Pancreatic Cancer

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KEY POINTS

• Pancreatic cancer is a growth of abnormal cells in the pancreas.
• Treatment may include surgery to remove part of the pancreas, gallbladder, and part of your small intestine, chemotherapy, or radiation. Often, more than 1 treatment is used.
• After treatment, you will need to have regular follow-up visits with your healthcare provider.

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What is pancreatic cancer?

Pancreatic cancer is a growth of abnormal cells in the pancreas. The pancreas is behind the stomach. It makes chemicals called enzymes that help break down food so that the nutrients can be used by your body. The pancreas also makes hormones, such as insulin. The hormones help your body use and store the energy it gets from food.

Pancreatic cancer can be life threatening. The sooner cancer is found and treated, the better your chances for recovery. However, even advanced cancer can usually be treated. Treatment may slow or stop the growth of the cancer and ease symptoms for a time. Ask your healthcare provider what you can expect with the type of cancer that you have.

What is the cause?

The exact cause of pancreatic cancer is not known. Most cases of pancreatic cancer happen in older adults. Some things that may increase the risk of this disease are:

• Smoking
• Diabetes
• Long-tem irritation of the pancreas (pancreatitis), often caused by alcohol abuse
• Obesity
• High-fat diet that includes a lot of red meat

Rarely, some families have inherited conditions that increase the risk for pancreatic cancer.

What are the symptoms?

Pancreatic cancer has been called a silent disease because it usually does not cause symptoms early on. When symptoms do appear, they may be so vague that they may be ignored or appear to be some other disease.

Symptoms may include:

• Yellowing of the skin and eyes, called jaundice
• Pain in the upper or middle belly and mid-back
• Weight loss
• Loss of appetite
• Tiredness

How is it diagnosed?

This cancer usually cannot be detected early, because the pancreas is tucked away, deep in the abdomen. It can be hard to examine. Your healthcare provider will ask about your symptoms and examine you. Your provider may feel a hard lump in your upper belly. Your liver or gallbladder may be larger than normal.

You may have tests such as:

• Blood tests
• CT scan, which uses X-rays and a computer to show detailed pictures of the belly
• Endoscopic ultrasound, which uses sound waves sent through a thin, flexible tube put through the mouth into the stomach to show pictures of the abdomen
• Biopsy of the pancreas, which may be done during a laparoscopy or with a needle passed through the skin to take a small sample of tissue for testing
• Laparoscopy, which uses a flexible, lighted tube put through a small cut through the belly to look at the organs and tissues inside the belly
• ERCP, which uses X-rays and a flexible, lighted tube to see the inside of the stomach and the first part of the small intestine and the pancreas
• MRCP, which uses a strong magnetic field and radio waves to show detailed pictures of the pancreas and the bile ducts

How is it treated?

You and your healthcare provider will discuss possible treatments. You may also talk with a surgeon and a cancer specialist. Some things to think about when making treatment decisions are:

• Your age
• Your overall health
• The stage of the cancer (how advanced the cancer is)
• Whether the cancer has spread to other parts of your body

Possible treatments are:

• Radiation therapy, which uses high-energy X-rays to kill cancer cells
• Chemotherapy (anticancer drugs), which uses medicine to kill cancer cells
• Surgery to remove part of the pancreas. You may also need surgery to remove the gallbladder or part of the small intestine.

Your treatment may also include:

• Preventing infections
• Controlling pain or other symptoms you may be having
• Preventing and controlling the side effects from treatments
• Helping you manage your life with cancer

Often, more than 1 treatment is used. You will need to have regular follow-up visits with your healthcare provider.

Ask your healthcare provider about clinical trials that might be available to you. Clinical trials are research studies to find new cancer treatments. It’s always your choice whether you take part in one or not.

How can I take care of myself?

If you have been diagnosed with pancreatic cancer:

• Talk about your cancer and treatment options with your healthcare provider. Make sure you understand your choices.
• Follow the full course of treatment prescribed by your healthcare provider.
• Ask your healthcare provider:
  • How and when you will get your test results
  • How long it will take to recover
  • If there are activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them
• Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

Other things that may help include:

• Follow your healthcare provider's advice about diet.
• Eat small, frequent meals instead of large meals.
• Take pancreatic enzyme pills if your provider prescribes them. These pills replace the enzymes usually made by your pancreas to help digest your food.
• Get regular exercise as recommended by your healthcare provider.
• Get plenty of rest.
• Try to reduce stress and take time for activities that you enjoy. It may help to talk with a counselor about your illness.
• Talk with your family and your healthcare providers about your concerns. Ask your healthcare provider any questions you have about the disease, treatments, side effects of the treatments, sexual activity, support groups, and anything else that concerns you.
• If you smoke, try to quit.
• Ask your provider if you need to avoid drinking alcohol. It may interfere with medicines you are taking. Alcohol can also make it harder for white blood cells to fight infections.
• Tell your provider if your treatment causes discomfort. Usually there are ways to help you be more comfortable.

For more information, contact:

• American Cancer Society, Inc.
  800-227-2345
  http://www.cancer.org
• National Cancer Institute
  800-422-6237 (TTY: 800-332-8615)
  https://www.cancer.gov/