Normal cells grow and divide to form new cells as the body needs them. When normal cells grow old or get damaged, they die, and new cells take their place.

Sometimes, this process goes wrong. New cells form when the body doesn’t need them, and old or damaged cells don’t die as they should. The buildup of extra cells often forms a mass of tissue called a growth or tumor.

Tumors in the pancreas can be benign (not cancer) or malignant (cancer). Benign tumors are not as harmful as malignant tumors

Pancreatic cancer can invade other tissues, shed cancer cells into the abdomen, or spread to other organs.

  • Invade: A malignant pancreatic tumor can grow and invade organs next to the pancreas, such as the stomach or small intestine.
  • Shed: Cancer cells can shed (break off) from the main pancreatic tumor. Shedding into the abdomen may lead to new tumors forming on the surface of nearby organs and tissues. The doctor may call these seeds or implants. The seeds can cause an abnormal buildup of fluid in the abdomen (ascites).
  • Spread: Cancer cells can spread by breaking away from the original tumor. They can spread through the blood vessels to the liver and lungs. In addition, pancreatic cancer cells can spread through lymph vessels to nearby lymph nodes. After spreading, the cancer cells may attach to other tissues and grow to form new tumors that may damage those tissues.

Early cancer of the pancreas often doesn’t cause symptoms. When the cancer grows larger, though, you may start to notice some or all of the following symptoms:

  • dark urine, pale stools, and yellow skin and eyes from jaundice
  • pain in the upper part of your belly
  • pain in the middle part of your back that doesn’t go away when you shift your position
  • nausea and vomiting
  • stools that float in the toilet

Also, advanced cancer may cause these general symptoms:

  • weakness or feeling very tired
  • loss of appetite or feelings of fullness
  • weight loss for no known reason

These symptoms may be caused by pancreatic cancer or by other health problems. People with these symptoms should tell their doctor so that problems can be diagnosed and treated as early as possible.

If you have symptoms that suggest cancer of the pancreas, your doctor will try to find out what’s causing the problems.

You may have blood or other lab tests done to help diagnose pancreatic cancer.

  • Physical exam: Your doctor feels your abdomen to check for changes in areas near the pancreas, liver, gallbladder, and spleen. Your doctor also checks for an abnormal buildup of fluid in the abdomen. Also, your skin and eyes may be checked for signs of jaundice.
  • CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of your pancreas, nearby organs, and blood vessels in your abdomen. You may receive an injection of contrast material so your pancreas shows up clearly in the pictures. Also, you may be asked to drink water so your stomach and duodenum show up better. On the CT scan, your doctor may see a tumor in the pancreas or elsewhere in the abdomen.
  • Ultrasound: Your doctor places the ultrasound device on your abdomen and slowly moves it around. The ultrasound device uses sound waves that can’t be heard by humans. The sound waves make a pattern of echoes as they bounce off internal organs. The echoes create a picture of your pancreas and other organs in the abdomen. The picture may show a tumor or blocked ducts.
  • EUS (endoscopic ultrasound): Your doctor passes a thin, lighted tube (endoscope) down your throat, through your stomach, and into the first part of the small intestine. An ultrasound probe at the end of the tube sends out sound waves that you can’t hear. The waves bounce off tissues in your pancreas and other organs. As your doctor slowly withdraws the probe from the intestine toward the stomach, the computer creates a picture of the pancreas from the echoes. The picture can show a tumor in the pancreas. It can also show how deeply the cancer has invaded the blood vessels.
  • ERCP (Endoscopic retrograde cholangiopancreatography): The doctor passes an endoscope through your mouth and stomach, down into the first part of your small intestine. Your doctor slips a smaller tube through the endoscope into the bile ducts and pancreatic ducts. After injecting dye through the smaller tube into the ducts, the doctor takes x-ray pictures. The x-rays can show whether the ducts are narrowed or blocked by a tumor or other condition.
  • MRI: A large machine with a strong magnet linked to a computer is used to make detailed pictures of areas inside your body.
  • PET scan: You’ll receive an injection of a small amount of radioactive sugar. The radioactive sugar gives off signals that the PET scanner picks up. The PET scanner makes a picture of the places in your body where the sugar is being taken up. Cancer cells show up brighter in the picture because they take up sugar faster than normal cells do. A PET scan may show a tumor in the pancreas. It can also show cancer that has spread to other parts of the body.
  • Needle biopsy: The doctor uses a thin needle to remove a small sample of tissue from the pancreas. EUS or CT may be used to guide the needle. A pathologist uses a microscope to look for cancer cells in the tissue.

Surgery

Surgery may be an option for people with an early stage of pancreatic cancer. The surgeon usually removes only the part of the pancreas that has cancer. But, in some cases, the whole pancreas may be removed.

The type of surgery depends on the location of the tumor in the pancreas. Surgery to remove a tumor in the head of the pancreas is called a Whipple procedure. The Whipple procedure is the most common type of surgery for pancreatic cancer. You and your surgeon may talk about the types of surgery and which may be right for you.

In addition to part or all of your pancreas, the surgeon usually removes the following nearby tissues:

  • duodenum
  • gallbladder
  • common bile duct
  • part of your stomach
  • spleen and nearby lymph nodes

Chemotherapy

Chemotherapy uses drugs to kill cancer cells. Most people with pancreatic cancer get chemotherapy. For early pancreatic cancer, chemotherapy is usually given after surgery, but in some cases, it’s given before surgery. For advanced cancer, chemotherapy is used alone, with targeted therapy, or with radiation therapy.

