If you or a loved one is dealing with a diagnosis of pancreatic cancer, our multispecialty team of gastrointestinal cancer specialists at West Cancer Center & Research Institute is here to surround you with the latest treatments and technology to design a personalized treatment plan specific for your disease. Our goal is to also provide resources and information to better help you understand and manage your disease.
What is Pancreatic Cancer?
Your pancreas is an organ that releases enzymes to aid in digestion and hormones to manage your blood sugar and is behind the lower part of your stomach. Pancreatic cancer affects the tissues of your pancreas and is difficult to detect in its early stages.
Stages of Pancreatic Cancer
In stage 0, abnormal cells are found in the lining of the pancreas. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.
In stage I, cancer has formed and is found in the pancreas only. Stage I is divided into stages IA and IB, depending on the size of the tumor.
- Stage IA: The tumor is 2 centimeters or smaller.
- Stage IB: The tumor is larger than 2 centimeters but not larger than 4 centimeters.
Stage II is divided into stages IIA and IIB, depending on the size of the tumor and where the cancer has spread.
- Stage IIA: The tumor is larger than 4 centimeters.
- Stage IIB: The tumor is any size and cancer has spread to 1 to 3 nearby lymph nodes.
In stage III, the tumor is any size and cancer has spread to:
- four or more nearby lymph nodes; or
- the major blood vessels near the pancreas.
In stage IV, the tumor is any size and cancer has spread to other parts of the body, such as the liver, lung, or peritoneal cavity (the body cavity that contains most of the organs in the abdomen).
Symptoms of Pancreatic Cancer
If you are experiencing any of these symptoms, we urge you to speak to your provider as soon as possible for further examination.
- Yellowing of your skin and the whites of your eyes (jaundice)
- Pain in the upper abdomen that radiates to your back
- New-onset diabetes
- Blood clots
- Loss of appetite or unintended weight loss
How to Diagnose Pancreatic Cancer
If your provider would like to further investigate the possibility of pancreatic cancer, one or more of the following diagnostic procedures may be performed:
Several blood tests are used for diagnosis of pancreatic cancer:
• A high level of bilirubin, a substance made by your liver, is an indicator that a tumor is blocking your bile duct.
• An increased level of the protein CA 19-9 in conjunction with other diagnosis and blood tumor markers can be an indicator of pancreatic cancer.
• Having high levels of the protein carcinoembryonic antigen is found in people with cancer of the gastrointestinal tract.
Tissue is collected using an endoscope (a thin, lighted tube) for visibility with either an endoscopic ultrasound or endoscopic retrograde cholangiopancreatography (ERCP)
COMPUTERIZED TOMOGRAPHY (CT)
A donut-shaped piece of equipment uses low dose radiation, either with or without a contrast fluid to detect abnormalities in your pancreas.
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP)
This procedure is done when your pancreatic ducts may be blocked or narrowing and allows your physician to look at your ducts without surgery.
ENDOSCOPIC ULTRASOUND (EUS)
This procedure uses an endoscope with a small ultrasound probe to see if the cancer has spread to the lymph nodes and wall of the esophagus and measure the thickness of your tumor
MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY (MPCP)
Magnetic Resonance Cholangiopancreatography MPCP reveals the extent of tumor growth within your gallbladder or bile ducts to help determine if a tumor can be surgically removed. Additional MRI may be necessary to see if the tumor has spread to the liver or other organs.
POSITRON EMISSION TOMOGRAPHY (PET)
A radioactive substance is injected into your bloodstream to collect in cancerous cells and identify the exact location of your cancer.
Types of Pancreatic Cancer Treatments
Your pancreatic cancer treatment plan will vary depending on multiple factors including, but not limited to, your stage of diagnosis, as well as the location of your cancer. Your dedicated team of cancer experts will discuss your treatment options and plan with you, allowing you and your loved ones to consider all possible treatment options for your diagnosis.
Sometimes just the middle of the pancreas is removed, usually for benign (noncancerous) tumors and the remaining pancreas is attached to the stomach or intestine.
Uses powerful drugs specifically designed to destroy your pancreatic cancer cells that are dividing rapidly. These drugs may be given before or during radiation to improve your outcome and care.
Ask your physician if you are a candidate for a clinical trial.
If you have tumors that are confined to the tail (left portion) of the pancreas your surgeon will remove the tail and sometimes part of the body of the pancreas and the spleen. This surgery can be done with an open surgical technique, laparoscopic ally or robotic-assisted.
This targeted therapy assist your immune system to find and eliminate the tumor cells. Late stage pancreatic cancer with MMR (DNA mismatch repair) deficiency or high MSI (microsatellite instability) are approved for immunotherapy.
High energy x-rays are used to destroy your pancreatic cancer cells. The type of treatment, dose and frequency are determined by your radiation oncologist.
If diagnostic tests show that your cancer has spread throughout your pancreas, your surgeon may recommend a total removal of the pancreas, involving removal of the gallbladder, part of the stomach, part of the small intestine, the lower half of the bile duct, the spleen, and nearby lymph nodes.
WHIPPLE PROCEDURE (PANCREATODUODENECTOMY)
If your bile duct tumor is outside the liver (extrahepatic), your gallbladder, part of your stomach, part of your small intestine, your bile ducts and the right section of your pancreas is surgically removed.