Pancreatic Cancer
Pancreatic cancer, or carcinoma, is a cancer of the pancreas, the large organ located upper abdomen, behind the stomach. The pancreas is responsible for making and releasing the enzymes that lead to absorption of fat in the body. It also produces and regulates insulin and blood sugar levels within the body. The most common form of this debilitating mutation of cells is adenocarcinoma, which presents itself in the exocrine section of the organ. Pancreatic cancer is the fourth leading cause of cancer death in the United States and abroad, accounting for millions of deaths annually.
Little is known about the cause of pancreatic cancer, but the disease has a higher prevalence among smokers and those who are categorized as obese. The risk of developing this cancer increases with age and is most often found in women. African Americans are at a higher risk than any other group of developing pancreatic carcinoma. In a smaller number of cases, cancer of the pancreas is hereditary, passed down through families through genetics.
The prognosis is grim for those diagnosed with this devastating cancer. Even when it is found in its early stages, the survival rate is less than 25%. In the 5th stage, or the end stages of the disease, the survival rate drops to about 5%.
Pancreatic Cancer Symptoms
One of the reasons for the low survival rate is that there are usually no symptoms until the disease is in the advanced stages.
A tumor or cancer in the pancreas may often grow without any symptoms at first. This may mean pancreatic cancer is more advanced when it is first found.
Early symptoms include:
- Pain in the stomach or upper abdominal area that doesn’t respond to normal pain remedies. The pain may radiate around the body to the back.
- Severe loss of appetite accompanied by extreme and rapid weight loss.
- Jaundice, which is a yellowing of the skin, eyeballs and mucous membranes. This is due to the body’s inability to regulate and rid the body of bile. Jaundice may also cause itching due to the body’s build up of excess bile.
- Extremely dark urine or stools that are very light and clay-colored.
- Extreme fatigue and weakness that does not respond to treatment or rest.
- Vomiting and nausea
- Severe back pain
- Blood clots, or Trousseau Sign, a condition in which the blood clots in the deep veins of the arms and legs.
- Clinical depression
- Uncontrollable diarrhea
- Late-onset diabetes or high blood sugar counts are often a sign of pancreatic malignancy.
Pancreatic Cancer Signs and tests
Pancreatic Cancer
Doctors will perform a series of tests and scans to determine the presence of the cancer. Among other tests, doctors will perform a CT scan of the abdomen, an MRI (magnetic resonance imaging) that examines the contents of the abdomen, endoscopic retrograde cholangiopancreatography (ERCP) or an endoscopic ultrasound. The most definitive test, however, for this cancer is the endoscopic needle biopsy. This test has an accuracy rate of 99.9% in diagnosing the cancer, even in the early stages.
Pancreatic Cancer Treatment
Treatment is limited by the stage of the disease. Because this cancer often does not exhibit any symptoms until it is in its advanced stage, surgery is not effective in most cases. When tumors are in their early stages, doctors can perform surgery to remove the cancerous tumors and stop the cancer in its tracks. The standard surgery for pancreatic cancer is commonly called the Whipple procedure. The Whipple procedure removes the head of the pancreas as well as the duodenum, creating a bypass for food to pass through. It also serves to help the body process and rid the body of bile.
For tumors that cannot be removed by this procedure, either due to the advanced stage of the disease or the age of the patient, chemotherapy is recommended. When the pancreatic tumors have metastasized, or spread to other organs such as the liver, kidneys or intestines, chemotherapy is the preferred method of treatment. In some cases tumors cannot be totally removed but doctors can relieve blockages that prevent the transportation of bile. This is done by placing a tiny metal tube called a stint to open the passageway and bypass the obstruction.
For patients in which a curative treatment is not suitable, doctors prescribe palliative chemotherapy. This form of chemotherapy can be used to bring comfort to the patient, improve the quality of life and prolong the survival of the patient. The average extension of survival for patients receiving chemotherapy is about 4-5 weeks.
Treatment programs for sufferers of pancreatic cancer often include support groups, hospice care and palliative care. One of the largest concerns for newly-diagnosed cancer patients is pain. Pain can be a very crippling situation to deal with. Cancer of the pancreas usually causes pain in the upper abdomen which spreads to other parts of the body. Untreated pain can lead to disillusionment, loss of hope, loss of the will to fight the disease and depression. There are many pain remedies that can treat mild, moderate and even severe pain, and patients need not suffer needlessly. Keeping open communication with the team is the first step in preventing and dealing with severe pain associated with cancer.
