugs are called angiogenesis inhibitors. Cancer cells need new blood vessels to get the nutrients they need to flourish. Without them, cancer cells may not be able to survive or spread to different locations in the body.
Alternative Meanings of Treating Pancreatic Cancer
When diagnosed with a disease that is full of uncertainty, you may want all available options to you for treatment; even if that means going outside the realm of conventional medicine. Many people turn to alternative and complementary medicine in hopes of a cure. However, as of 2011, no form of alternative or complementary medicine has been proven effective in eliminating cancer or stopping the growth of pancreatic cancer cells in the body.
If you wish to undergo complementary or alternative medicine treatments, talk to your doctors first. Alternative and complementary medicine treatments can sometimes have adverse effects on conventional cancer treatments.
When conventional treatment is not enough, some patients may turn to alternative treatments to help deal with the emotional stress that comes along with a cancer diagnosis. Art therapy, relaxation techniques, yoga, music therapy, meditation, spirituality and exercise may be able to help you. Talk to your doctor about these methods, especially prior to engaging in an exercise program with pancreatic cancer.
Support groups may also be beneficial in dealing with stress and emotions often associated with pancreatic cancer.
As with all cancers and cancer treatments, there are risks of complications. Complications can include:
- Liver problems
- Blood clots
- Weight loss
- Side effects associated with cancer treatment.
The prognosis of pancreatic cancer is often grim. Approximately 95 percent of patients will not be alive within five years of their diagnosis. Patients, who have pancreatic cancer that has not spread beyond the pancreas, can often be cured through means of surgery. However, this is not the case for 80 percent of pancreatic cancer patients. For 80 percent of patients, the tumor has spread beyond the pancreas and cannot be removed completely just after diagnosis.
Pancreatic Cancer Prevention
It is hard to predict who pancreatic cancer will strike and who will fall victim to pancreatic cancer. However, taking good care of yourself can help to decrease your risks of developing pancreatic cancer. Consider:
- Smoking cessation if you smoke
- Eating a well-balanced diet packed with fruits, vegetables and whole grains
- Exercising on a regular basis (5 days a week, in 30 minute sessions)
- National Institutes of Health: Pancreatic Carcinoma
- National Cancer Institute: Pancreatic Cancer