What is the Pancreas?
The pancreas is a vital organ that secretes hormones to help your body process sugar and digestive juices to help you digest food. It is approximately 6 inches in length and sits in the center of the abdomen primarily behind the lower part of the stomach.
Types of Pancreatic Cancer
The pancreas is a vital organ that secretes hormones to help your body process sugar and digestive juices to help you digest food. It is approximately 6 inches in length and sits in the center of the abdomen primarily behind the lower part of the stomach.
Risk Factors for Pancreatic Cancer
Factors that may increase your risk of pancreatic cancer include:
African-American race
Obesity
Smoking
Chronic inflammation of the pancreas (chronic pancreatitis)
Diabetes
Family History of genetic syndromes that can increase cancer risk
Family history of pancreatic cancer
Causes of Pancreatic Cancer
The exact cause of pancreatic cancer is unknown however there are known risk factors. There are specific inherited DNA changes present in some families that increase the risk of pancreatic cancer. These syndromes cause a very small portion of all pancreatic cancers.
Other DNA changes are a result of exposure to cancer-causing chemicals (like those found in tobacco smoke). However, many DNA changes are probably just random events that sometimes happen inside a cell, without having an outside cause.
Screening for Pancreatic Cancer
Unfortunately, there is no widely accepted routine screening test for pancreatic cancer as there is for colon cancer. Patients with a strong family history of pancreatic cancer or with a known genetic syndrome that increases their risk could elect to undergo screening via endoscopic ultrasound, which is performed by a specially trained gastroenterologist.
The doctor passes an endoscope (a thin, flexible, tube with a small video camera) with an ultrasound probe down the throat and into the stomach and small intestine near the pancreas. Doctors have been able to find early pancreatic cancers in some members of high-risk families with this test.
Symptoms of Pancreatic Cancer
Diagnosis of pancreatic cancer usually starts with a physical exam by a physician followed by blood work, imaging studies and a biopsy.
The physical exam will focus mostly on your abdomen to check for any masses or fluid buildup. Cancers that block the bile duct may cause the gallbladder to swell to the point that it can be felt on physical exam. Pancreatic cancer may spread to the liver, causing it to enlarge. Your skin and the whites of your eyes will be checked for yellowing (jaundice).
Common associated blood work abnormalities include elevated liver enzymes and elevated levels of specific tumor markers in the blood.
Imaging studies such as ultrasound, CT scan and MRI can be used to visualize a suspected mass.
The only way to definitely diagnose pancreatic cancer is to remove a small sample of tumor and look at it under the microscope. This procedure is called a biopsy. Biopsies can be done in different ways. Traditionally, biopsies were performed with a surgery or percutaneously (needle passed through the skin and into the abdomen). Recently, the preferred modality is by endoscopic ultrasound. The doctor passes a needle through the stomach or intestine and into the tumor under guidance of the video and ultrasound capabilities of the scope. This procedure is done under anesthesia but requires no incision of the skin.
Treatment
The main types of treatment for pancreatic cancer are:
Surgery
Research has shown that removing only part of the cancer does not help patients live longer, so potentially curative surgery is only done if the surgeon thinks all of the cancer can be removed. Fewer than 1 out of 5 patients can undergo curative surgery.
Radiation Therapy
Radiation therapy uses high-energy x-rays (or particles) to kill pancreatic cancer cells. Radiation therapy is similar to getting an x-ray, but the radiation is stronger. The procedure itself is painless.
Chemotherapy
Chemotherapy uses anti-cancer drugs injected into a vein or taken by mouth. These drugs enter the bloodstream and reach all areas of the body, making this treatment potentially useful for cancers that have spread beyond the pancreas.
Ablation
Ablation refers to treatments that destroy tumors, usually with extreme heat or cold. This type of treatment typically does not require hospitalization.
If you have any of the symptoms or risk factors for pancreatic cancer a consultation with one of our specialists at Hunterdon Gastroenterology Associates can help. We are one of the few practices in New Jersey that can perform endoscopic ultrasound, a key diagnostic study in the diagnosis and staging of pancreatic cancer.
Be proactive about your health and make your appointment to be screened today!
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