Description

Pancreatic cancer is a type of cancer that begins as a growth of the cells in the pancreas. The pancreas is located behind the lower part of the stomach. Makes enzymes that help digest food and hormones that help control blood sugar.

The most common type of pancreatic cancer is pancreatic ductal adenocarcinoma. This type begins in the cells that line the ducts that carry digestive enzymes from the pancreas.

Pancreatic cancer is rarely found in its early stages when the chance of cure is greater. This is because it often does not cause symptoms until after it has spread to other organs.

Your health care team considers that the extent of his cancer of the pancreas at the time of creating your treatment plan. Treatment options may include surgery, chemotherapy, radiation therapy, or a combination of these.

Symptoms

Pancreatic cancer often does not cause symptoms until the disease is advanced. When they do occur, signs and symptoms of pancreatic cancer may include:

  • Stomach pain, pain that extends to the sides or to the back.
  • Loss of appetite.
  • The loss of weight.
  • Yellowing of the skin and the whites of the eyes, called jaundice.
  • Light-colored stools, or floating.
  • Dark-colored urine.
  • The itching.
  • New diagnosis of diabetes or diabetes, which is becoming more and more difficult to control.
  • The pain and swelling of an arm or leg, which may be caused by a blood clot.
  • Tiredness or weakness.

When to see a doctor

Make an appointment with a health care professional if you have symptoms that concern you.

Causes

It is not clear what causes pancreatic cancer. Doctors have found some factors that can increase the risk of this type of cancer. These include smoking, and family history of pancreatic cancer.

Understanding pancreas

The pancreas is about 6 inches (15 centimeters) long, and has the appearance of a pear lying on its side. Releases hormones, including insulin. These hormones help the body process sugar in the food that you eat. The pancreas also produces digestive juices that help the body digest food and assimilate nutrients.

How to pancreatic cancer forms

Pancreas cancer occurs when cells in the pancreas develop changes in their DNA. A cell's DNA contains the instructions that tell a cell what to do. In healthy cells, the instructions that tell cells to grow and multiply at a set rate. Cells die at a set time. In cancer cells, changes that are given different instructions. The changes, to tell the cancer cells to make many more cells quickly. Cancer cells can continue living when healthy cells would die. This means there is too many cells.

The cancer cells may form a mass called a tumor. The tumor can grow to invade and destroy healthy body tissue. At the time, cancer cells can break off and spread to other parts of the body.

The majority of pancreatic cancer begins in the cells that line the ducts of the pancreas. This type of cancer is called pancreatic ductal adenocarcinoma or pancreatic exocrine cancer. Less often, cancer can form in the hormone-producing cells or neuroendocrine cells of the pancreas. These types of cancer are called pancreatic neuroendocrine tumors or pancreatic endocrine cancer.

Risk factors

Factors that may increase the risk of pancreatic cancer include:

  • The habit of smoking.
  • Type 2 diabetes.
  • The chronic inflammation of the pancreas, called pancreatitis.
  • The history of the family of the changes in DNA that may increase the risk of cancer. These include changes in the BRCA2 gene, Lynch syndrome and familial atypical multiple mole melanoma (FAMMM) syndrome.
  • Family history of pancreatic cancer.
  • Obesity.
  • Advanced age. Most people with pancreatic cancer are over the age of 65 years.
  • Drinking a lot of alcohol.

Complications

As pancreatic cancer progresses, it can cause complications such as:

