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Pancreatic Cancer

The pancreas is a small gland located between the stomach and the spine, and surrounded by the liver, intestine, duodenum and stomach.  Pancreatic cancer is difficult to detect and, therefore, usually goes undiagnosed until it has reached an advanced stage that is very difficult to treat completely.

Individuals with chronic pancreatitis or with a family history of pancreatic, colon or ovarian cancer may be appropriate for screening diagnostic tests aimed at detecting pancreatic cancer at an earlier, more curable, stage. Individuals who have diabetes, are over 60 years old, are male or are African American also have a higher-than-average risk for pancreatic cancer.

How is it diagnosed?
How is it treated?
How does Advocate Christ Medical Center make a difference?
Frequenstly Asked Questions
Genetic Cancer Risk Assessment Program

How is it diagnosed?

Certain tests and procedures may be recommended to diagnose or rule out pancreatic cancer. Diagnostics include:

  • Physical exam by your physician, particularly looking for signs of jaundice or ascities (fluid accumulation in the abdomen)
  • Lab analysis or blood, urine or stool samples to detect elevated levels of bilirubin.
  • Computed tomography (CT or CAT scan)-a diagnostic imaging procedure that combines multiple X-rays and computer technology to create cross-sectional images ("slices") of the pancreas and surrounding organs, blood vessels and other tissues.
  • Ultrasound-uses sound waves to create a real-time image of organs. To view the pancreas, the physician may use endoscopic ultrasound (with a probe inserted through the mouth) or transabdominal ultrasound.
    Endoscopic retrograde cholangiopancreatography (ERCP)-provides a view into the stomach, pancreas and small intestine.
  • Endoscopic ultrasound (endosonography)-an advanced procedure that combines endoscopy and ultrasound to create more detailed images of digestive tract structures. This more detailed information is useful determining cancer staging for lesions in the pancreas-which is critical information for treatment planning. Endoscopic ultrasound can find tumors less than 1 cm (about 0.4 inch), which can't be seen in a CT scan.
  • Tissue biopsy-a small sample of tissue is taken and analyzed to confirm whether it is malignant (cancerous) or benign (non-cancerous). Detailed pathology testing can reveal important details about the cancer's molecular and cellular characteristics, and is a key step in staging a cancer (determining how advanced the cancer is).

Advocate Christ Medical Center has a genetic cancer risk assessment program that offers genetic counseling and testing for families who are at high risk for pancreatic cancer.

How is it treated?

Like any cancer, early intervention offers the best opportunity for effective treatment. Early-stage pancreatic cancer that is localized (has not spread) may be eliminated in many patients. More advanced pancreatic cancer is not curable, but may respond to treatments that slow the disease progression.

Surgery is usually considered for localized tumors and for some more advanced pancreatic cancer.  However, surgical removal of part of the pancreas may make it difficult to digest foods, so the patient will need supplemental care to address dietary issues.

The standard surgery for pancreatic cancer is a Whipple procedure, which involves surgically removing the "head" portion of the pancreas, part of the small intestine, some lymph nodes, the gallbladder and a part of the stomach.  A modified Whipple procedure preserves the stomach to minimize digestive problems.  The modified Whipple procedure may be an option for patients with smaller or fewer tumors.

Radiation therapy also may be recommended to shrink tumors and to relieve pain.  Radiation therapy uses ionizing radiation to kill cancer cells. It can be administered from outside the body using a linear accelerator, or from inside the body by tiny radioactive seeds or rods that are implanted right into the tumor or affected organ.  Physicians at Advocate Christ Medical Center utilize CyberKnife® stereotactic radiosurgery that delivers precisely focused radiation to destroy cancerous tissue.

Chemotherapy is usually not very effective against pancreatic cancer.

How does Advocate Christ Medical Center make a difference?

Advocate Christ Medical Center treats patients who were told elsewhere that surgical treatment for pancreatic cancer was impossible. Our surgeons are specially trained to perform special surgical procedures that can provide additional options for patients, such as the Whipple procedure.

The Cancer Institute of Christ Medical Center is one of few centers in the Chicago region to use endoscopic ultrasound (also called EUS or endosonography) for staging and removal of tumors in the pancreas. This non-surgical technique gives the doctor a much clearer view of the pancreas compared to CT or MRI scans, and can help locate tumors as small as 1 cm (about 0.4 inches).  It also helps the physician distinguish between cysts and tumors, without making an incision.

Christ Medical Center features the only Illinois gastroenterologist not affiliated with an academic medical center who is skilled at intraductal ultrasound (IDUS), a procedure that uses a thin microprobe passed through an endoscope and into the pancreatic duct and bile ducts.  This procedure can be very useful for distinguishing between cancerous and non-cancerous tissues within the pancreatic ducts-an important distinction to help guide appropriate treatment.

Patients at Advocated Christ Medical Center benefit from the collaboration of many specialists who have expertise in a broad range of areas yet all dedicated to providing the best solutions to diagnose and treat cancers of the digestive system.  Gastroenterologists, GI surgeons, medical oncologists, radiation oncologists, pathologists, hepatologists, oncology nurses and others work collaboratively to consider all perspectives and potentialities before recommending a treatment plan tailored to each individual's situation.

Our genetics program offers genetic testing and risk assessment for people concerned about a family history of pancreatic cancer.  Specialized genetic testing can identify specific genes related to pancreatic cancer.  Medical geneticists and genetic counselors can provide blood testing and counseling for family members who may be at risk for pancreatic cancer due to genetic factors.

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