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Pancreatic Cancer

Alternate Names

  • cancer of the pancreas
  • Pancreas

Definition

Pancreatic cancer occurs when cells within the pancreas undergo changes that make the cells grow and divide uncontrollably.

What is going on in the body?

The pancreas is a gland located in the middle part of the upper abdomen. Cells known as islet cells in the pancreas produce insulin to help the body regulate blood glucose. Other cells in the pancreas produce substances to help the body digest food. When a cell in the pancreas becomes cancerous, it grows into a tumor that destroys the tissue around it.
A tumor in the pancreas tends to quickly invade tissue in the back of the upper area of the abdomen and the nearby liver. Usually, the liver will become affected, and part of it will be destroyed.
The cancer can also metastasize, or spread, through the bloodstream to other parts of the body. Pancreatic cancer is usually found late in the disease when it is most likely to be fatal.

Risks

What are the causes and risks of the disease?

Cigarette smoking significantly increases a person's risk for pancreatic cancer. It is not clear if other factors also increase the risk. The influence of alcohol and caffeine on the development of this cancer is uncertain and controversial.

Prevention

What can be done to prevent the disease?

Individuals who smoke can lower their risk for pancreatic cancer if they quit smoking. Some studies suggest that people who have had a tonsillectomy or various allergies may be at less risk for pancreatic cancer, but more research is needed.

Diagnosed

How is the disease diagnosed?

Diagnosis of pancreatic cancer begins with a medical history and physical exam.
The healthcare professional may order tests, including:
  • an abdominal CT scan
  • a biopsy to remove a small piece of pancreatic tissue for examination
  • CT scans and specialized X-rays to determine if the cancer has spread

Long Term Effects

What are the long-term effects of the disease?

If found early, the cancer can sometimes be controlled for a period of time. However, pancreatic cancer usually causes death. If the cancer has spread, which most have, the average survival is four to six months from the time of diagnosis.

Other Risks

What are the risks to others?

Pancreatic cancer is not contagious and poses no risk to others.

Treatments

What are the treatments for the disease?

Treatment varies depending upon the extent of the disease. If the disease is localized and the tumor is small, surgical removal of the tumor may offer long-term control or care of the cancer. Chemotherapy with radiation therapy may be offered once a small tumor is removed. This may be helpful in slowing the return of the tumor.
Most pancreatic cancers are found when the tumors are too large to remove. Large tumors may block the intestines. Surgery may be performed to bypass the blockage and relieve symptoms such as nausea and vomiting. Chemotherapy may be offered to relieve symptoms, such as pain, by shrinking the tumor. Advanced pancreatic cancer is not usually curable.

Side Effects

What are the side effects of the treatments?

Most people treated with surgery generally heal without difficulty. The effects of radiation therapy are temporary and will resolve after completion. During therapy, the person is likely to experience nausea, skin burning, temporarily lowered blood cell counts, and difficulty swallowing. Medicines will help control the nausea.
Chemotherapy given to a person with early-stage disease makes the radiation work better. By itself, the chemotherapy can cause mouth sores, stomach upset, fatigue, hair loss, and increased risk of infections. Radiation may intensify some of the side effects, but this is temporary. Chemotherapy given to treat late-stage cancers is usually well tolerated. It is given to relieve symptoms.

After Treatment

What happens after treatment for the disease?

Pancreatic cancer is likely to progress, even with treatment. As the cancer progresses, treatments can be given to make the person more comfortable.

Monitor

How is the disease monitored?

Someone with pancreatic cancer needs to make regular visits to the healthcare professional. CT scans will follow the progress of the disease. When the liver is damaged by cancer, it will begin to fail. Liver function tests will indicate how well the liver is functioning. As different interventions are used to bring comfort, the person will be monitored closely. Any new or worsening symptoms should be reported to the healthcare professional.

Sources

Brower, S.T;Jones, D.V.;Cunningham, J.D.;&Myerson, R.J.(1996). Pancreatic cancer, hepatobiliary cancer, and neuroendocrine cancers of the GI tract in Cancer Management: A Multidisciplinary Approach. PRR: Huntington, NY. pp.107-141.

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