Frequently Asked Questions About Pancreatic Cancer
Q. What is pancreatic cancer?
A. The pancreas is an organ located in the abdomen. It is surrounded by the stomach, intestines, liver and other organs. Over 95 percent of the cells in the pancreas form exocrine glands and ducts, so it makes sense that most pancreatic cancers occur in these cells. While the exocrine cells of the pancreas can form benign tumors (non-cancerous), malignant tumors (cancerous) are more common.
Q. What are the causes and risk factors for pancreatic cancer?
A. It is difficult to discover what actually causes cancer from one person to another, but researchers have found several specific factors that increase a person’s likelihood of developing pancreatic cancer. Risk factors for pancreatic cancer include:
- Over 50 years of age
- Men are about 30 percent more likely to develop pancreatic cancer than women
- African Americans are more likely to develop cancer of the pancreas than are white Americans or Asian Americans
- Cigarette smoking
- Diet high in meats and fat
- Diabetes mellitus
- An inherited tendency to develop this cancer may be a factor in about 5 to 10 percent of cases
- People with chronic pancreatitis may also have an increased risk of developing pancreatic cancer
Q. What are the symptoms for pancreatic cancer?
A. Cancer of the pancreas is difficult to detect early. Often, tumors in the pancreas do not cause noticeable symptoms. You should consult a doctor if you have any of the following symptoms:
- Pain in the upper abdomen and back
- Loss of appetite
- Weight loss
Q. How will my doctor know if I have pancreatic cancer?
A. To find the cause of a person's symptoms, the doctor performs a physical exam and asks about the person's medical history. In addition to checking general signs of health, the doctor may perform blood, urine and stool tests. Doctors may perform several tests that involve taking pictures of the pancreas and surrounding tissues and organs to help with diagnosis. These are called imaging tests. Imaging tests include Upper GI series, CT scanning, MRI, Ultrasonography and ERCP.
Q. What about treatment? What should I ask?
A. Three kinds of treatment are used for pancreatic cancer:
- Surgery – taking out the cancer in an operation
- Radiation therapy – using high-dose x-rays or other high-energy rays to kill cancer cells
- Chemotherapy – using drugs to kill cancer cells
A doctor may use just one method or combine methods to treat the cancer most effectively. These are some questions a person may want to ask his/her doctor before treatment begins:
- What is my diagnosis?
- What is the stage of the disease?
- What are my treatment choices? Which do you recommend for me? Why?
- What are the chances that the treatment will be successful?
- Would a clinical trial be appropriate for me?
- What are the risks and possible side effects of each treatment?
- How long will my treatment last?
- Will I have to change my normal activities?
- What is the treatment likely to cost?
Surgery is the mainstay of treatment for pancreatic cancer. Depending on the location of the tumor within the pancreas, several operations can be performed. Most commonly, the tumor is located in the "head" of the pancreas, but can also be found in the body or tail. Tumors in the head usually require a Whipple procedure, an operation where the surgeon removes the head of the pancreas as well as other tissues in close proximity. Not all tumors can be removed surgically, particularly if they have spread to other organs or if they invaded major blood vessels.
Chemotherapy and radiation therapy are frequently used after surgery to reduce the risk of the tumor recurring, or coming back. Occasionally chemotherapy and radiation are given prior to surgery in an effort to reduce the tumor. When tumors cannot be removed surgically, chemotherapy can be used to slow the spread.
Q. What are the side effects of treatment?
A. It is hard to limit the effects of therapy so that only cancer cells are destroyed. Because treatment often damages healthy cells and tissues, it can cause unpleasant side effects.
Surgery usually causes pain and fatigue, but to varying degrees depending on the patient. Afterward, a patient may not have enough pancreatic juices or hormones, and this can cause digestive problems or even diabetes. Prescribed medicine can help relieve diarrhea or other problems such as pain, feelings of fullness, or cramping, and replace hormones that are no longer being produced.
Radiation therapy may cause permanent darkening or "bronzing" of the skin in the treated areas. During radiation therapy patients are likely to become very tired, especially in the later weeks of treatment. Radiation therapy may cause nausea, vomiting, diarrhea, or problems with digestion. In most cases, side effects go away when treatment is over.
As a result of chemotherapy, patients may have an increased chance of infection, bruise or bleed easily, have less energy (caused by affected blood cells), loose their hair (caused by affected hair root cells), and suffer from nausea, vomiting, loss of appetite, diarrhea, or mouth sores (caused by affected digestive tract cells).
Q. Will I be able to adjust to this disease well?
A. Each cancer survivor’s recovery is different, and a person’s adjustment after cancer treatment depends on a number of factors. Pancreatic cancer can drastically affect dietary habits and can cause serious conditions like diabetes. Unfortunately, pancreatic cancer is considered a "silent" disease, meaning that its symptoms are usually not felt until the later stages of the disease. Behavioral scientists have found that taking advantage of a social support system, such as a cancer support group, can improve quality of life for cancer patients and survivors. Maintain an open dialogue with your cancer care team to address your concerns.
Q. Are there clinical trials available for pancreatic cancer?
A. For a current list of all clinical trials at the OSU Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute, click here.