Questions and Answers - Recent questions and answers in Pancreatic Cancer

Answered: What's the difference between exocrine and endocrine cell cancers?

Sat, 01 Feb 2020 08:13:47 +0000

In metastatic pancreatic cancer, surgery is used only for symptom control, such as for pain, jaundice, or gastric outlet obstruction. Radiation may be used for symptom relief, as well.

Chemotherapy can also help improve pancreatic cancer symptoms and improve chances of survival. Gemcitabine has been the most wildly used chemotherapy drug for treating metastatic pancreatic cancer. Other drug combinations include gemcitabine with erlotinib, gemcitabine with capecitabine, gemcitabine with cisplatin, and gemcitabine with nab-paclitaxel. If you’re in fairly good health, you may receive FOLFIRINOX (5-FU/leucovorin/oxaliplatin/irinotecan). Other combinations include gemcitabine alone or with another agent like (nab)-paclitaxel or capecitabine. Next line drug combinations to treat pancreatic cancer include oxaliplatin/fluoropyrimidine, or irinotecan liposome (Onivyde) in combination with fluorouracil plus leucovorin.

How is metastatic pancreatic cancer treated?

Sat, 01 Feb 2020 08:09:40 +0000

Answered: How does cigarette smoking affect the risk for pancreatic cancer?

Sat, 01 Feb 2020 08:00:46 +0000

Cigarette smoking is one controllable risk factor for pancreatic cancer. People who smoke are about twice as likely as nonsmokers to get pancreatic cancer.

Fortunately, the reverse is also true. After quitting smoking, the risk for pancreatic cancer steadily falls, eventually falling to the same risk as a nonsmoker after 10 to 15 years.

Answered: How does DNA damage lead to pancreatic cancer?

Sat, 01 Feb 2020 07:57:55 +0000

No one knows exactly how the process of DNA damage leading to pancreatic cancer occurs. Analyzing pancreatic cancers removed by surgery shows certain mutations that occur in nearly all cases, and others that vary between people.

Some of these mutations occur randomly. Others occur in response to things we do or experience in the environment. Some mutations may be inherited. When enough mutations accumulate, a cell becomes malignant and a tumor begins to grow.

Answered: What is the prognosis for pancreatic cancer?

Sat, 01 Feb 2020 07:55:20 +0000

Among common cancers, pancreatic cancer has one of the poorest prognoses. Because pancreatic cancer often grows and spreads long before it causes any symptoms, only about 6% of patients are still alive five years after diagnosis.

Answered: Can an endoscopic ultrasound be used for early detection of pancreatic cancer?

Sat, 01 Feb 2020 07:52:17 +0000

Studies are ongoing to see if aggressive screening with endoscopic ultrasound works for early detection of pancreatic cancer in healthy family members. Early results are promising. However, endoscopy is an invasive procedure, so its use is only justified in people already at a high risk for pancreatic cancer.

Answered: What are the symptoms of pancreatic cancer?

Sat, 01 Feb 2020 07:48:31 +0000

Symptoms that may arise as pancreatic cancer progresses include: Significant weight loss accompanied by abdominal pain -- the most likely warning signs.
Vague but gradually worsening abdominal pain that may decrease when leaning forward and increase when lying down. Pain is often severe at night and may radiate to the lower back.
Digestive or bowel complaints such as diarrhea, constipation, gas pains, bloating, or belching.
Nausea, vomiting, and loss of appetite.
Jaundice, which is usually painless and is indicated by yellowish discoloration of the skin and eye whites, very dark urine, and light-colored stools.
Sudden onset of glucose tolerance disorder, such as diabetes.
Black or bloody stool, indicating bleeding from the digestive tract.
Overall weakness.
Enlarged liver and gallbladder.
Itching.
Blood clots in the legs.
Mental status changes, such as a new onset of depression.

What symptoms of pancreatic cancer may arise as the cancer progresses?