The majority of pain complaints can be treated with oral medications. In moderate to severe pain, an intravenous medicine may be prescribed. Patients suffering from cancer are given around the clock pain options, as the main focus is to freedom from the discomfort of the disease.
Pancreatic Cancer Prognosis
Cancer of the pancreas has been closely linked and associated with an onset of diabetes. Because of the body’s inability to produce insulin, many patients develop diabetes. In addition, a sudden onset of diabetes later in life, (after age 60) is sometimes a symptom of pancreatic cancer.
A small percentage of people diagnosed with this carcinoma will undergo surgery to remove the diseased tumors and be cured of the disease. In over 80% of cases, however, the cancer has already spread to other organs and parts of the body and cannot be cured through surgery. In these cases, patients are advised to undergo aggressive chemotherapy and radiation. For cancerous cells that cannot be completely removed through surgical intervention or do not respond to chemotherapy, the survival rate is usually less than one year. Patients are often advised by their doctors to participate in clinical trials to try out new medicines and treatments that may prolong life.
Ninety-five percent of patients who receive a diagnosis of cancer of the pancreas will no longer be living within five years.
For pancreatic cancer:
For all stages of the cancer 1-5 combined, 25% of diagnosed patients will survive for one year, and less than 5% will survive for five years or longer.
If the disease is localized and has not been spread to other parts of the body or organs, 20% of patients will survive for 5 years or longer.
For advanced cancer that has not spread to other organs or body parts, the average survival rate is between 6 and 10 months.
For patients who receive no active treatment, either in the form of surgery or chemotherapy, the survival rate is between 3 and 5 months.
Total remission of pancreatic cancer is extremely rare.
In 2010, nearly 45,000 people were diagnosed with pancreatic cancer in the United States. Of that number, over 85 percent of those newly diagnosed were no longer living by the end of the first quarter of 2011.
Actress Joan Crawford and actor Patrick Swayze are some of the most recognizable names who have developed and died from pancreatic cancer. Little is known about others who are suffering, as most are diagnosed at a late stage in the disease. Apple founder and entrepreneur Steve Jobs is also living with the debilitating disease, and while he has since stopped working full time for the company, he remains in relatively good health and enjoys a high quality of living.
There is hope, however, for people facing the devastating effects of pancreatic carcinoma. New clinical trials are underway that are significantly improving the quality and duration of life for those suffering from the illness. New studies have been showing that aggressive treatment of the cancer using chemotherapy radiation in the early stages has been known to prolong and preserve the life of the patient. In addition there have been widespread campaigns geared at raising awareness of the disease and encouraging early testing for pancreatic cancer, even if no symptoms or risk factors exist.
Choosing a Doctor to Treat Cancer of the Pancreas
The selection of the right doctor to treat the cancer often starts with the hospital itself. Specialized cancer centers have years of experience in treating these cancers, and can offer solutions that other mainstream hospitals may not. Find a hospital with a comprehensive oncology department or one that is geared toward cancer patients. For patients that are resigned to their condition and are seeking comfort, or are not interested in extraordinary measures, it is often best to obtain treatment in a hospital close to home and family. For those looking for aggressive measures, or who have early-stage cancer that can be treated or even cured, it may be advantageous to seek out the most specialized hospitals, even if they are a distance from home.
When selecting a doctor to treat the symptoms of the disease, it is important to be very selective in the physical who will handle the treatment regimen. This person should be available to handle the entire case from start to finish, and should work with a team who specializes in the treatment of this cancer. The doctor will more than likely be an oncologist, or one who treats cancer patients. The oncologist will work with a team of radiologists, nutritionists, surgeons, nurses and social workers who will be appointed to the care of the patient.
The outcome of the treatment plan also depends, to an extent on the patient. A patient who is ready and willing to fight the cancer aggressively may find the outcome more favorable than one who chooses a more passive option. The patient and doctor should agree on the course of treatment. Patients should choose a doctor who will act in a manner congruent with the patient’s wishes. The surgeon on the team should be experienced with the Whipple Procedure and perform it on a regular basis, with positive results.
The doctor caring for the patient should be compassionate about the issues facing the patient. He should be knowledgeable about the emotional, financial and familial issues that accompany a new diagnosis and be well-equipped to handle these issues. The doctor, in conjunction with the hospital staff should be able to provide information on palliative care, hospice care and support for the family and friends of the patient.
Cancer of the pancreas is a debilitating disease that has a low survival rate. However, with new treatments, effective pain management and compassionate care, there are many ways to increase the quality of life for the cancer patient.
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