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What Is Pancreatic Cancer?
You might not know much about pancreatic cancer, but chances are you’ve heard of it. Public awareness of the disease has increased in recent years as well-known people including Steve Jobs, Luciano Pavoratti, Patrick Swayze, and Gene Upshaw were diagnosed with various forms of pancreatic cancer. According to the American Cancer Society, more than 35,000 Americans are expected to die from pancreatic cancer during 2009. Risk factors Scientists don’t know exactly what causes cancer of the pancreas, an organ in the abdomen that produces insulin and digestive enzymes. However, several factors are thought to increase the risk of pancreatic cancer. These include cigarette smoking, chronic pancreatitis (inflammation of the pancreas), obesity, and diabetes. People with a family history of pancreatic, ovarian, or colon cancer and those who are age 50 years or older, male, or African-American also have a higher risk of developing the disease. Having one or all of these risk factors does not mean a person will develop pancreatic cancer, and some people with the disease have no known risk factors. Symptoms Unfortunately, most symptoms of pancreatic cancer occur only when the cancer has progressed to an advanced stage, said Gauri Varadhachary, M.D., an associate professor in the Department of Gastrointestinal Medical Oncology at The University of Texas M. D. Anderson Cancer Center. As the tumor grows, various symptoms may be caused by its interference with other organs of the digestive system. These symptoms can include jaundice (yellowing of the eyes and skin), a change in the color of urine or stool, pain, nausea, loss of appetite, and weight loss. Symptoms like indigestion or a sudden change in blood sugar levels may occur because the pancreas is unable to perform its normal functions. Having one or all of these symptoms does not necessarily mean a person has cancer, but it does mean he or she should see a physician to find the cause. Diagnosis Because the symptoms of pancreatic cancer are vague and could be caused by numerous other diseases, it is often difficult for doctors to diagnose pancreatic cancer. There is no blood test that can screen for pancreatic cancer, although increased levels of certain substances in the blood can indicate the need for further testing. When doctors suspect pancreatic cancer, they will usually order imaging tests, first to confirm the presence of the cancer and then to determine whether it has spread to other parts of the body. These tests may include computed tomography (CT), ultrasonography, positron emission tomography (PET), and magnetic resonance imaging (MRI). If imaging tests show a tumor, the next step usually is biopsy, which involves the removal of tumor tissue so it can be examined for cancer under a microscope. Pancreas biopsy is commonly done using a thin needle, which is guided into the tumor by CT or ultrasonography. Tissue samples can also be taken during a procedure known as endoscopic retrograde cholangiopancreatography, or ERCP, which is done to drain blocked bile ducts by inserting plastic or metal stents. Laparoscopic examination through tubes inserted in the abdomen is sometimes done to see whether the tumor has spread. A patient’s treatment options are determined largely by the stage of the tumor and whether it has spread. Treatment If the tumor has not spread beyond the pancreas, it may be possible for doctors to surgically remove the entire tumor. Unfortunately, because pancreatic cancer often has spread in microscopic form beyond the pancreas before being detected, only about 20%–25% of patients can be cured by surgery. Typically, chemotherapy, radiation therapy, or both are used in combination with surgery. While chemotherapy and radiation therapy alone will not cure pancreatic cancer, they are often used to relieve symptoms and prolong life in patients for whom surgery is not an option because their cancer has spread. In those patients, different surgical procedures or medication may relieve symptoms. “Optimal pain control can be achieved in most patients,” Dr. Varadhachary said. Because treatment options are fewer as the disease progresses, people with the symptoms listed above should share their concerns with their physician. — B. Tutt For more information, talk to your physician, visit www.mdanderson.org, or call askMDAnderson at 1-877-632-6789. Other articles in OncoLog, October 2009 issue: Home/Current Issue | Previous Issues | Articles by Topic | Patient Education ©2009 The University of Texas M. D. Anderson Cancer Center |
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