Pancreatic Cancer

Pancreatic (pan-kree-AT-ik) cancer is a condition in which the cells in the pancreas (PAN-kree-us), a digestive gland located behind the stomach, divide without control or order, forming tumors that frequently spread to other parts of the body. It is usually fatal.

What Is Pancreatic Cancer?

The pancreas is a six-inch-long gland in the abdomen ^* that is surrounded by the stomach, intestine, and other digestive organs. It is shaped like a long, flattened pear, wide at one end and narrow at the other. This gland produces fluids that contain digestive enzymes (EN-zymes), proteins that help the body break down food for use in the body.

These fluids travel through a series of ducts, or tubes, into a main pancreatic duct that joins the common bile duct coming from the liver and gallbladder. Along with the bile, which helps the body digest fat, the pancreatic juices empty into the small intestine. The pancreas also manufactures and releases hormones that help the body store or use the energy that comes from food. One example of these is insulin, which helps control the amount of sugar in the blood. The pancreas's hormone-releasing cells are called islet (EYE-let) cells.

Cancer usually begins in the juice-carrying ducts; only rarely does it start in the islet cells. A tumor forms and eventually grows into the surrounding organs. Cancer cells may also break away from the tumor and spread to other parts of the body, such as the lymph nodes ^* , liver, lungs, and bones.

Finding cancer early is the key to treating it successfully, but with pancreatic cancer, symptoms usually are not noticeable until the cancer has spread to other parts of the body. By then it is usually too late for successful treatment.

What Are the Symptoms of Pancreatic Cancer?

People with cancer of the pancreas eventually develop pain in the upper abdomen that sometimes spreads to the back and may become worse after eating or lying down. They also may experience nausea, loss of appetite, weight loss, and weakness. If the tumor blocks the common bile duct so that bile cannot pass into the small intestine, they develop jaundice (JAWN-dis), a condition in which the skin and whites of the eyes turn yellow. Islet cell cancer can cause the pancreas to make too much insulin or other hormones. As a result, the person may feel weak or dizzy and experience chills, muscle spasms, or diarrhea.

How Is Cancer of the Pancreas Diagnosed?

When doctors suspect pancreatic cancer, they perform x-rays and other imaging tests that produce pictures of the pancreas and the areas surrounding it. The symptoms described above can be caused by many other less serious conditions, so doctors need to rule out these possibilities.

All of these visual tests provide clues to determine whether the person has cancer of the pancreas. However, the only way to know for sure is to take a tissue sample and view it under the microscope, a procedure called biopsy (BY-op-see). Surgeons can obtain this tissue in different ways. They can get it through a needle that is inserted through the abdomen into the pancreas or through a thin flexible tube passed down the throat and into the stomach region.

How Is Pancreatic Cancer Treated?

Pancreatic cancer has the highest mortality rate of all cancers. Only about 1 out of 10 cases of pancreatic cancer can potentially be cured, usually when the tumor is confined to the pancreas and the immediate surrounding area. More commonly, treating the disease aims at lessening the pain and improving the person's quality of life.

In either case, the most common forms of treatment are surgery, radiation therapy, and chemotherapy (kee-mo-THER-a-pee), or a combination of them. Surgery involves removing part or all of the pancreas in a procedure called pancreatectomy (pan-kree-a-TEK-to-mee). Radiation therapy uses high-energy rays to damage cancer cells and stop them from growing and dividing. Chemotherapy is the use of anticancer drugs that are fed into a vein or given in pill form.

Who Develops Cancer of the Pancreas and Why?

As with most other types of cancer, pancreatic cancer is usually diagnosed in middle-aged and older people. It rarely occurs before age 40, and most people who develop it are around age 70. Cancer of the pan-creas is the fourth most common kind of cancer in men and the fifth most common kind of cancer in women.

Doctors are not sure what causes this type of cancer. Research shows that people are more likely to develop it if they smoke cigarettes or they have diabetes ^* . Some studies suggest that a fatty diet that is low in fruits and vegetables contributes to pancreatic cancer, while others indicate that people who are exposed to certain harsh chemicals in their jobs are at higher risk. Heredity is another possible factor: people may inherit a tendency to develop tumors in the pancreas. However, more research is needed to pinpoint specific causes of pancreatic cancer. Many people get it for no apparent reason.