Pancreatic Cancer

The pancreas is considered a glandular organ. It is about 7 inches by 1.5 inches in size. It lies under the stomach and at the beginning of the small intestine, and functions as an exocrine organ by producing fluids for digesting food. It functions as an endocrine organ as it releases hormones. When released into the blood stream, these hormones regulate our glucose levels (insulin and glucagon).

Pancreatic cancer is a cancerous tumor that occurs in the tissues of this gland/organ.

Estimated new cases and deaths from pancreatic cancer in the United States in 2008 per the National Cancer Institute: New cases, 37,680 and deaths, 34,290.

This type of cancer typically spreads fast and is often not diagnosed in the early stages.

Per the Mayo Clinic, signs and symptoms of pancreatic cancer, which may not occur until the cancer is in the advanced stages:

• Upper abdominal pain that may radiate to your back
• Yellowing of your skin and the whites of your eyes
• Loss of appetite
• Weight loss
• Depression

There are two types of pancreatic cancer: exocrine and endocrine. Endocrine cancers are very rare. The American Cancer Society states that exocrine cancers are the most common and 95% of those diagnosed are adenocarcinomas.

Risk Factors for Exocrine (Pancreatic) Cancers:

• Smoking
• Obesity
• Gender-men have a slightly increased rate of occurrence
• Race-occurs more often in blacks than Caucasians
• Age-most people diagnosed are in their 70’s and 80’s
• Personal or family history of pancreatic cancer
• History of chronic pancreatitis
• Diabetes-occurs more often in diagnosed diabetics

The American Cancer Society site discusses risk factors that are uncertain or under research.

Diagnosis:

While there is no screening for pancreatic cancer you may undergo a CT, Ultrasound, and/or MRI if your physician suspects this disease.

Other diagnostic tests:

• Endoscopic retrograde cholangiopancreatography–ERCP-a dye is injected into your bile ducts and they are examined with a scope as air is blown into the ducts.
• Endoscopic Ultrasound-EUS–a scope with an ultrasound device is passed through the stomach into the duodenum to take pictures. It may also collect biopsy specimens.

• Percutaneous transhepatic cholangiography-PTC–a needle is inserted into the liver from outside the body and a tube is threaded into the bile ducts. Dye is injected into the ducts to detect blockages.

If a diagnosis confirms the cancer then further tests may be ordered to stage the disease and determine if it has spread. A CA19-19 blood test may be ordered to monitor your response to treatment.

Basic staging per the Mayo Clinic:

• Resectable. All the tumor nodules can be removed.
• Locally advanced. The tumor can no longer be removed with surgery because the cancer has spread to tissues around the pancreas or into the blood vessels.
• Metastatic. At this stage, the cancer has spread to distant organs, such as the lungs and liver.

For further staging information, including The American Joint Committee on Cancer TNM, numerical staging, see The American Cancer Society site.

Current Treatment for Exocrine (Pancreatic) Cancer:

• Surgery (resection)
• Chemotherapy
• Radiation therapy
• Targeted Gene Therapy

Battling Books:

100 Q & A About Pancreatic Cancer by Eileen O’Reilly M.D.

My Journey with Pancreatic Cancer by Calvin E. Rains Sr. (2006)

Pancreatic Cancer in the News:

ScienceDaily, January 9, 2008. Pancreatic Cancer: The smaller the tumor, the better your chances, study shows. “The odds of surviving cancer of the pancreas increase dramatically for patients whose tumors are smallest, according to a new study by researchers at Saint Louis University and the M.D. Anderson Cancer Center in Houston — the first study to specifically evaluate the link between tumor size and survival rates for one of the most common and deadly cancers.”

Resources:

The Pancreatica.org Clinical Trials Database is the largest resource of clinical trials for pancreatic cancer in the world.

PanCAN, the Pancreatic Cancer Action Network. “Working Together for a Cure”

The National Pancreas Foundation. Support, Education and Research.