Pancreatic Cancer

Definition

Pancreatic cancer is the growth of cancer cells in the pancreas. The pancreas is a long, flattened pear-shaped organ in the abdomen. It makes digestive enzymes and hormones including insulin.

The Pancreas

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Cancer occurs when cells in the body divide without control or order. If cells keep dividing uncontrollably, a mass of tissue forms. This is called a growth or tumor. The term cancer refers to malignant tumors. They can invade nearby tissue and spread to other parts of the body.

Causes

The cause is unknown. Research shows that certain risk factors are associated with the disease.

Risk Factors

Factors that increase your risk of developing pancreatic cancer include:

• Age: 40 or older
• Sex: male
• Smoking and using smokeless tobacco (eg, chewing tobacco)
• Alcohol abuse
• Diabetes
• Chronic pancreatitis, hereditary pancreatitis, family nonpolyposis colon cancer syndrome
• Family or personal history of certain types of colon polyps or colon cancer
• Family history of pancreatic cancer (especially in Ashkenazi Jews with BRCA2 [breast cancer associated]) gene
• High-fat diet
• Overweight or obese, which may also reduce your chance of survival from pancreatic cancer.

Symptoms

Pancreatic cancer does not cause symptoms in its early stages. The cancer may grow for some time before it causes symptoms. When symptoms do appear, they may be very vague. In many cases, the cancer has spread outside the pancreas by the time it is discovered.

Symptoms will vary depending on the location and size of the tumor. Symptoms include:

• Nausea
• Loss of appetite
• Unexplained weight loss
• Pain—in the upper abdomen, sometimes spreading to the back (a result of the cancer growing and spreading)
• Jaundice—yellowness of skin and whites of the eyes; dark urine (if the tumor blocks the common bile duct); tan stool or stool that floats to the top of the bowl.
• Weakness, dizziness, chills, muscle spasms, diarrhea (especially if the cancer involves the islet cells that make insulin and other hormones)

These symptoms may also be caused by other, less serious health conditions. Anyone experiencing these symptoms should see a doctor.

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam may be done. The doctor may order blood and urine tests, as well as check for hidden blood in bowel movements.

Test may include:

• Upper gastrointestinal (GI) series—a series of x-rays of the upper digestive system taken after drinking a barium solution
• Computed tomography (CT) scan —a type of x-ray that uses a computer to make pictures of structures inside the abdomen
• Magnetic resonance imaging (MRI) scan —a test that uses magnetic waves to make pictures of structures inside the abdomen
• Ultrasonography—a test that uses sound waves to find tumors
• Endoscopic retrograde cholangiopancreatography (ERCP) —a type of x-ray that shows the pancreatic ductal system after dye has been sent through a tube down the throat and into the pancreas
• Percutaneous transhepatic cholangiography (PTC)—a type of x-ray test that shows blockages in the bile ducts of the liver
• Angiography—x-rays of blood vessels taken after an injection of dye that makes the blood vessels show up on the x-rays
• Biopsy—removal of a sample of pancreatic tissue to test for cancer cells

Treatment

Once cancer of the pancreas is found, staging tests are performed. These test help to find out if the cancer has spread and, if so, to what extent. Treatments for pancreatic cancer depend on the stage of the cancer.

Treatments include:

Prevention

If you think you are at risk for pancreatic cancer, talk to your doctor about ways to reduce your risk, such as:

• Quitting smoking
• Reducing how much alcohol you drink or not drinking any alcohol
• Losing weight if you are overweight
• Eating a healthy diet
• Taking steps to prevent getting diabetes (eg, diet and exercise)
• Avoiding exposure to cancer-causing agents (eg, if you work in the petroleum or dry-cleaning industries)