The pancreas is a large organ located behind the stomach. It makes and releases enzymes into the intestines that help the body absorb foods, especially fats.
Hormones called insulin and glucagon, which help your body control blood sugar levels, are made in special cells in the pancreas called islet cells. Tumors can also occur in these cells, but they are called islet cell tumors.
The exact cause of pancreatic cancer is unknown. It is more common in:
Because pancreatic cancer is often advanced when it is first found, very few pancreatic tumors can be removed by surgery. The standard surgical procedure is called a pancreaticoduodenectomy (Whipple procedure).
This surgery should be done at centers that perform the procedure often. Some studies suggest that surgery is best performed at hospitals that do more than five of these surgeries per year.
When the tumor has not spread out of the pancreas but cannot be removed, radiation therapy and chemotherapy together may be recommended.
When the tumor has spread (metastasized) to other organs such as the liver, chemotherapy alone is usually used. The standard chemotherapy drug is gemcitabine, but other drugs may be used. Gemcitabine can help about 25% of patients.
Patients whose tumor cannot be totally removed, but who have a blockage of the tubes that transport bile (biliary obstruction) must have that blockage relieved. There are two approaches:
Surgery
Placement of a tiny metal tube (biliary stent) during ERCP
Managing pain and other symptoms is an important part of treating advanced pancreatic cancer. Palliative care teams and hospice can help with pain and symptom management, and provide psychological support for patients and their families during the illness.
Support Groups
You can ease the stress of illness by joining a support group with members who share common experiences and problems (see cancer - support group).
Expectations (prognosis)
Some patients with pancreatic cancer that can be surgically removed are cured. However, in more than 80% of patients the tumor has already spread and cannot be completely removed at the time of diagnosis.
Chemotherapy and radiation are often given after surgery to increase the cure rate (this is called adjuvant therapy). For pancreatic cancer that cannot be removed completely with surgery, or cancer that has spread beyond the pancreas, a cure is not possible and the average survival is usually less than 1 year. Such patients should consider enrolling in a clinical trial (a medical research study to determine the best treatment).
Ninety-five percent of the people diagnosed with this cancer will not be alive 5 years later.
Complications
Blood clots
Depression
Infections
Liver problems
Pain
Weight loss
Calling your health care provider
Call for an appointment with your health care provider if you have:
Abdominal pain that does not go away
Back pain
Loss of appetite
Unexplained fatigue or weight loss
Other symptoms of this disorder
Prevention
If you smoke, stop smoking.
Eat a diet high in fruits, vegetables, and whole grains.
Exercise regularly.
References
National Cancer Institute. Pancreatic Cancer Treatment PDQ. Updated August 13, 2010.
National Comprehensive Cancer Network. Clinical Practice Guidelines in Oncology: Pancreatic Adenocarcinoma. Version 2.2011.
Review Date:
8/24/2011
Reviewed By:
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
