Pancreatic Cancer

Overview

Learning you have cancer can be an emotional experience—not only for you but for everyone in your life who loves and cares about you. Feelings of anxiety and confusion are common, but the more you learn about the specifics of this disease, the more you’ll realize there is always hope and help available.

This publication will help guide you and your support system through all aspects of pancreatic cancer and prepare you for what to expect following your diagnosis. Knowledge is power, and by playing an active role in your recovery through your research, you’ll make your health care team immeasurably stronger and more effective.

About the pancreas

Roughly one in 76 people will develop cancer of the pancreas, a pear-shaped organ located in the abdomen, just behind the stomach (see Figure below). It’s approximately 6 inches long and 2 inches wide and contains three parts: the head is the large, rounded end on the right side; the body is the middle portion; and the tail is the long, thin end on the left side.

The pancreas also contains two types of glands: exocrine and endocrine.

  • Exocrine glands produce pancreatic fluid, which contains enzymes that help with digestion. More than 95 percent of pancreatic cells are exocrine cells.
  • Endocrine glands release hormones, such as glucagon and insulin, into the bloodstream. Only a small percentage of pancreatic cells are endocrine cells.

The vast majority of pancreatic cancer begins in the exocrine glands.

Approximately 48,960 new cases of pancreatic cancer are diagnosed each year in the U.S., and approximately 95 percent of these are adenocarcinomas. Other types of pancreatic cancers exist, distinguishable by how they look under a microscope, but they are much less common.

Pancreatic cancer often goes undiagnosed during routine physicals because the pancreas is located deep inside the body. In addition, signs and symptoms of pancreatic cancer typically don’t develop until the cancer has already progressed. By the time symptoms do occur, they commonly include jaundice, weight loss, abdominal pain, gallbladder enlargement, digestive problems, blood clots, nausea, vomiting and diabetes. For those patients who don’t experience any symptoms, pancreatic cancer is often detected while undergoing an imaging test being done for another reason, or while they’re in the hospital or at the doctor's office for an unrelated issue.

Risk factors

When you receive a diagnosis of pancreatic cancer, it’s important to know what may have caused the disease. Pancreatic cancer is most common in people age 45 or older, and the rate of new cases is higher among men than women and highest for African-Americans.

Other factors that raise the risk of developing pancreatic cancer include tobacco use, obesity, diabetes, a family history of pancreatic cancer, chronic pancreatitis (inflammation of the pancreas), hereditary pancreatitis, exposure to certain chemicals, infection with hepatitis B, and rare inherited conditions, such as Peutz-Jeghers syndrome, Lynch syndrome, Li-Fraumeni syndrome, familial adenomatous polyposis, and hereditary breast and ovarian cancer syndrome.

Your health care team

Fighting cancer takes a team approach, and you will likely encounter several different types of medical professionals throughout your treatment. They are all important participants in your recovery, as they will help you better understand your diagnosis and choose the most effective treatment plan based on the specifics of your disease.

Some of the pancreatic cancer specialists who will likely become crucial members of your treatment team include:

  • Case manager – A nurse or cancer specialist who helps coordinate appointments, works with the insurance companies, answers questions and directs patients and their families to advocacy groups for support.
  • Gastroenterologist – A doctor whose focus is on diagnosing and treating diseases affecting the digestive system or gastrointestinal (GI) tract; usually the first doctor you will see if/when you experience any problems or symptoms.
  • Medical oncologist – An internal medicine specialist who manages cancer treatment with chemotherapy and other drugs.
  • Surgical oncologist – A doctor who specializes in surgically removing cancer.
  • Radiation oncologist – A specialist who uses radiation therapy to treat cancer patients.

Following a diagnosis of cancer, your health care team will determine the extent of the disease – a process called staging – to help you narrow your treatment options. It’s in your best interest to consult with several different types of specialists so that you are aware of the possibilities and can make an informed and confident decision about the treatment plan that’s right for you. While many cancer patients worry about the side effects of treatment, the good news is that many are minimal or manageable with help from your team of doctors.

Pancreatic cancer is usually treated with surgery, radiation therapy, chemotherapy, ablative techniques and targeted therapy. You might also receive palliative (supportive) therapy to relieve any symptoms and side effects you may experience. You will learn more about the various treatment options and your specific treatment plan here.

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