Cancer that starts in the pancreas is called pancreatic cancer.
The pancreas is a spongy, tube-shaped organ about 6 inches long. It is located in the back of the abdomen, behind the stomach. The head of the pancreas is on the right side of the abdomen. It is connected to the duodenum, the upper end of the small intestine. The narrow end of the pancreas, called the tail, extends to the left side of the body.
The pancreas makes hormones, including insulin. Pancreatic juices, also called enzymes, help digest food in the small intestine. Insulin controls the amount of sugar in the blood. Both enzymes and hormones are needed to keep the body working right.
As pancreatic juices are made, they flow into the pancreatic duct. This duct joins the common bile duct, which connects the pancreas to the liver and the gallbladder. The common bile duct, which carries bile (a fluid that helps digest fat), connects to the small intestine near the stomach.
When pancreatic cancer spreads, it usually travels through the lymphatic system. The lymphatic system includes a network of thin tubes that branch, like blood vessels, into tissues all over the body. Cancer cells are carried through these vessels by lymph, a colorless, watery fluid that carries cells that fight infection.
Along the network of lymphatic vessels are groups of small, bean-shaped organs called lymph nodes. Surgeons often remove lymph nodes near the pancreas to learn whether they contain cancer cells.
Cancer cells can also be carried through the bloodstream to the liver, lungs, bone, or other organs. Pancreatic cancer that spreads to other organs is called metastatic pancreatic cancer.
Pancreatic cancer has been called a "silent" disease because early pancreatic cancer usually does not cause symptoms.
If the tumor blocks the common bile duct and bile cannot pass into the digestive system, the skin and the whites of the eyes may become yellow, and urine may become darker. This condition is called jaundice.
As the cancer grows and spreads, pain often develops in the upper abdomen and sometimes spreads to the back. The pain may become worse after the person eats or lies down. Cancer of the pancreas can also cause nausea, loss of appetite, weight loss, and weakness.
A rare type of pancreatic cancer, called islet cell cancer, begins in the cells of the pancreas that produce insulin and other hormones. Islet cell cancer can cause the pancreas to make too much insulin or hormones. When this happens, the patient may feel weak or dizzy and may have chills, muscle spasms, or diarrhea.
Although there are many similarities in approaches, treatment for pancreatic cancer depends primarily on whether the cancer affects the exocrine or endocrine (islet cell) functions. The stage of the disease is also important. In addition, doctors consider the patient's age and general health and other factors.
Cancer of the pancreas is curable only when it is found in its earliest stages, before it has spread. Otherwise, it is very difficult to cure. However, it can be treated, symptoms can be relieved, and the quality of the patient's life can be improved.
Pancreatic cancer is treated with surgery, radiation therapy, or chemotherapy. Researchers are also studying biological therapy to see whether it can be helpful in treating this disease. Sometimes, several treatment methods are used.
Surgery may be done to remove all or part of the pancreas. Sometimes it is necessary to remove a portion of the stomach, duodenum, and other nearby tissues. This operation is called a Whipple procedure. In cases where the cancer in the pancreas cannot be removed, the surgeon may be able to create a bypass around the common bile duct or the duodenum if either is blocked.
Radiation therapy (also called radiotherapy) uses high-powered rays to damage the cancer cells and stop them from growing. Radiation is usually given 5 days a week for 5 to 6 weeks. This schedule helps protect normal tissue by spreading out the total dose of radiation. Weekend rests give normal cells time to heal.
Chemotherapy uses drugs to kill cancer cells. The doctor may use just one drug or a combination. Chemotherapy may be given by mouth or by injection into a muscle or vein. The drugs enter the bloodstream and travel through the body. Chemotherapy is usually given in cycles; a treatment period is followed by a rest period, then another treatment period, and so on.