  • The loss of weight. People with cancer of the pancreas can lose weight as the cancer uses more of the body's energy. The nausea and vomiting caused by cancer treatment or cancer pressing on the stomach can make it difficult to eat. Sometimes, the body has trouble getting nutrients from food because the pancreas is not making enough digestive juices.
  • Jaundice.Pancreatic cancer that blocks the liver's bile duct can cause jaundice. The signs include yellowing of the skin and the whites of the eyes. Jaundice can cause dark-colored urine and pale colored stools. Jaundice often occurs without pain in your abdomen. If the bile duct is blocked, a plastic or metal tube called a stent may be put within him. The stent helps keep the bile duct open. This is done using a procedure called endoscopic retrograde cholangiopancreatography, also called ERCP. DuringERCP, a professional of the health put a long tube with a tiny camera, called an endoscope, through the throat. The tube passes through the stomach and in the upper part of the small intestine. The health care professional makes a contrast medium into the pancreatic ducts and bile ducts through a small tube that fits through the endoscope. The dye helps the ducts are displayed in the test image. The healthcare provider uses the images to place a stent in the right place at the duct to help keep it open.
  • Pain.A growing tumor may press on the nerves in your abdomen, causing pain that can become severe. Pain medications can help you feel more comfortable. Treatments, such as radiotherapy and chemotherapy, may help slow the growth of the tumor and relieve the pain. When the medications are not helping, a health professional may suggest a celiac plexus block. This procedure uses a needle to put alcohol into the nerves that control pain in the belly. The alcohol stops the nerves from sending pain signals to the brain.
  • Intestinal obstruction.Pancreatic cancer can grow in the press about the first part of the small intestine, called the duodenum. This can block the flow of digested food in the stomach to the intestines. A health care professional may be able to suggest to put a tube called a stent in the small intestine to keep it open. Sometimes, it may help to have a surgery to place a feeding tube. Or the surgery can attach the stomach to a lower part of the intestines where the cancer is not causing an obstruction.

Jaundice. Pancreatic cancer that blocks the liver's bile duct can cause jaundice. The signs include yellowing of the skin and the whites of the eyes. Jaundice can cause dark-colored urine and pale colored stools. Jaundice often occurs without pain in your abdomen.

If the bile duct is blocked, a plastic or metal tube called a stent may be put within him. The stent helps keep the bile duct open. This is done using a procedure called endoscopic retrograde cholangiopancreatography, also called ERCP.

During ERCP , a professional of the health put a long tube with a tiny camera, called an endoscope, through the throat. The tube passes through the stomach and in the upper part of the small intestine. The health care professional makes a contrast medium into the pancreatic ducts and bile ducts through a small tube that fits through the endoscope. The dye helps the ducts are displayed in the test image. The healthcare provider uses the images to place a stent in the right place at the duct to help keep it open.

Pain. A growing tumor may press on the nerves in your abdomen, causing pain that can become severe. Pain medications can help you feel more comfortable. Treatments, such as radiotherapy and chemotherapy, may help slow the growth of the tumor and relieve the pain.

When the medications are not helping, a health professional may suggest a celiac plexus block. This procedure uses a needle to put alcohol into the nerves that control pain in the belly. The alcohol stops the nerves from sending pain signals to the brain.

Intestinal obstruction. Pancreatic cancer can grow in the press about the first part of the small intestine, called the duodenum. This can block the flow of digested food in the stomach to the intestines.

A health care professional may be able to suggest to put a tube called a stent in the small intestine to keep it open. Sometimes, it may help to have a surgery to place a feeding tube. Or the surgery can attach the stomach to a lower part of the intestines where the cancer is not causing an obstruction.

Prevention

Screening tests for people with a high risk of pancreatic cancer

Detection of uses tests to look for signs of pancreatic cancer in people who do not have symptoms. Could be an option if you have a very high risk of cancer of the pancreas. The risk may be higher if you have a strong family history of pancreatic cancer, or if you have inherited the DNA of change that increases the risk of cancer.

Detection of pancreatic cancer may involve imaging tests such as magnetic resonance imaging, and ultrasound. These tests are usually repeated every year.

The goal of screening is to find cancer of the pancreas when it is small and is more likely to be cured. The investigation is ongoing, so it is not yet clear whether screening can reduce the risk of dying from cancer of the pancreas. There are risks for the detection. This includes the possibility of finding something that requires surgery, but then it turns out that it is not cancer.

Talk about the benefits and risks of cancer of the pancreas screening with your health care team. Together you can decide whether screening is right for you.

Genetic testing for cancer risk

If you have a family history of pancreatic cancer, talk with a health care professional. The health care professional can check the history of your family and help you understand if genetic testing may be right for you.

The genetic test can find changes in the DNA that are run in families and increase the risk of cancer. If you are interested in genetic testing, you may be referred to a genetic counselor or other health care professional trained in genetics.

