Pancreatic Cancer

If you’ve recently been diagnosed with pancreatic cancer, you and your family might be overwhelmed with questions and concerns. Your first decision is where to get treatment.

You want a place where you can get the most advanced treatment options available. A place where you are supported by a team of compassionate experts. A place where you are treated as a whole person.

MultiCare Regional Cancer Center is that place. We have the region’s best health care providers in the field of oncology. Our world-class treatment facility offers cutting-edge technology in a welcoming and positive healing environment.

Learn about our comprehensive treatment approach, our cancer care team or more about pancreatic caner in the tabs below.

Pancreatic Cancer Facts

The pancreas is a large organ behind the stomach that produces enzymes to help the body absorb certain foods, especially fats. Insulin is made in the pancreas, which assists with balancing your blood sugar levels.

Causes

Cancer forms in the pancreas when cells develop genetic mutations and form tumors. There are two types of pancreatic cancer tumors. Adenocarcinomas are the most common and are sometimes called exocrine tumors. Cancer that forms in the hormone-producing cells of the pancreas is called endocrine cancer and is very rare.

Symptoms

These and other symptoms may be caused by pancreatic cancer, but other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:

• Jaundice (yellowing of the skin and whites of the eyes)
• Pain in the upper or middle abdomen and back
• Unexplained weight loss
• Loss of appetite
• Fatigue and weakness
• Dark urine or clay-colored stools
• Nausea and vomiting

Prevention

Risk Factors

Anything that increases your risk of getting a disease is called a risk factor. Risk factors for pancreatic cancer include the following:

• Smoking
• Long-standing diabetes
• Obesity
• Being over 60 years old
• Being male
• Family history of pancreatic cancer
• Diets high in red meat and sugar-sweetened drinks and low in vegetables and fruit
• Chronic pancreatitis
• Certain hereditary conditions - such as:
  • Hereditary pancreatitis
  • Multiple endocrine neoplasia type 1 Syndrome
  • Hereditary nonpolyposis colon cancer (HNPCC; Lynch syndrome)
  • Yon Hippel-Lindau Syndrome
  • Ataxia-telangiectasia
  • Familial atypical multiple mole melanoma syndrome (FAMMM)

There is no proven way to prevent pancreatic cancer, but lowering your risk factors is a good start. Quitting smoking; getting regular exercise; eating a healthy, low-fat, balanced diet and reducing excess weight are all ways you can try to protect yourself.

Diagnosis

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 of pancreatic cancer, when present, are like the signs of many other illnesses.
• The pancreas is hidden behind other organs such as the stomach, small intestine, liver, gallbladder, spleen and bile ducts.

Detecting, Diagnosing and Staging Tests

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:

• Chest X-Ray: An X-ray of the organs and bones inside the chest.
• 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.
• CT 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.
• 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.
• PET Scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radionuclide glucose (sugar) is injected into a vein so the scanner makes a picture of where glucose is being used in the body.
• Endoscopic Ultrasound (EUS): A procedure in which an endoscope (thin, tube-like instrument) is inserted into the body, usually through the mouth or rectum. 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.
• 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.
• 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.
• 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.
• 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 may be inserted into the pancreas during an X-ray or ultrasound to remove cells. Tissue may also be removed during a laparoscopy (a surgical incision made in the wall of the abdomen).

Treatments

Surgery

One of the following types of surgery may be used to take out the tumor:

• Whipple Procedure: A surgical procedure in which the head of the pancreas, the gallbladder, part of the stomach, part of the small intestine, and the bile duct are removed. Enough of the pancreas is left to produce digestive juices and insulin.
• Total Pancreatectomy: This operation removes the whole pancreas, part of the stomach, part of the small intestine, the common bile duct, the gallbladder, the spleen and nearby lymph nodes.
• Distal Pancreatectomy: The body and the tail of the pancreas and usually the spleen are removed.

Radiation Therapy

Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing.

There are two types of radiation therapy:

• External radiation therapy uses a machine outside the body to send radiation toward the cancer.
• Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires or catheters that are placed directly into or near the cancer.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing.

When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy).

Nutritional Considerations

Surgery to remove the pancreas may interfere with the production of pancreatic enzymes that help to digest food. As a result, patients may have problems digesting food and absorbing nutrients into the body. To prevent malnutrition, the doctor may prescribe medicines that replace these enzymes.

Supportive and Integrative Therapies

In addition to the therapies described above, we offer integrative therapies such as nutritional therapy, physical therapy, yoga, massage and emotional counseling. Many of these therapies are remarkably effective in addressing the side effects of chemotherapy, surgery and radiation by easing tension, reducing pain and improving quality of life.