Martin-O'Neil Cancer Center

Pancreatic Cancer

Approximately 40,000 new cases of pancreatic cancer are diagnosed each year in the United States, and pancreatic cancer is the fourth most common cause of cancer related death among both men and women in the United States.

Located deep in your abdomen between your stomach and backbone, your pancreas is about 6 inches long, surrounded by your liver, intestine, and other organs.

The pancreas is really two glands in one organ. One part makes pancreatic juices, which contain enzymes that help break down food. The juices flow through a system of ducts out to the small intestine. The pancreas also makes insulin and other hormones that balance the amount of sugar in the blood.

The most common type of cancer of the pancreas is exocrine pancreatic cancer, which starts in the ducts. Much less often, pancreatic cancer begins in the cells that make hormones, known as endocrine pancreatic cancer or islet cell cancer.

Pancreatic cancer can invade nearby tissues, and cancer cells can break off to spread to organs in other parts of the body as metastatic pancreatic cancer. For more information on pancreatic cancer, we the NCCN (National Comprehensive Cancer Network) patient and care giver website at http://www.nccn.com/ or the National Cancer Institute (http://www.cancer.gov/) are two credible sources.

Risk Factors

While the cause of pancreatic cancer is unknown, people with certain risk factors are more likely than others to develop the disease.  Here are some known risk factors as well as conditions which may be associated with a higher risk for pancreatic cancer

• Age and Race:  There is a higher incidence rate in people aged in their 70s and 80s as well as in African Americans.
• Smoking: the single most important risk factor, with heavier smoking associated with higher risk.
• New Onset Diabetes: an endocrine disorder affecting the pancreas, diabetes increases the risk of pancreatic cancer.
• Family history: a mother, father, or sibling with pancreatic cancer indicates increased risk.
• Chronic Pancreatitis: long-term Inflammation of the pancreas.
• Obesity: being overweight or obese is associated with higher risk.
• Gender: being overweight or obese
  
• Alcohol:  heavy alcohol consumption.

Symptoms

Pancreatic cancer may cause one or more of these common symptoms:

• Jaundice: Yellowing of the skin and eyes
• Pain: Pain in the upper part of your abdomen, or in the middle part of your back that doesn’t go away when you shift your position
• Digestive problems: Nausea and vomiting; pale, greasy stools that float in the toilet; loss of appetite or feelings of fullness and early satiety (feeling full quickly).
• Weight loss: Losing weight over a period of time for no known reason

Surgery

Surgery may be indiicated to remove the tumor.  Whether surgery is recommended or not depends on the stage of the cancer, the anatomy, and the person's overall health.   The type of surgery depends on the stage of the cancer, the location and size of the tumor:

•  Whipple Procedure- if the tumor is located at part of the gland known as the "head" of the pancreas, this portion is removed along with the first part of the small bowel (called the duodenum), a portion of the bile duct, the gallbladder, and possibly a portion of the stomach.
• Pylorus preserving pureveatico duodenectomy – this is the same as the classic Whipple procedure, but preserves the stomach .
• Distal Pancreatectomy - if the tumor is located in a part known as the body or the tail of the pancreas, these sections of the pancreas will be removed, possibly along with the spleen.
• Total Pancreatectomy- the entire pancreas, portion of the small intestine, common bile duct possibly the stomach, and the gallbladder and spleen are removed.

Chemotherapy

There are a number of different chemotherapy drugs and treatment options. Chemotherapy may be used before or after surgery, and may be used alone or in combination with targeted therapy or radiation therapy.

Targeted Therapy

People with cancer of the pancreas who can’t have surgery may receive a type of oral drug called targeted therapy along with chemotherapy to slow the cancer’s growth and help prevent cancer cells from spreading.

Radiation Therapy

Radiation therapy uses precisely-targeted high-energy rays to kill cancer cells. It can be given along with surgery or chemotherapy. MOCC has some of the most advanced radiation technology in the Bay Area, allowing doctors to spare healthy tissue and minimize side effects.

Clinical Trials

The treatment of pancreatic cancer is advancing rapidly, with many new drugs and treatments under study. An important treatment option for many patients is participation in these clinical trials. MOCC has established unique partnerships with some of the leading cancer research centers in California.

The Best in Multi-Disciplinary Care

At MOCC, our goal is to provide you with a single, comprehensive resource for the best cancer treatment available. We’ve brought together top cancer specialists, state-of-the-art technology, and an unparalleled philosophy of caring into a single cancer treatment facility.

Information on pancreatic cancer was adapted from the National Cancer Institute (http://www.cancer.gov/).