Definition Pancreatic cancer occurs when cells within the pancreas undergo changes that make the cells grow and divide uncontrollably. Pancreatic cancer is not a common cancer. When it occurs, it is likely to cause death.
What is going on in the body? The pancreas is a gland located in the middle part of the upper abdomen. Insulin is produced by the pancreas to help the body regulate blood sugar. The pancreas also produces substances to help the body digest food. When a cell in the pancreas becomes cancerous, it will grow into a tumour that destroys the tissue around it.
A tumour in the pancreas tends to invade the nearby liver early in the development of this type of cancer. Eventually the liver will be affected, and part of it will be destroyed. The cancer can also spread, or metastasise, through the bloodstream to other parts of the body. Most people do not realise they have pancreatic cancer until it has advanced into the liver. At that time, the person will have symptoms related to the destruction of the liver. This cancer is usually found late in the disease when it is most likely to be fatal.
What are the signs and symptoms of the disease? There may be no symptoms until the cancerous tumour grows large enough to affect the liver. Unexplained weight loss is the most common symptom. Destruction or blockage of the liver will cause jaundice. Jaundice is yellowing of the skin due to bile from the liver not being excreted normally. The person may also have nausea and vomiting from the tumour's effect on the pancreas and liver. Pain often occurs in the middle to upper part of the abdomen. All of these symptoms occur late in the disease. Early stage disease may not cause any symptoms.
What are the causes and risks of the disease? Cigarette smoking significantly increases the risk for developing this disease. It is not clear if other factors also increase the risk. The influence of alcohol ingestion and caffeine on the development of this cancer is uncertain and controversial.
What can be done to prevent the disease? There is no known method of preventing this cancer. Avoiding tobacco products would help reduce the risk. Some studies suggest that people who have had a tonsillectomy or various allergies may be at less risk for pancreatic cancer, but more research is needed.
How is the disease diagnosed? A physical examination may not indicate the reason for the symptoms. That's why specialised x-rays, such as an abdominal CT scan, will help. These tests may reveal a mass in the abdomen. When a mass is noted, a biopsy is done to remove a piece of it for examination. The examination will determine if the tumour is cancer and, if so, what type of cancer it is. Other CT scans and specialised x-rays will be done to determine if the cancer has spread. This information will assist in treatment planning.
What are the long-term effects of the disease? If found early, the cancer can sometimes be controlled for a period of time. However, pancreatic cancer usually causes death. The average survival is 4.1 months.
What are the risks to others? There are no risks to others from this cancer. It cannot spread to others.
What are the treatments for the disease? Treatment varies depending upon the extent of the disease.
If the disease is localised and the tumour is small, surgical removal of the tumour may offer long-term control of the cancer. Chemotherapy with radiation therapy may be offered once a small tumour is removed. This may be helpful in slowing the return of the tumour.
Most pancreatic cancers are found when the tumours are too large to remove. Large tumours may block the intestines. Surgery may be performed to bypass the blockage and relieve symptoms such as nausea and vomiting. Chemotherapy may be offered to relieve symptoms, such as pain, by shrinking the tumour. Advanced pancreatic cancer is not usually cured.
What are the side effects of the treatments? Side effects vary, depending on the treatment that is given.
Most people treated with surgery generally heal without difficulty.
The effects of radiation therapy are temporary and will resolve after completion. During therapy, the person is likely to experience nausea and difficulty swallowing. Medications will help control the nausea.
Chemotherapy given to a person with early stage disease makes the radiation work better. By itself, the chemotherapy would cause few problems other than mouth sores. Radiation may intensify this problem but is temporary. Chemotherapy given to treat late stage cancers is usually well tolerated. It is given to relieve symptoms.
What happens after treatment for the disease? The person will need to be closely followed. The cancer is likely to progress. As the cancer progresses, treatments can be given to make the person more comfortable.
How is the disease monitored? Physical examination will reveal the general condition of the person. CT scans will indicate the progress of the disease. When the liver is damaged by cancer, it will begin to fail. Liver function tests will also indicate how well the liver is functioning. As different interventions are used to bring comfort, the person will be monitored closely.
Author: Miriam P. Rogers, EdD, RN, AOCN, CNS Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
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