Key Points
- Pancreatic cancer is a disease in which malignant (cancer)
cells form in the tissues of the pancreas.
- Smoking and health history can affect the risk of pancreatic cancer.
- Signs and symptoms of pancreatic cancer include jaundice, pain, and
weight loss.
- Pancreatic cancer is difficult to detect (find) and diagnose
early.
- Tests that examine the pancreas are used to detect (find),
diagnose, and stage pancreatic cancer.
- Certain factors affect prognosis (chance
of recovery) and treatment options.
Smoking and health history can affect the risk of pancreatic cancer.
Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. Talk with your doctor if you think you may be at risk.
Risk
factors for pancreatic cancer include the following:
Signs and symptoms of pancreatic cancer include jaundice, pain, and
weight loss.
Pancreatic cancer may not cause early signs
or symptoms. Signs and symptoms may be caused by pancreatic cancer or by other conditions. Check with your doctor if you have any of the following:
- Jaundice
(yellowing of the skin and whites of the eyes).
- Light-colored stools.
- Dark urine.
- Pain in the upper or middle abdomen
and back.
- Weight loss for no known reason.
- Loss of appetite.
- Feeling very tired.
Pancreatic cancer is difficult to detect (find) and diagnose
early.
Pancreatic cancer is difficult to detect and diagnose
for the
following reasons:
- There aren’t any noticeable signs or symptoms in the early stages
of pancreatic
cancer.
- The signs and symptoms of pancreatic cancer, when present, are like the
signs and symptoms of many other illnesses.
- The pancreas is hidden behind other organs
such as the
stomach, small intestine, liver, gallbladder, spleen, and bile
ducts.
Tests that examine the pancreas are used to detect (find),
diagnose, and stage pancreatic cancer.
Pancreatic cancer is usually diagnosed with tests and procedures
that make pictures of the pancreas and the area around it. The process used
to find out if cancer
cells
have spread within and around the pancreas is
called staging. Tests and procedures
to detect, diagnose, and stage pancreatic cancer are usually done at the same
time. In order to plan treatment, it is important to know the stage of
the disease and whether or not the pancreatic cancer can be removed by surgery.
The following tests and
procedures may be used:
-
Physical exam
and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
-
Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances, such as bilirubin, released into the blood by organs and tissues
in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.
-
Tumor marker test: A procedure in which a sample of blood, urine, or tissue is checked to measure the amounts of certain substances, such as CA 19-9, and carcinoembryonic antigen
(CEA), made by organs, tissues, or tumor
cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the body. These are called tumor markers.
-
MRI
(magnetic
resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
-
CT scan
(CAT
scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray
machine. A dye may be injected
into a vein
or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. A spiral
or helical CT
scan
makes a series of very detailed pictures of areas inside the body using an x-ray machine that scans the body in a spiral path.
-
PET scan
(positron
emission tomography scan): A procedure to find malignant
tumor
cells in the body. A small amount of radioactive
glucose
(sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do. A PET scan and CT scan may be done at the same time. This is called a PET-CT.
-
Abdominal ultrasound: An ultrasound exam used to make pictures of the inside of the abdomen. The ultrasound transducer
is pressed against the skin of the abdomen and directs high-energy sound waves (ultrasound) into the abdomen. The sound waves bounce off the internal tissues and organs and make echoes. The transducer receives the echoes and sends them to a computer, which uses the echoes to make pictures called sonograms. The picture can be printed to be looked at later.
- Endoscopic
ultrasound
(EUS): A procedure in which an endoscope
is inserted into the body, usually through the mouth or rectum. An endoscope is a thin, tube-like instrument with a light and a lens
for viewing. A probe at the end of the endoscope is used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. This procedure is also called endosonography.
-
Endoscopic
retrograde cholangiopancreatography
(ERCP): A procedure used to x-ray the ducts
(tubes) that carry bile
from the liver to the gallbladder and from the gallbladder to the small intestine. Sometimes pancreatic cancer causes these ducts to narrow and block or slow the flow of bile, causing jaundice. An endoscope (a thin, lighted tube) is passed through the mouth, esophagus, and stomach into the first part of the small intestine. A catheter
(a smaller tube) is then inserted through the endoscope into the pancreatic ducts. A dye
is injected through the catheter into the ducts and an x-ray is taken. If the ducts are blocked by a tumor, a fine tube may be inserted into the duct to unblock it. This tube (or stent) may be left in place to keep the duct open. Tissue samples may also be taken.
-
Percutaneous
transhepatic cholangiography
(PTC): A procedure used to x-ray the liver and bile ducts. A thin needle is inserted through the skin below the ribs and into the liver. Dye is injected into the liver or bile ducts and an x-ray is taken. If a blockage is found, a thin, flexible tube called a stent is sometimes left in the liver to drain
bile into the small intestine or a collection bag outside the body. This test is done only if ERCP
cannot be
done.
-
Laparoscopy: A surgical
procedure to look at the organs inside the abdomen to check for signs of disease. Small incisions
(cuts) are made in the wall of the abdomen and a laparoscope
(a thin, lighted tube) is inserted into one of the incisions. The laparoscope may have an ultrasound probe at the end in order to bounce high-energy sound waves off internal organs, such as the pancreas. This is called laparoscopic ultrasound. Other instruments may be inserted through the same or other incisions to perform procedures such as taking tissue samples from the pancreas or a sample of fluid
from the abdomen to check for cancer.
-
Biopsy: The removal of cells or tissues so they can be viewed under a microscope
by a pathologist
to check for signs of cancer. There are several ways to do a biopsy for pancreatic cancer.
A fine needle
or a core needle
may be inserted into the pancreas during an x-ray or
ultrasound to remove cells. Tissue
may also be removed during a laparoscopy.
Certain factors affect prognosis (chance
of recovery) and treatment options.
The prognosis
(chance of recovery) and treatment options depend on the following:
- Whether or not the tumor can be removed by surgery.
- The stage
of the cancer (the size of the tumor and whether the cancer has spread outside
the pancreas to nearby tissues or lymph
nodes
or to other places in the body).
- The patient’s general
health.
- Whether the cancer has just been diagnosed or has recurred
(come back).
Pancreatic cancer can be controlled only if it is found before it
has spread, when it can be completely removed by surgery. If the cancer has spread, palliative treatment
can improve the patient's quality of life
by controlling the
symptoms and complications
of this disease.