PANCREATIC CANCER - Watsons Health

PANCREATIC CANCER

OVERVIEW

The pancreas secrete enzymes that aids in digestion.  It is located in the abdomen, behind the lower part of the stomach.  When cancer cells form in this organ, secretion of the enzymes stop or increases.  Pancreatic cancer is hard to detect, and usually once detected, it is already in it’s advanced stage, when treatment is not effective.

The cause of pancreatic cancer is not clear, but factors which may increase the risk of cancer have been idetified, these are:

  • African-American race
  • Excess body weight
  • Chronic inflammation of the pancreas (pancreatitis)
  • Diabetes
  • Family history of genetic syndromes that can increase cancer risk, including a BRCA2 gene mutation, Lynch syndrome and familial atypical mole-malignant melanoma (FAMMM)
  • Personal or family history of pancreatic cancer
  • Smoking

Signs and symptoms of pancreatic cancer often don’t occur until the disease is advanced.  Symptoms of pancreatic cancer include:

  • Jaundice (yellowing of the skin and whites of the eyes)
  • Pain in the upper or middle abdomen and back
  • Unexplained weight loss
  • Loss of appetite
  • Fatigue
  • Depression
  • Blood clots

DIAGNOSIS

After taking down your health history and performing a physical exam, the doctor may order several tests to determine the cause of your problem or extent of the condition, including:

  • CT scan (computed tomography)
  • MRI (magnetic resonance imaging)
  • Endoscopic ultrasound (EUS)
  • Laparoscopy (surgical procedure to look at organs)
  • Endoscopic retrograde cholangiopancreatography (ERCP)
  • Percutaneous transhepatic cholangiography (PTC; procedure used to X-ray liver and bile ducts)
  • Biopsy (removal of tissue to view it under a microscope)

In addition to radiologic tests, suspicion of a pancreatic cancer can arise from the elevation of a “tumor marker,” a blood test which can be abnormally high in people with pancreatic cancer. The tumor marker most commonly associated with pancreatic cancer is called the CA 19-9. It is often released into the bloodstream by pancreatic cancer cells and may be elevated in patients newly found to have pancreatic cancer.

 

RECOMMENDED TREATMENT

The first goal of pancreatic cancer treatment is to eliminate the cancer, when possible. When that isn’t an option, the focus may be on preventing the pancreatic cancer from growing or causing more harm.

When pancreatic cancer is advanced and treatments aren’t likely to offer a benefit, your doctor will help to relieve symptoms and make you as comfortable as possible.

Surgery

Surgery may be an option if your pancreatic cancer is confined to the pancreas. Operations used in people with pancreatic cancer include:

  • Surgery for tumors in the pancreatic head. If your pancreatic cancer is located in the head of the pancreas, you may consider an operation called a Whipple procedure (pancreatoduodenectomy).
  • Surgery for tumors in the pancreatic tail and body. Surgery to remove the tail of the pancreas or the tail and a small portion of the body is called distal pancreatectomy.

Radiation therapy

Radiation therapy uses high-energy beams, such as X-rays, to destroy cancer cells. You may receive radiation treatments before or after cancer surgery, often in combination with chemotherapy. Or, your doctor may recommend a combination of radiation and chemotherapy treatments when your cancer can’t be treated surgically.

Chemotherapy

Chemotherapy uses drugs to help kill cancer cells. Chemotherapy can be injected into a vein or taken orally. You may receive only one chemotherapy drug, or you may receive a combination of chemotherapy drugs.

In people with advanced pancreatic cancer, chemotherapy may be used alone or it may be combined with targeted drug therapy.

Targeted therapy

Targeted therapy uses drugs that attack specific abnormalities within cancer cells. The targeted drug erlotinib (Tarceva) blocks chemicals that signal cancer cells to grow and divide. Erlotinib is usually combined with chemotherapy for use in people with advanced pancreatic cancer.

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