Ways to reduce the risk

You can reduce your risk of pancreatic cancer if:

  • Stop smoking. If you smoke, talk with a member of your health care team about ways to help stop. These may include support groups, medications and nicotine replacement therapy.
  • Maintain a healthy weight. If you are at a healthy weight, work to maintain it. If you need to lose weight, aim for a slow, steady weight loss of 1 to 2 pounds (0.5 to 1 kilogram) a week. To help you lose weight, exercise, most days of the week. Gradually increase the amount of exercise. Choose a diet rich in vegetables, fruits and whole grains with smaller portions.

Diagnosis

Tests to diagnose pancreatic cancer include:

  • Imaging tests. Imaging tests make pictures that show the inside of the body. Imaging tests are used to diagnose pancreatic cancer include ultrasound, computed tomography, magnetic resonance imaging, and, sometimes, positron emission tomography scans, also called PET.
  • An area with ultrasound. Endoscopic ultrasound, also called EUS, is a test to make images of the digestive tract and organs and surrounding tissues. USE use a long, thin tube with a camera, called an endoscope. The endoscope is passed through the throat and into the stomach. An ultrasound device in the endoscope uses sound waves to create images of tissues nearby. It can be used to make images of the pancreas.
  • Removing a sample of tissue for analysis.A biopsy is a procedure to remove a small sample of tissue for testing in a lab. More often, a health care professional gets the sample duringEUS. DuringEUS, special tools are passed through the endoscope to take some of the tissues of the pancreas. Less often, a tissue sample is collected from the pancreas by the insertion of a needle through the skin and in the pancreas. This is called fine needle aspiration. The sample goes to a lab for testing to see if his cancer. Other specialized tests can show that the changes in the DNA are present in the cancer cells. The results help your healthcare team to create your treatment plan.
  • Blood tests. Blood tests can show proteins called tumor markers that pancreatic cancer cells do. One of the tumor markers test that is used in cancer of the pancreas is called the CA19-9. Doctors often repeat this test during and after treatment to understand how the cancer is responding. Some of the cancers of the pancreas do not produce more of CA19-9, so this test is not useful for everyone.
  • The genetic testing. If you are diagnosed with pancreatic cancer, talk with your health care team about genetic testing. Genetic testing uses a sample of blood or saliva to search for inherited changes in the DNA that increase the risk of cancer. The results of the genetic testing could help to guide treatment. The results can also show if the members of the family might have an increased risk of pancreatic cancer.

Removing a sample of tissue for analysis. A biopsy is a procedure to remove a small sample of tissue for testing in a lab. More often, a health care professional gets the sample during the USE . During the USE , special tools are passed through the endoscope to take some of the tissues of the pancreas. Less often, a tissue sample is collected from the pancreas by the insertion of a needle through the skin and in the pancreas. This is called fine needle aspiration.

The sample goes to a lab for testing to see if his cancer. Other specialized tests can show that the changes in the DNA are present in the cancer cells. The results help your healthcare team to create your treatment plan.

Assay

After confirming a diagnosis of pancreatic cancer, your health care team works to find the extent of the cancer. This is called the stage of the cancer. Your healthcare team uses the stage of the cancer to understand their prognosis and to create a treatment plan.

The stages of pancreatic cancer using the numbers 0 to 4. In the lower stages, the cancer is found only in the pancreas. As the cancer grows, the stage increases. In stage 4, the cancer has spread to other parts of the body.

Treatment

The treatment for pancreatic cancer depends on the cancer's stage and location. Your health care team also considers your overall health and your preferences. For most people, the first goal of pancreatic cancer treatment is to eliminate the cancer, when possible. When this is not possible, the focus may be on improving the quality of life and maintain the growth of the cancer or cause more damage.

Pancreatic cancer treatments can include surgery, radiation, chemotherapy, or a combination of these. When the cancer is advanced, these treatments are not willing to help. So treatment focuses on relieving symptoms to keep you as comfortable as possible for as long as possible.

Surgery

The surgery can cure the cancer of the pancreas, but there is an option for everyone. Can be used to treat the cancer that has not spread to other organs. The surgery may not be possible if the cancer grows or spreads in the blood vessels nearby. In these situations, treatment may begin with other options, such as chemotherapy. Sometimes the surgery can be performed after these treatments.

