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Pancreatic Cancer

The pancreas is an organ that is part of the digestive system. It is located behind the abdominal cavity, behind and below the stomach. It has two main functions: making digestive enzymes, which help break down proteins in your food, and producing the hormone insulin, which helps regulate your blood sugar levels.

What causes pancreatic cancer?

The biggest risk factor for developing pancreatic cancer is smoking. Smokers are twice as likely to pass on the disease as non-smokers. Other causes of pancreatic cancer that can be controlled are obesity and exposure to certain work-related pesticides, dyes, and other chemicals. Risk factors for uncontrollable pancreatic cancer include aging, being a mixed-African-American male, family history, diabetes, and certain genetic disorders.

What are the symptoms of pancreatic cancer?

In the early stages, pancreatic cancer may not show any symptoms, or if it does, the symptoms may resemble other diseases. For this reason, the disease is often referred to as the “silent killer” because it can be difficult to diagnose early. When symptoms do occur, they include yellowing of the skin and whites of the eyes (jaundice), light-colored stools, dark urine, abdominal pain, unexplained weight loss, and fatigue.

How is pancreatic cancer diagnosed?

To diagnose pancreatic cancer, the doctor will first perform a complete physical examination and history. Blood, urine and stool tests can then be done.

Additional tests that a doctor may order to diagnose and stage pancreatic cancer

1. Angiogram: An X-ray that views blood vessels to show if an area of blood flow, such as this tumor, is blocked.
2. CT scans: These are types of X-rays that show cross-sections of the body and also help determine if the cancer has spread to other organs.
3. Transabdominal ultrasound: Here sound waves are used to create a picture of organs in the abdomen, and types of pancreatic tumors can be distinguished.

ERCP (endoscopic retrograde cholangiopancreatogram):
This is a type of scope test that allows doctors to examine the ducts that drain the pancreas.

Endoscopic ultrasound (EUS):
This is a newer procedure in which, similar to ERCP, an endoscope containing an ultrasound probe is inserted into the mouth and down the stomach, and then the pancreas is screened for cancer.

How is pancreatic cancer treated?

Since pancreatic cancer usually shows no symptoms in the early stages, it is often found in the later stages, which makes it difficult to cure the disease. Treatment for pancreatic cancer depends on the stage or grade of cancer and the patient’s health. Treatment options include surgery, ablative treatments to destroy the tumor, chemotherapy, and radiation.

Surgery may be necessary to treat pancreatic cancer

There are two types of surgery for this: potentially curative (done when tests show that all of the cancer can be removed) and palliative (done to relieve symptoms when the cancer cannot be completely removed).
The most common potentially curative surgery is also called pancreaticoduodenectomy, or the Whipple procedure, in which the head and sometimes body of the pancreas are removed. In some cases, parts of the small intestine, bile duct, gallbladder, lymph nodes, and stomach may also be removed. This is a major surgery performed by a surgeon who is best experienced in performing the procedure.

What are the side effects of pancreatic cancer surgery?

The complications or side effects of pancreatic surgery depend on the procedure performed, the patient’s overall health, and other factors. Most patients will experience postoperative pain that can be controlled with medication. You may feel weak or tired after surgery, and it may take several weeks to months for you to recover. Following the Whipple procedure, you may experience bloating, fullness, nausea, or vomiting. This can often be changed by changes in diet as your body recovers.
Some complications following surgery to treat pancreatic cancer include infections, bleeding, difficulty emptying the stomach, and leakage from various surgical connections

Radiation therapy can be used to treat pancreatic cancer

In radiation therapy (radiotherapy), high-energy radiation is used to kill cancer cells. It is usually given in a hospital or clinic, and the course of treatment is usually 30-minute sessions five days a week for several weeks.

Radiation therapy can also be used to relieve pain caused by the tumor or to inhibit the growth of the tumor. Sometimes it is given before surgery to try to shrink the tumor before surgery, or it can be given post-surgery to kill any cancer cells that remain after surgery.

What are the side effects of pancreatic cancer radiation therapy?

While the radiation therapy procedure itself is painless, patients may experience side effects from the treatment, such as nausea, vomiting, loss of appetite, diarrhea, and extreme fatigue. Most side effects can be treated with medications, and most resolve within a few weeks after treatment has stopped.

Chemotherapy can be used to treat pancreatic cancer

Chemotherapy, also called “chemo,” is another treatment option for cancer and uses drugs, usually given intravenously, to kill cancer cells in the body. It is not localized and can also damage healthy cells.
It can be given before or after surgery, alone or in combination with radiation therapy. It is usually administered in cycles of several weeks, along with a rest period for the body to recover.

What are the side effects of chemotherapy?

Because chemotherapy can also damage healthy cells, it often causes side effects. Hair loss is common here. Because chemotherapy damages the cells in the hair follicles. Damage to blood cells can cause infections, bruising, or bleeding easily, weakness, and fatigue. Additionally, damage to cells in the digestive tract can cause nausea, vomiting, diarrhea, loss of appetite, and mouth or lip sores. Some chemotherapy drugs can cause numbness or tingling in the hands and feet.

New Targeted therapies could be used to treat pancreatic cancer

In targeted therapy, substances produced by the body or synthetic versions of these substances (such as antibodies, cytokines, and other immune system substances that can target cancer cells) are used to treat the disease.
One type of targeted therapy is called immunotherapy, and the goal is to stimulate the body’s immune system to attack cancer cells.

What are the side effects of pancreatic cancer biologic therapy?

The side effects of targeted therapies vary depending on the type of treatment. Many cause flu-like symptoms, allergic reactions, low blood counts, and even organ damage. Some of them can cause side effects such as urinary side effects and even secondary cancer.

What happens after pancreatic cancer treatment?

It is very important that you go to all your follow-up appointments with your doctor after completing treatment. Some of the side effects of the treatment will last for months, years, or even the rest of your life and will need to be treated. You will need to be closely monitored to check for a recurrence of the cancer. Your follow-ups will likely include a physical exam, blood tests, and CT scans.

What does the future hold for pancreatic cancer?

Medical advances are being made that may offer new treatment possibilities in the future. Some of the treatments studied include some form of laparoscopic surgery, new types of radiation therapy, new combinations of chemotherapy drugs, targeted therapies (such as growth factor inhibitors and anti-angiogenesis drugs), immunotherapies (such as monoclonal antibodies and vaccines), and personalized therapies.

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