Pancreatic cancer occurs when malignant cells begin to grow in the pancreas—the organ that secretes enzymes to aid digestion and hormones to regulate sugar metabolism. It is a difficult cancer to diagnose for the following reasons:
- Noticeable signs or symptoms are not present in the early stages of pancreatic cancer. As the cancer grows, symptoms may include:
- Pain in the middle or upper abdomen
- Yellowed skin and eyes
- Weakness or fatigue
- Appetite loss
- Nausea and vomiting
- Weight loss
- The signs of pancreatic cancer, when present, are like the signs of many other illnesses, including
- Polyps in the duodenum (the intestine next to the pancreas)
- Scarring or strictures in the pancreas
- Bile duct tumors or strictures
- Cysts of the pancreas and pseudocysts
- The pancreas is hidden behind other organs (such as the stomach, small intestine, liver, gallbladder, spleen, and bile ducts)
For these reasons, and because it spreads quickly, pancreatic cancer is serious and usually unaddressed until it has advanced in the abdomen. However, we're finding new ways to cure and manage this type of cancer, and the specialists at MedStar Health are experts in treating and managing pancreatic cancer.
- Most cases of pancreatic occur after age 60.
- Cigarette smokers are two to three times more likely than nonsmokers to develop pancreatic cancer.
- The disease is more common in men than women.
- African-Americans tend to get this cancer more often than individuals from other ethnic groups.
- People with diabetes have a greater risk, as do those with a history of chronic pancreatitis, a chronic inflammation of the pancreas.
- If you have immediate family members with a history of pancreatic, colorectal, or ovarian cancer, you have an increased risk.
Take these steps to lower your risk:
- If you smoke, quit.
- Maintain a healthy weight.
- Limit your consumption of pork, red meat, and processed meat-such as lunch meat, sausage, and bacon.
- Avoid cooking meats at high temperatures. Doing so can help reduce your exposure to harmful chemicals that are formed in high temperature cooking.
- Include at least five servings of fruits and vegetables in your daily diet.
At MedStar Health, we believe that a multidisciplinary approach is the only approach. Our specialists work together as a team to find a definitive diagnosis and create a treatment plan. Before your doctors make decisions about your treatment, however, they must know how far the cancer has spread. Our doctors specialize in looking at scans for signs of pancreatic cancer, as well as performing more in-depth diagnostic procedures. Any of the following will most likely be used to establish a diagnosis:
- Endoscopic ultrasound (EUS): Sound waves create images of body tissues where high-energy sound waves are bounced off internal tissues and organs; the echoes are then changed into pictures called sonograms. EUS can also guide the removal of tissue for biopsies/
- Laparoscopy: A laparoscope (a thin, lighted tube) is inserted through an incision in the abdominal wall to determine if the cancer is within the pancreas only or has spread to nearby tissues and if it can be removed by surgery later.
- Endoscopic retrograde cholangiopancreatography (ERCP): An x-ray of the ducts that carry bile from the liver to the gallbladder and from the gallbladder to the small intestine. Because pancreatic cancer can cause these ducts to narrow and block or slow the flow of bile, causing jaundice, the ERCP can detect this blockage. ERCP can also remove tissue for biopsies.
- Percutaneous transhepatic cholangiography (PTC): An X-ray of the liver and common bile ducts.
- Liver function test: Evaluates how well your liver is working, as pancreatic cancer may affect your liver function.
- Serum bilirubin test: Measures the amount of bilirubin (a fluid produced by the liver) in your blood.
- Biopsy: Cells, tissues, or fluid are removed and viewed under a microscope to see if cancer cells are present.
- Physical exam and history
- Chest X-ray
- CT scan
- PET scan
If you have just received a pancreatic cancer diagnosis, you are probably full of questions and anxiety about your treatment options. At MedStar Health, our doctors have dedicated their careers to researching and discovering the best new treatments for pancreatic cancer, including innovative surgical procedures and revolutionary radiatotherapies like CyberKnife®. We are all here to answer your questions and give you the best, most compassionate care.
Surgery is prescribed for nearly all pancreatic cancer patients when the cancer is found at an early stage. Some of the surgical procedures involve removing the diseased part of the pancreas and reattaching the rest of the organ so that your body can continue to function as it did before. Your MedStar Health surgeon will choose the best option based on your particular condition.
Radiation and Chemotherapy
Because pancreatic cancer is often not diagnosed until it is more advanced, surgery may not be an option. Chemotherapy, targeted therapy, and radiation may be part of your treatment plan, as well. Sometimes you will first have surgery and then follow up with these other treatments to prevent the cancer from recurring (coming back), or you may receive chemotherapy and/or radiation medicine first to shrink the tumor prior to surgery.
CyberKnife Radiation for Pancreatic Cancer
Many pancreatic tumors are virtually impossible to remove surgically. Conventional radiation is hard to deliver directly to these tumors because they are moving targets, moving as you breathe. Surrounding healthy tissue often receives unnecessary doses of radiation in these procedures. But CyberKnife, with an advanced combination of computer and imaging technology, identifies the exact location of the pancreatic tumor, coordinates with the Synchrony® Respiratory Tracking System (which follows the tumor's movement as you breathe), and accurately focuses radiation on the tumor without affecting surrounding healthy tissue. While CyberKnife does not necessarily cure pancreatic cancer, it helps reduce the pain and complications associated with the disease.
Our CyberKnife teams are among the most experienced in the nation, and our doctors are currently researching the effectiveness of using CyberKnife with chemotherapy to reduce tumors so they can be removed surgically.