Operations used to treat cancer of the pancreas include:

  • Surgery for cancer in the head of the pancreas.The Whipple procedure, also called a pancreaticoduodenectomy, is an operation to remove the head of the pancreas. It also involves the removal of the first part of the small intestine and the bile duct. Sometimes, the surgeon removes part of the stomach and nearby lymph nodes. The rest of the organs are reattached to allow the food move through the digestive system.
  • The surgery for the cancer in the body and tail of the pancreas. The surgery to remove the body and tail of the pancreas is called a distal pancreatectomy. With this procedure, the surgeon may also need to remove the spleen.
  • The surgery to remove the whole pancreas. This is called total pancreatectomy. After the surgery, you are going to take medication to replace the hormones and enzymes produced by the pancreas for the rest of your life.
  • Surgery for cancers that affect the blood vessels nearby. When a cancer in the pancreas grows to involve the blood vessels nearby, the more complex procedure may be necessary. The procedure may need to engage to make and the reconstruction of parts of the blood vessels. Some medical centers in the united States have been trained surgeons to make these blood vessels operations safely.

Surgery for cancer in the head of the pancreas. The Whipple procedure, also called a pancreaticoduodenectomy, is an operation to remove the head of the pancreas. It also involves the removal of the first part of the small intestine and the bile duct. Sometimes, the surgeon removes part of the stomach and nearby lymph nodes. The rest of the organs are reattached to allow the food move through the digestive system.

Each of these operations involves the risk of bleeding and infection. After surgery, some people have nausea and vomiting if the stomach has trouble emptying, called delayed gastric emptying. Expect a long recovery after any of these procedures. You're going to spend several days in the hospital, and then recover for several weeks in the house.

The research shows that the pancreatic cancer surgery tends to cause fewer complications when done by highly experienced surgeons in centers that many of these operations. Ask about your surgeon and the hospital experience with the pancreatic cancer surgery. If you have any doubt, seek a second opinion.

Chemotherapy

Chemotherapy uses strong drugs to kill cancer cells. The treatment may involve a chemotherapy drug or a combination of them. The majority of chemotherapy drugs are given through a vein, but some are taken in pill form.

Chemotherapy may be the first treatment that is used when the first treatment may not be the surgery. Chemotherapy can also be given at the same time as radiation therapy. Sometimes this combination of treatment shrinks the cancer enough to make surgery possible. This approach to treatment is offered at specialized medical centers that have expertise in the care of many people with pancreatic cancer.

Chemotherapy is often used after surgery to destroy any cancer cells that may remain.

When the cancer is advanced and has spread to other parts of the body, chemotherapy may help to control it. Chemotherapy can help to relieve the symptoms, such as pain.

Radiation therapy

Radiation therapy uses high-energy rays to kill cancer cells. The energy can come from X-rays, protons or other sources. During radiation therapy, you lie on a table while a machine moves around you. The machine directs radiation to precise points on your body.

The radiation may be used before or after surgery. On many occasions is done after chemotherapy. The radiation can also be combined with chemotherapy.

When surgery is not an option, radiation therapy and chemotherapy could be the first treatment. This combination of treatments may reduce the cancer and make it possible for the surgery.

When the cancer spreads to other parts of the body, the radiation therapy may help relieve symptoms, such as pain.

Immunotherapy

Immunotherapy is a treatment with a medication that helps the body's immune system destroys the cancer cells. The immune system fights diseases by attacking the germs and other cells that should not be in the body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the cells of the immune system find and kill cancer cells. Immunotherapy may be an option if your cancer of the pancreas has specific DNA changes that would make the cancer likely to respond to these treatments.

Clinical trials

Clinical trials are studies of new treatments. These studies provide an opportunity to test the latest treatments. The risk of side effects may not be known. Ask your health care professional if you might be able to be in a clinical trial.

Palliative care

Palliative care is a special type of health care that helps people with serious illness to feel better. If you have cancer, palliative care can help relieve the pain and other symptoms. A team of health professionals does palliative care. The team may include doctors, nurses and other specially trained professionals. The team's goal is to improve the quality of life for you and your family.

Palliative care specialists work with you, your family and your health care team to help you to feel better. They provide an extra layer of support, while you have cancer treatment. You can have palliative care at the same time so strong cancer treatments, such as surgery, chemotherapy or radiation therapy.

When palliative care is used with all of the other appropriate treatments, people with cancer may feel better and live longer.

