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Pancreatic Cancer

What is the Pancreas?

The pancreas is a gland about 6 inches long that is shaped like a thin pear lying on its side.. The pancreas lies behind the stomach and in front of the spine. The pancreas is a dual functioning gland of the digestive system made up of two types of cells: one produces digestive juices and the other releases hormones that help regulate blood sugar levels

What is pancreatic cancer?

Cancer of the pancreas occurs when normal cells in the pancreas become abnormal and grow out of control. The pancreas is an organ that sits behind the stomach. It makes hormones and juices that help the body break down food.

What are the symptoms of pancreatic cancer?

Symptoms of pancreatic cancer can include:

  • Pain - People can have pain that spreads from their stomach area around to their back. The pain can come and go, and it can get worse after eating.
  • Weight loss - People might not feel hungry, or might feel full after eating very little.
  • Pale or floating bowel movements can look greasy or be difficult to flush in the toilet bowl.
  • Yellowing of the skin, called jaundice - Both the skin and the white part of the eyes can turn yellow. When jaundice happens in people with pancreatic cancer, it is usually because one of the tubes that carry bile from the liver to the intestines is blocked.

These symptoms can also be caused by conditions that are not pancreatic cancer. But if you have these symptoms, tell your doctor or nurse about them.

What tests are performed for pancreatic cancer?

The tests for pancreatic cancer include:

  • Imaging tests, such as an ultrasound, a CT scan, MRI scan or a test called ERCP (which stands for endoscopic retrograde cholangiopancreatography) – These tests create pictures of the inside of the body and can, not always show abnormal growths.
  • Endoscopic Ultrasound Biopsy – For a biopsy, a doctor takes a small sample of tissue from the pancreas, which can, but not always, show the presence of cancer cells.

What is cancer staging?

Cancer staging is a way in which doctors find out how far a cancer has spread, using a CT scan or sometimes a PET scan or diagnostic laparoscopy.

The right treatment for you will depend a lot on the stage of your cancer. Your treatment will also depend on your age and other medical problems.

How is pancreatic cancer treated?

Treatment recommendations are made after a specialist multidisciplinary team discussion and is based on if the cancer has spread already.

Tumours confined to the pancreas and removable – You should be assessed to have potentially curative surgery. Either a Whipple’s procedure for right sided cancers or a distal pancreatectomy for left sided tumours. Most people will require chemotherapy after surgery.

Tumours confined to the pancreas which are possibly (borderline) removable – You should be assessed for surgery and chemotherapy. It may be recommended to have surgery followed by chemotherapy or chemotherapy prior to surgery. Your surgery may involve removal and replacement of a major vein within the pancreas.

Tumours extending beyond the pancreas but not spread to the liver, lung or abdominal cavity – You should be assessed to have chemotherapy to try and shrink the tumour. A small number of patients may be able to undergo radical surgery, if chemotherapy is highly successful. A Nanoknife® procedure may also be appropriate if chemotherapy is successful.

Tumours that have spread to the liver, lung or abdominal cavity – A biopsy should be taken to confirm the presence of spread.  Surgery in this setting is not beneficial. Radiotherapy and chemotherapy are used with the intention to control symptoms and prolong life.

Where can I find more information about pancreatic surgery?

More information is available on, pancreatic surgery.

Will I need chemotherapy?

Even if the tumour has been completely removed, tiny cancer cells may remain in the body and grow, causing relapse after surgery. Chemotherapy can prolong survival by eliminating the tiny cancer cells before they have a chance to grow

What happens after pancreatic surgery? 

Following treatment, you will be checked every so often to see if the cancer comes back. Follow up tests usually include exams, blood tests, and imaging tests. If the cancer comes back after treatment, you might have chemotherapy or radiation therapy. You might also get pain medicine or other treatments to help with pain.

What is the prognosis of pancreatic cancer?

The survival in pancreatic cancer depends on many factors; whether the tumour can be removed, if you are fit enough to undergo major surgery and chemotherapy and whether it has spread outside the pancreas to lymph nodes and other sites. This discussion is best had with your surgeon or oncologist who can make an informed estimate.

In general, only a small proportion of people diagnosed with pancreatic cancer will be able to undergo potentially curative treatment. Of those who undergo surgery, life expectancy is increased, but there is a good chance of the cancer returning in some form in the future.