Pancreatic Cancer

The pancreas is an organ in the mid-abdomen behind the stomach. It has two functions: to control blood sugar levels and to make special enzymes and juice to help in the digestion of food. Each function is controlled by a different cell type, and pancreatic cancer can originate in two types. Exocrine cells produce the digestive enzymes, and tumors arising from them are more common (95%) than endocrine tumors (Neuroendocrine tumors-(NET)), which can be either malignant or benign. Because endocrine tumors often all look the same under a microscope, diagnosis can be difficult.

There are multiple treatment plans for patients with pancreatic cancer depending on the type, location, and size of the tumor. Often surgery is used in the early initial treatment of pancreatic cancer, or surgery may be reserved until after chemotherapy. Some patients are not candidates for pancreas surgery. When surgery is an option, many different operations can be performed in either a standard “open” surgery or through smaller incisions in a technique known as minimally invasive surgery.

Our comprehensive multispecialty team diagnoses and treats more upper GI cancer cases than any other hospital in the region. We perform over 100 major surgeries for pancreatic cancer each year, and with these high volumes have improved patient and disease outcomes.

Treatments for Pancreatic Cancer

Diagnosing and treating pancreatic cancer can be challenging, and multiple types of treatment may be needed.

Our experienced team of experts includes surgeons, medical oncologists, radiation oncologists, gastroenterologists and geneticists. They will work together to determine the best treatment plan for your individual disease.

Chemotherapy
This well-known cancer treatment uses medicines taken intravenously or by mouth to kill cancer cells throughout the body. Chemotherapy may be given before surgery to shrink tumors, or after to fight cancer cells that have potentially spread.

Distal Pancreatectomy
This operation removes tumors in the left side of the pancreas (body and tail). It typically involves removing the spleen as well.

Minimally Invasive Surgery
This technique allows the completion of surgery using several small incisions. The same procedure is performed as when using a standard “open” incision.

NanoKnife® Pancreatic Surgery
The NanoKnife® is a novel, non-heat based procedure allowing treatment of locally advanced tumors near blood vessels. It may provide an additional treatment option for some tumors that are otherwise considered inoperable.

Robotic Pancreatic Surgery
A minimally invasive technique using the assistance of a surgical robot to complete complex procedures. 

Stereotactic Radiation Therapy
Non-invasive, radiation therapy directed at the tumor. The stereotactic technique minimizes radiation from affecting normal tissue.

Whipple Procedure
A complex surgery that removes the right side of the pancreas (head) and other nearby structures, then with re-connection of the intestine to the remaining part of the pancreas,  bile ducts, and stomach to allow normal digestion of food.

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What Is Pancreatic Cancer?

Cancer of the pancreas refers to growth of cancer cells in the pancreas. The pancreas is in the abdomen (belly), with the stomach, intestines, and other organs around it. It makes juices used in digestion and several hormones, including insulin, which controls blood sugar (glucose) level. It releases these substances into ducts (tubes). Pancreatic cancer starts from cells lining these ducts.

Almost 30,000 people in the United States are diagnosed with this cancer each year. Pancreatic cancer is the fourth leading cause of cancer-related deaths in the United States. Early detection is best for a cure, but this cancer is hard to find early because most symptoms do not occur until the cancer has spread.

What Causes Pancreatic Cancer?

Causes are unclear, but smoking, alcoholism, and chronic inflammation (swelling) of the pancreas (pancreatitis) are related to this disease. Pancreatic cancer isn’t contagious, and it’s not hereditary except in rare cases.

What Are the Symptoms of Pancreatic Cancer?

Because pancreatic cancer doesn’t cause symptoms early, it’s called silent. Symptoms depend on the cancer’s location and size. If the bile duct is blocked so that bile cannot pass into the intestines, jaundice may occur. The skin and whites of the eyes become yellow and urine may become dark.

Growing cancer causes pain in the upper abdomen and sometimes the back. Pain becomes worse after eating or lying down. Other symptoms are nausea, reduced appetite, weight loss, and weakness.

How Is Pancreatic Cancer Diagnosed?

The health care provider makes a preliminary diagnosis from symptoms and special imaging tests called computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound. They help decide the stage (extent) of disease by showing whether cancer affects other organs.

The best way to diagnose cancer is with a biopsy. A piece of pancreas is taken and checked with a microscope to detect cancer cells.

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How Is Pancreatic Cancer Treated?

Surgery may be done to remove all (total pancreatectomy) or part of the pancreas and other tissues. In the Whipple procedure, the surgeon removes the head of the pancreas, parts of the small intestine and stomach, and other tissues. Sometimes cancer cannot be completely removed, but surgery can help relieve symptoms.

Radiotherapy and chemotherapy are also used. Radiotherapy uses high-energy rays to kill cancer cells. Chemotherapy (drugs to kill cancer cells) may be given alone or with radio-therapy if cancer cannot be removed. Doctors sometimes give chemotherapy after surgery to control cancer cell growth.

DOs and DON’Ts in Managing Pancreatic Cancer:
  • DO understand that you’ll need a team of doctors for care. The team will include a primary care health care provider, surgeon, oncologist (a health care provider specializing in cancer), and maybe a radiation oncologist (a health care provider specializing in using radiotherapy for cancer).
  • DO call your health care provider if you have jaundice, abdominal pain, weight loss, or no appetite.
  • DO call your health care provider if you have fever or see drainage from the incision site after surgery.
  • DON’T forget that treatments have side effects, such as pain and infection (surgery) and nausea, vomiting, and hair loss (chemotherapy).
  • DON’T be afraid to ask for a second opinion.
FOR MORE INFORMATION

Contact the following source:

  • National Cancer Institute
    Phone: (800) 4-CANCER (422-6237)
    Website: http://www.cancer.gov
  • American Cancer Society
    Tel: (800) ACS-2345 (227-2345)
    Website: http://www.cancer.org

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

Ferri’s Netter Patient Advisor