Alternative medicine

Some of integrative medicine and alternative therapies that may help with the symptoms caused by cancer or cancer treatments.

Treatments to help deal with the anxiety

People with cancer often have anxiety. The anguish can be felt as the concern, the fear, the anger and the sadness. If you have these feelings, you may find it hard to sleep. You might think about his cancer, all the time.

Talk about your feelings with a member of your health care team. The specialists can help you sort through your feelings. They can help you find ways to cope. In some cases, medications can help.

Integrative medicine and alternative therapies can also help you to cope with your feelings. Examples include:

  • Art therapy.
  • Exercise.
  • Meditation.
  • Music therapy.
  • The relaxation exercises.
  • Spirituality.

Talk with a member of your health care team if you'd like to try some of these treatment options.

Coping and support

Learning is a life-threatening illness can feel stress. Some of the following suggestions may help:

  • Learn about your cancer.Learn enough about your cancer to help you make decisions about your care. Ask a member of your health care team about the details of your cancer and your treatment options. Ask about trusted sources of more information. If you are doing your own research, good places to begin, the National Cancer Institute and the Pancreatic Cancer Action Network.
  • Build a support system. Ask friends and family to form a network of support for you. You may not know what to do after your diagnosis. Helping with simple tasks could give you comfort and relieve you of those tasks. Think about the things that you want to help, such as preparing meals or getting to appointments.
  • Find someone to talk to. AAlthough friends and family can often be your best support, sometimes it can be difficult to deal with his diagnosis. It might help to talk with a counselor, medical social worker, or a pastoral or religious counselor. Ask a member of your health care team for a referral.
  • Connect with other cancer survivors. You may find comfort in talking with other cancer survivors. Contact your local chapter of the American Cancer Society to find cancer support groups in your area. The Pancreatic Cancer Action Network offers support groups online and in person.
  • Consider hospice. Hospice care provides comfort and support to people at the end of life and their loved ones. It allows family and friends, with the help of nurses, social workers and trained volunteers, to care for and comfort a loved one at home or in a hospice setting. Hospice care also provides emotional, social and spiritual support to people who are sick and those closest to them.

Learn about your cancer. Learn enough about your cancer to help you make decisions about your care. Ask a member of your health care team about the details of your cancer and your treatment options. Ask about trusted sources of more information.

If you are doing your own research, good places to begin, the National Cancer Institute and the Pancreatic Cancer Action Network.

Preparing for your appointment

Start by making an appointment with a doctor or other health care professional if you have symptoms that concern you. Then, you could be referred to as:

  • A doctor who diagnoses and treats digestive conditions, called a gastroenterologist.
  • A doctor who treats cancer, called an oncologist.
  • A doctor who uses radiation to treat cancer is called a radiation oncologist.
  • A surgeon who specializes in operations on the pancreas, called a surgical oncologist.

What you can do

When you call to make the appointment, ask about anything that you need to do to make the appointment, such as restrict your diet. Ask a relative or friend to go with you to help you remember all the information.

Make a list of:

  • All of your symptoms and when they began.
  • Key personal information, including any recent changes or stressors, and family history of pancreatic cancer.
  • All medications, vitamins and supplements, including doses.

Questions to ask your doctor

  • Do I have cancer of the pancreas?
  • What is the stage of my cancer?
  • More evidence is needed?
  • Can my cancer be cured?
  • What are my treatment options?
  • Can any treatment that will help me live longer?
  • What are the possible risks of each treatment?
  • There is a treatment you think is best for me?
  • What advice would you give to a friend or a family member in my situation?
  • What is your experience with the pancreatic cancer diagnosis and treatment? How many of the surgical procedures for this type of cancer this medical center each year?
  • What can you do to help relieve my symptoms?
  • What clinical trials are available for pancreatic cancer? Am I eligible for any?
  • Am I eligible for the molecular profiling of my cancer?
  • Do you have brochures or other printed material that I can take? What sites do you recommend?

What to expect from your doctor

Be prepared to answer some questions about your symptoms and your health, such as:

  • Do you have symptoms all the time, or come and go?
  • Do your symptoms get in the way of your everyday activities?
  • Does anything make your symptoms worse or better?
Symptoms and treatment of Pancreatic cancer