Pancreatic Cancer

What is pancreatic cancer?

Pancreatic cancer is the fourth most common cause of cancer death in men and women in the US. According to the American Cancer Society, it is estimated that there will be 42,470 new cases of pancreatic cancer in 2009, and 35,420 deaths are expected. Pancreatic cancer occurs when malignant cells grow out of control.

Risk factors for pancreatic cancer, according to the National Cancer Institute, include:

• age – most pancreatic cancer occurs in people over the age of 45.
• smoking – heavy cigarette smokers are two or three times more likely than non-smokers to develop pancreatic cancer.
• diabetes – pancreatic cancer occurs more often in people who have diabetes than in those who do not.
• gender – more men than women are diagnosed with pancreatic cancer.
• race – African Americans are more likely than Asians, Hispanics, or Caucasians to be diagnosed with pancreatic cancer.
• family history – the risk for developing pancreatic cancer triples if a person’s mother, father, or a sibling had the disease.
• chronic pancreatitis – this condition of the pancreas has been linked with increased risk for pancreatic cancer.
There are several types of pancreatic cancers, including the following:
• adenocarcinoma of the pancreas – the most common pancreatic cancer, which occurs in the lining of the pancreatic duct.
• cystadenocarcinoma – a rare pancreatic cancer.
• acinar cell carcinoma – a rare pancreatic cancer.
Some benign (noncancerous) tumors in the pancreas include the following:
• insulinoma – a rare pancreatic tumor that secretes insulin, the hormone that lowers glucose levels in the blood.
• gastrinoma – a tumor that secretes above average levels of gastrin, a hormone that stimulates the stomach to secrete acids and enzymes. Gastrinoma can cause peptic ulcers.
• glucagonoma – a tumor that secretes glucagon, a hormone that raises levels of glucose in the blood, leading to a rash.

Treatment for pancreatic cancer:

Specific treatment for pancreatic cancer will be determined by your physician based on:

• your age, overall health, and medical history
• extent of the disease
• type of cancer
• your tolerance of specific medicines, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

Depending upon the type and stage, pancreatic cancer may be treated with the following:

• surgery – may be necessary to remove the tumor – a section or entire pancreas and/or the small intestine. The type of surgery depends on the stage of the cancer, the location and size of the tumor, and the person’s health. Types of surgery for pancreatic cancer include the following:

o Whipple procedure – this procedure involves removal of the head of the pancreas, part of the small intestine, the gall bladder, part of the stomach, and lymph nodes near the head of the pancreas. Most pancreatic tumors occur in the head of the pancreas, so the Whipple procedure is the most commonly performed surgical procedure for pancreatic cancer.
o distal pancreatectomy – if the tumor is located in the body and tail of the pancreas, both of these sections of the pancreas will be removed, along with the spleen.
o total pancreatectomy – the entire pancreas, part of the small intestine and stomach, the common bile duct, the spleen, the gallbladder, and some lymph nodes will be removed.
• external radiation (external beam therapy) – a treatment that precisely sends high levels of radiation directly to the cancer cells. The machine is controlled by the radiation therapist. Since radiation is used to kill cancer cells and to shrink tumors, special shields may be used to protect the tissue surrounding the treatment area. Radiation treatments are painless and usually last a few minutes. Radiation therapy may be given alone, or in combination with surgery and chemotherapy.
• chemotherapy – the use of anticancer drugs to treat cancerous cells. In most cases, chemotherapy works by interfering with the cancer cell’s ability to grow or reproduce. Different groups of drugs work in different ways to fight cancer cells. The oncologist will recommend a treatment plan for each individual. Chemotherapy may be given alone, or in combination with surgery and radiation therapy.
• medication (to relieve or reduce pain)
Long-term prognosis for individuals with pancreatic cancer depends on the size and type of the tumor, lymph node involvement, and degree of metastases (spreading) at the time of diagnosis.