What are the Risk Factors? Diagnosis and Testing Needle biopsy: The doctor uses a thin needle to remove a Studies have found the following risk factors for cancer of If you have symptoms that suggest cancer of the pancreas, small sample of tissue from the pancreas. EUS or CT may Understanding the pancreas: your doctor will try to find out what’s causing the problems. be used to guide the needle. A pathologist uses a micro- scope to look for cancer cells in the tissue. Smoking: Smoking tobacco is the most important You may have blood or other lab tests. Also, you may have risk factor for pancreatic cancer. People who smoke one or more of the following tests: Stages of Pancreatic Cancer tobacco are more likely than nonsmokers to develop Physical exam: Your doctor will assess for changes in Pancreatic Staging is a careful attempt to find out the following: this disease. Heavy smokers are most at risk. areas near the pancreas, liver, gallbladder, and spleen. Your The size of the tumor in the pancreas Diabetes: People with diabetes are more likely than doctor also checks for an abnormal buildup of fluid in the Whether the tumor has invaded nearby tissues other people to develop pancreatic cancer. abdomen. Also, your skin and eyes may be checked for signs Whether the cancer has spread, and if so, to what parts Cancer Family history: Having a mother, father, sister, or of jaundice. of the body brother with pancreatic cancer increases the risk of CT scan: An x-ray machine linked to a computer takes a developing the disease. series of detailed pictures of your pancreas, nearby organs, These are the stages of cancer of the pancreas: Inflammation of the pancreas: Pancreatitis is a and blood vessels in your abdomen. Stage I: The tumor is found only in the pancreas. painful inflammation of the pancreas. Having pancre- Ultrasound: The ultrasound device uses sound waves that Stage II: The tumor has invaded nearby tissue but not atitis for a long time may increase the risk of pancre- can’t be heard by humans. The sound waves make a pattern nearby blood vessels. The cancer may have spread to the atic cancer. of echoes as they bounce off internal organs. These echoes lymph nodes. Obesity: People who are overweight or obese are create a picture of the pancreas and other organs in the Stage III: The tumor has invaded nearby blood vessels. slightly more likely than other people to develop abdomen. The picture may show a tumor or blocked ducts. Stage IV: The cancer has spread to a distant organ, such pancreatic cancer. EUS: A thin, lighted tube (endoscope) is passed your throat as the liver or lungs. Diet & lifestyle: A diet high in saturated fat or heavy while you are under anesthesia, through your stomach, and drinking of alcoholic beverages may increase the risk into the first part of the small intestine. An ultrasound probe Second Opinion of pancreatic cancer at the end of the tube sends out sound waves. These waves Before starting treatment, you may want a second opinion What are the Symptoms? bounce off tissues in your pancreas and other organs. As about your diagnosis, the stage of cancer, and the treatment your doctor slowly withdraws the probe from the intestine to- plan. You may also want to find a medical center that has Early cancer of the pancreas often doesn’t cause symp- ward the stomach, the computer creates a picture of the pan- experience treating people with pancreatic cancer. There are toms. When the cancer grows larger, you may notice one creas from the echoes. The picture can show a tumor in the many ways to find a doctor for a second opinion. Ask your or more of these common symptoms: pancreas. It can also show how deeply the cancer has in- doctor, a local or state medical society, or a nearby hospital • Dark urine, pale stools, and yellow skin and eyes vaded the blood vessels. or medical school for names of specialists. from jaundice ERCP: An endoscope is passed through your mouth and • Pain in the upper part of your belly stomach, down into the first part of your small intestine. Your • Pain in the middle part of your back that doesn’t go doctor slips a smaller tube through the endoscope into the away when you shift your position bile ducts and pancreatic ducts. After injecting dye through the smaller tube into the ducts, the doctor takes x-ray pic- • Nausea and vomiting tures. The x-rays can show whether the ducts are narrowed • Stools that float in the toilet or blocked by a tumor or other condition. • Weakness or feeling very tired MRI: A large machine with a strong magnet linked to a com- • Loss of appetite or feelings of fullness puter. Used to make detailed pictures of areas inside your body. • Weight loss for no known reason PET scan: You’ll receive an injection of a small amount of These symptoms may be caused by pancreatic cancer or radioactive sugar. The radioactive sugar gives off signals that 1-866-WINTHROP by other health problems. People with these symptoms the PET scanner picks up. The PET scanner makes a picture should tell their doctor so that problems can be diagnosed of the places in your body where the sugar is being taken up. and treated as early as possible. Cancer cells show up brighter in the picture because they take up sugar faster than normal cells do. A PET scan may show a tumor in the pancreas. It can also show cancer that has spread to other parts of the body. What are some questions What is Pancreatic Cancer? How is Pancreatic Cancer treated? ? I can ask my doctor? There are two main types of pancreatic cancer. Treatment options for people