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Pancreatic Cancer
What Is Pancreatic Cancer
Pancreatic cancer, currently the fifth leading cause of death from cancer in the United States, is the growth of malignant cells in the pancreas, a pearshaped organ located just below and behind the stomach. The pancreas secretes digestive enzymes into the small intestine via the common bile duct, and islet cells of the pancreas secrete hormones (insulin and glucagon) into the blood. Pancreatic cancer impairs the digestive process and may block the bile duct as it grows. Most cases occur after age 50; men are affected slightly more often than women. A cure is sometimes possible with early diagnosis and surgical removal. However, pancreatic cancer is extremely difficult to diagnose and has usually spread by the time symptoms appear, so cures are uncommon. Islet cell tumors (insulinomas) are much less common. They release excessive amounts of insulin, causing low blood glucose (hypoglycemia). Only about 10 percent of insulinomas are malignant, and the symptoms of hypoglycemia can be eliminated by surgical removal of the tumor.
Symptoms of Pancreatic Cancer
- Poor appetite; weight loss.
- Pain in the upper-central or right abdomen.
The pain may spread to the back and may be
relieved by sitting up and leaning forward.
- Jaundice.
- Itching skin.
- Nausea and vomiting.
- Diarrhea or constipation, dark-colored urine,
or pale stools.
- A feeling of fullness.
- Fatigue, depression, and mood swings.
- Shakiness, irritability, profuse perspiration,
chills, dizziness, or muscle spasms in patients
with an islet cell tumor, due to associated
hypoglycemia (see Hypoglycemia).
What Causes Pancreatic Cancer
- The cause of pancreatic cancer is unknown.
- Pancreatic cancer is two to three times more common in heavy smokers than nonsmokers.
- Exposure to solvents, petroleum, and coal tar compounds may lead to the disease.
- Hereditary pancreatitis may be associated with a greater risk of pancreatic cancer.
Prevention of Pancreatic Cancer
- Minimize exposure to toxic chemicals at home and in the workplace, and avoid cigarettes.
Diagnosis of Pancreatic Cancer
- Chest and abdominal x-rays are performed initially.
- Ultrasound scans or CT (computed tomography) scans detect about 80 percent of cases. Further tests are performed if diagnosis is questionable.
- ERCP (endoscopic retrograde cholangiopancreatogram) is done using a thin, lighted, viewing tube (endoscope) passed down the throat and into the small intestine. Contrast material is injected into the bile duct, and x-rays are taken. The endoscope may also be used to take a biopsy.
- Diagnosis is confirmed by biopsy of pancreatic tissue, which is extracted with a needle, or in some cases, using exploratory abdominal surgery.
How To Treat Pancreatic Cancer
- Surgical removal of the tumor is possible with a relatively small tumor that has not yet spread, which may prolong survival time. Surgery may involve removal of the entire pancreas as well as a portion of the small intestine.
- Surgery to bypass a bile duct blocked by the tumor may be performed to relieve symptoms.
- Chemotherapy in combination with radiation therapy may destroy cancerous cells and ease symptoms.
- Analgesics or narcotics are administered to reduce pain. Antihistamines or amphetamines may be used to enhance analgesic effects. In cases of severe pain, the relevant nerves may be cut or destroyed by an alcohol injection at the time of surgery.
- Tablets containing pancreatic enzymes may be prescribed if food is poorly absorbed because of a blockage of pancreatic secretions.
When To Call A Doctor
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