Pancreatic Cancer

What is Pancreatic Cancer?

Pancreatic cancer is the abnormal growth of cells in the pancreas that results in a tumor. If the abnormal cells originated in the pancreas, it is considered a primary pancreatic tumor. In this case, most tumors begin in the ducts of the pancreas and are called adenocarcinomas. If the abnormal cells originated in the pancreas and were carried to other parts of the body through blood or other bodily fluids, then it is considered a metastatic pancreatic tumor.

It is estimated that 37,000 new cases of pancreatic cancer will occur in the United States in 2008, and an estimated 34,000 people will die from this disease in 2008 alone. Over 200,000 cases of pancreatic cancer occur annually throughout the world. Left untreated, median survival is about 4 months; although only 2% of cancers in the United States are pancreatic, it is the 4th leading killer. Its low rate of cure reflects, in part, the fact that a large proportion of pancreatic cancers are advanced when they are first detected.

How is Pancreatic Cancer detected?

In its early stages, pancreatic cancer usually does not cause symptoms. When symptoms occur, the cancer is often advanced. Patients may experience jaundice, pain and weight loss. A physical exam and blood tests may be used in the initial diagnosis, but blood tests alone cannot confirm pancreatic cancer. Computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, ultrasound and positron emission tomography-CT (PET-CT) scans may be used to aid in the diagnosis. A biopsy may be needed to determine the nature of the cancer cells in patients who are not surgical candidates. Doctors then determine the “stage” – or extent of the disease – by establishing how big the tumor is and how much it has spread.

How is Pancreatic Cancer treated?

Treatment of pancreatic cancer depends on its type and the stage. Early-stage pancreatic cancer may be removed surgically with the goal of curing the patient. The most common surgery is called the Whipple Procedure.  This is the surgical resection for a tumor in the head of the pancreas and entails the removal of a portion of the pancreas, the gall bladder, the duodenum (small intestine) and part of the stomach. Generally, surgical resection is only possible in 20 percent of pancreatic cancer cases. In those cases, surgical resection has a median survival of 15 to 25 months and a 15 percent to 20 percent long-term survival rate. Chemotherapy, radiation therapy, and/or radiosurgery can be used to treat patients whose disease is more advanced. In these cases, chemotherapy combined with concurrent standard radiation therapy typically results in a median survival of eight to 12 months. At the end stages of the disease, medicine, limited surgeries and other therapies may be used to treat the pain, obstruction of the bile duct and hormonal consequences of pancreatic cancer. Radiation therapy alone, or in conjunction with chemotherapy, has been shown to provide some pain control at this stage, with 35 percent to 65 percent effectiveness.