with pancreatic cancer include: Most often, pancreatic cancer starts in the ducts that • Surgery • Targeted therapy As you cope with cancer and cancer treatment, we carry pancreatic juices. This type is called exocrine • Chemotherapy • Radiation therapy encourage you to have honest, open talks with your pancreatic cancer. The treatment that’s right for you depends mainly on the doctor. Feel free to ask any question that's on your mind, no matter how small it might seem. Here are The pancreas is an organ that is about 6 inches long. location of the tumor in your pancreas, whether the disease has spread, and your age and general health. some questions you might want to ask. Be sure to add It’s located deep in your belly between your stomach and You may have a team of medical professionals to help plan your own questions as you think of them. Nurses, social backbone. Your liver, intestine, and other organs surround and manage your treatment. Specialists who treat cancer of workers, and other members of the treatment team may your pancreas. also be able to answer many of your questions. the pancreas include surgeons, medical oncologists, radiation The pancreas The widest part of the pancreas is called the head. The and nearby oncologists, gastroenterologists, oncology nurses, dietitians, 1. What kind of pancreatic cancer do I have? head of the pancreas is closest to the small intestine. The organs. and palliative care or supportive care specialists. middle section is called the body, and the thinnest part is Surgery 2. What is the clinical stage of cancer? called the tail. Surgery may be an option for people with an early stage of What does this means in my case? Is it resectable? The pancreas makes pancreatic juices. These juices con- pancreatic cancer. The surgeon usually removes only the part tain enzymes that help break down food. The juices flow of the pancreas that has cancer. But, in some cases, the 3. Has my cancer spread beyond the primary whole pancreas may be removed. through a system of ducts leading to the main site? The type of surgery depends on the location of the tumor in the pancreatic duct. The pancreatic juices flow through the 4. What other treatments might be right for pancreas. Surgery to remove a tumor in the head of the pan- main duct to the duodenum, the first part of the small me? Why? creas is called a Whipple Procedure. The Whipple Procedure is intestine. the most common type of surgery for pancreatic cancer. 5. Among those treatments, what are the The pancreas is also a gland that makes insulin and other In addition to part of, or your entire pancreas, the surgeon risks or side effect I should expect? hormones. These hormones enter the bloodstream and usually removes duodenum, gallbladder, common bile duct 6. What are the chances of the cancer coming travel throughout the body. They help the body use or and part of your stomach (sometimes). back with the treatment you suggest? store the energy that comes from food. For example, For tumors located in the body or tail of the pancreas, a What would be our next step if this insulin helps control the amount of sugar in the blood. The head, body, and tail of the pancreas. distal pancreatectomy may be performed. During this happened? operation, the surgeon may remove your spleen and nearby 7. What is my expected survival rate based on lymph nodes. Cancer Cells clinical stage, grade, and various treatment Chemotherapy options? Cancer begins in cells, the building blocks that make up Chemotherapy uses drugs to kill cancer cells. Most people Benign tumors (such as cysts): 8. Should I follow a special diet? tissues. Tissues make up the pancreas and the other with pancreatic cancer get chemotherapy. For early pancre- • are usually not a threat to life atic cancer, chemotherapy is usually given after surgery, but organs of the body. 9. Is there another kind of doctor • can be removed and usually don’t grow back in some cases, it’s given before surgery. For advanced I should see? Normal cells grow and divide to form new cells as the • don’t invade the tissues around them cancer, chemotherapy is used alone, with targeted therapy, body needs them. When normal cells grow old or get 10. How much experience do you have with • don’t spread to other parts of the body or with radiation therapy. damaged, they die, and new cells take their place. In this type of treatment? Malignant growths: Targeted Therapy cancer, new cells form when the body doesn’t need them, People with cancer of the pancreas who can’t have surgery 11. May I have a copy of my pathology report? • may be a threat to life and old or damaged cells don’t die as they should. The may receive a type of drug called targeted therapy along with 12. What other tests (if any) do you think buildup of extra cells often forms a mass of tissue called • sometimes can be removed but can grow back chemotherapy. Targeted therapy slows the growth of pancre- I need and why? a growth or tumor. • can invade and damage nearby tissues and organs atic cancer. It also helps prevent cancer cells from spreading. Tumors in the pancreas can be benign (not cancer) or • can spread to other parts of the body Radiation Therapy 13. What are the chances that I will have malignant (cancer). Benign tumors are not as harmful as Pancreatic cancer can invade other tissues, shed cancer Radiation therapy uses high-energy rays to kill cancer cells. diabetes? malignant tumors: cells into the abdomen, or spread to other organs. It can be given along with other treatments, including chemotherapy.