Chemotherapy for pancreatic cancer is usually given by vein (intravenous). The drugs enter the bloodstream and travel throughout your body.

Chemotherapy may be given in an outpatient part of the hospital, at the doctor’s office, or at home. Rarely, you may need to stay in the hospital.

Targeted Therapy

People with cancer of the pancreas who can’t have surgery may receive a type of drug called targeted therapy along with chemotherapy.

Targeted therapy slows the growth of pancreatic cancer. It also helps prevent cancer cells from spreading. The drug is taken by mouth.

Radiation Therapy

Radiation therapy uses high-energy rays to kill cancer cells. It can be given along with other treatments, including chemotherapy.

The radiation comes from a large machine. The machine aims beams of radiation at the cancer in the abdomen. You’ll go to a hospital or clinic 5 days a week for several weeks to receive radiation therapy. Each session takes about 30 minutes.

When you get a diagnosis of cancer, it’s natural to wonder what may have caused the disease. Doctors can’t always explain why one person gets pancreatic cancer and another doesn’t. However, we do know that people with certain risk factors may be more likely than others to develop cancer of the pancreas. A risk factor is something that may increase the chance of getting a disease.

Studies have found the following risk factors for cancer of the pancreas:

  • smoking. Smoking tobacco is the most important risk factor for pancreatic cancer. People who smoke tobacco are more likely than nonsmokers to develop this disease. Heavy smokers are most at risk.
  • diabetes. People with diabetes are more likely than other people to develop pancreatic cancer.
  • family history. Having a mother, father, sister, or brother with pancreatic cancer increases the risk of developing the disease.
  • inflammation of the pancreas. Pancreatitis is a painful inflammation of the pancreas. Having pancreatitis for a long time may increase the risk of pancreatic cancer.
  • obesity. People who are overweight or obese are slightly more likely than other people to develop pancreatic cancer.

Many other possible risk factors are under active study. For example, researchers are studying whether a diet high in fat (especially animal fat) or heavy drinking of alcoholic beverages may increase the risk of pancreatic cancer. Another area of active research is whether certain genes increase the risk of disease.

Many people who get pancreatic cancer have none of these risk factors, and many people who have known risk factors don’t develop the disease.

Every cancer diagnosis is different, just as every person who is diagnosed with cancer is different. Cancer knows no barriers to race, age, or social group. However there is one thing that each and every person who is diagnosed with cancer will have in common: help with fighting and beating the disease.

Life after being diagnosed with cancer will be different for everyone. Some people will have minimal disease and it will be a short chapter of their lives, while others will have a diagnosis that will change the course of the rest of their lives. Cancer diagnoses can change relationships, your routines, your work and home life. One thing is certain: no one person’s experience will be exactly the same. There are however, plenty of resources to learn about what life was like for other people, and what they did to achieve balance, maintain their health and personal life, keep peace of mind, and enjoy their lives with or after cancer.

Clinical Trials

The search for a cure for cancer is an ongoing, constant battle. Clinical trials are the basis upon which new treatments and medications are proven to help the fight against cancer, or if researchers should pursue another tactic. The advancement of medicine depends on willing and able cancer patients to volunteer for experimental treatments so that future generations will have proven and effective cures. Not every patient with cancer will be eligible for a clinical trial, as the scientific method needs specific patients with specific types of cancers. However, patients who are selected for trials may benefit from being at the cutting edge of new research, and gain time they otherwise might not have had.

The National Cancer Institute at the National Institutes of Health has a comprehensive database of over 10,000 ongoing clinical trials that both help advance medicine and help patients.

Financial Help

Unfortunately, cancer treatment can be costly, even if a patient has very comprehensive health insurance. For patients who do not have health insurance, the cost of treatment may seem insurmountable. Fortunately many pharmaceutical companies offer cost assistance to help make treatment more affordable. The National Comprehensive Cancer Network has compiled a Virtual Reimbursement Room where patients can find information for accessing financial help with their treatment costs.

Doctors all over the world are conducting many types of clinical trials (research studies in which people volunteer to take part). Clinical trials are designed to find out whether new treatments are safe and effective.

Doctors are studying new drugs, other treatments, and their combinations, including combinations of surgery, chemotherapy, targeted therapy, and radiation therapy.

Even if the people in a trial do not benefit directly, they may still make an important contribution by helping doctors learn more about cancer of the pancreas and how to control it. Although clinical trials may pose some risks, doctors do all they can to protect their patients.

Life after being diagnosed with cancer will be different for everyone. Some people will have minimal disease and it will be a short chapter of their lives, while others will have a diagnosis that will change the course of the rest of their lives. Cancer diagnoses can change relationships, your routines, your work and home life. One thing is certain: no one person’s experience will be exactly the same. There are however, plenty of resources to learn about what life was like for other people, and what they did to achieve balance, maintain their health and personal life, keep peace of mind, and enjoy their lives with or after cancer.

Your experience with cancer will depend on the type of cancer you have, your choices of treatment and the lifestyle you lead. Be sure to speak with your doctor about the side effects of your disease and the treatments you choose. Your doctor will be able to consult with you on realistic lifestyle expectations. 

Review Date: 
March 27, 2012
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