Pancreatic Cancer

WHAT YOU SHOULD KNOW

The pancreas---a large gland that produces digestive enzymes and the sugar-regulating hormone insulin---is located deep inside the abdomen, so tumors in the pancreas are rarely detected until the disease has spread to nearby organs, particularly the lymph nodes, the liver, and the lungs. Pancreatic tumors can form in the tissue of the gland, the ducts that drain it, and the clusters of cells that produce insulin. By the time the tumors are discovered, it's usually too late for a cure. However, treatment can sometimes prolong life and improve its quality.

Causes

Doctors don't know what triggers pancreatic cancer, but they do know that smoking and a high-fat diet can increase the risk of the disease. This form of cancer is also more likely in people who have problems with insulin production (diabetes).

Signs/Symptoms

The most common signs of pancreatic cancer are significant weight loss and severe pain in the upper abdomen radiating to the back. Other potential symptoms include loss of appetite, nausea, yellow skin and eyes, digestive problems, and stomach bleeding. High blood sugar is a problem for a number of patients; but if a tumor develops in insulin-producing cells, excessive insulin may cause blood sugar levels to drop, leading to symptoms such as depression, dizziness, drowsiness, and fatigue.

Care

To make certain that the problem is pancreatic cancer, your doctor will probably order images of the pancreas, typically produced by ultrasound (a device that bounces sound waves off the internal organs), computed tomography (a scanning technique that generates cross-sectional views of the organs), or pancreatography (x-rays that highlight the pancreatic ducts). The diagnosis is confirmed with a biopsy---a microscopic study of a tissue sample removed from the pancreas through a needle.

If the cancer hasn't spread, surgical removal of the pancreas is the standard treatment. (If the tumor is limited to insulin-producing cells, only a portion of the pancreas may be removed.) Surgery is often followed by a combination of radiation and chemotherapy. The type of treatment you will need depends on the extent, or stage, of the disease, the size of the cancerous tumor or tumors, your overall health, and the condition of the pancreas.

• Surgery: Small, localized tumors in insulin-producing areas can often be removed and successfully cured. Cancer in the pancreatic ducts typically warrants complete removal of the pancreas. If the cancer has spread too far to be removed, surgery can still be used to keep open critical ducts, relieve symptoms, and prevent further complications.
• Chemotherapy: Often called "chemo," this type of therapy uses drugs to kill or shrink new tumor cells. Given along with radiation after surgery, it is known to extend life. Many different chemo medicines are available. They may be taken as a pill or shot, or given through an IV. You will probably need frequent blood tests to determine how your body is doing and how much chemo you need. The drugs can produce unpleasant side effects and may leave you susceptible to infection for a while.
• Radiation: X-rays or gamma rays can kill cancer cells, slow the growth of tumors, and help prevent them from spreading. They can also be effective in reducing pain and controlling bleeding. Like chemo, however, radiation is likely to have significant side effects.

Risks

Too often, little can be done to halt the progress of this deadly form of cancer. Still, treatment sometimes can prolong life, and often improves the quality of life---despite severe side effects.

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