Sat, 01 Feb 2020 07:41:22 +0000

Answered: Does the Whipple procedure work better before or after surgery for pancreatic cancer?

Sat, 01 Feb 2020 07:40:20 +0000

It's not yet known if therapy works better before or after surgery. But some research suggests that therapy could allow a few patients who are initially thought to be ineligible for surgery to eventually undergo the Whipple procedure. Studies are ongoing.

Answered: What are islet cell tumors?

Sat, 01 Feb 2020 07:39:45 +0000

Islet cell tumors, also called neuroendocrine tumors, arise from the cells in the pancreas that make hormones. Islet cell tumors account for less than 5% of all pancreas tumors.

Answered: Which pancreatic cancer patients can have the Whipple procedure done?

Sat, 01 Feb 2020 07:38:56 +0000

Only about 20% of pancreatic cancer patients are eligible for the Whipple procedure and other surgeries. These are usually patients whose tumors are confined to the head of the pancreas and haven't spread into any nearby major blood vessels, the liver, lungs, or abdominal cavity. Intensive testing is usually necessary to identify possible candidates for the Whipple procedure.

Answered: What has been found in studies of early symptoms of pancreatic cancer?

Sat, 01 Feb 2020 07:37:50 +0000

One study published in 2001 that surveyed 305 people with pancreatic cancer illustrated the challenge of early diagnosis: Of the 49.5% of the people surveyed who reported early problems, about 4% reported having a sudden disgust for preferred tastes (like coffee, smoking, or wine) that preceded other symptoms by more than six months. Five percent had a loss of appetite, a feeling of early fullness with meals, or profound weakness more than six months before more obvious symptoms developed, and 1% had attacks of acute pancreatitis more than six months before their diagnosis with pancreatic cancer.

The rarity and vagueness of these situations points out the difficulty of using early symptoms to catch pancreatic cancer at an early stage.

Answered: How is magnetic resonance imaging used in the diagnosis of pancreatic cancer?

Sat, 01 Feb 2020 07:02:48 +0000

Five percent to 10% of people with pancreatic cancer have an immediate family member who also had it. Several different genes have been associated with the increased risk, although no "pancreatic cancer gene" has yet been identified.

Answered: When is pancreatic cancer diagnosed?

Sat, 01 Feb 2020 07:01:02 +0000

Diagnosing pancreatic cancer usually happens when someone comes to the doctor after experiencing weeks or months of symptoms. Pancreatic cancer symptoms frequently include abdominal pain, weight loss, itching, or jaundice (yellow skin).

Answered: How does pancreatic cancer develop?

Sat, 01 Feb 2020 06:59:58 +0000

Pancreatic cancer develops when a cell in the pancreas acquires damage to its DNA that causes it to behave and multiply abnormally. A single cancer cell grows and divides rapidly, becoming a tumor that does not respect normal boundaries in the body. Eventually, cells from the tumor travel elsewhere in the body (metastasize) through the blood or lymphatic system.

Answered: What are symptoms of hormonal imbalances caused by pancreatic cancer?

Sat, 01 Feb 2020 06:59:08 +0000

A few rare types of pancreatic cancer cause hormonal imbalances that produce their own symptoms, which might include: Episodes of weakness, sweating, rapid heartbeat, irritability, or skin flushing related to low blood sugar
Severe watery diarrhea
A new, unusual skin rash
Severe gastrointestinal symptoms, such as stomach pain and watery diarrhea, which do not respond to antacids or ulcer medications

If you experience any of these symptoms, call your doctor for a full physical exam.

Answered: Can diet affect the risk for pancreatic cancer?

Sat, 01 Feb 2020 06:58:24 +0000

A diet high in fat and meat (especially smoked or processed meat) has been linked to pancreatic cancer in animal studies. Eating a healthy diet rich in fruits and vegetables decreased pancreatic cancer risk in other studies. Still other studies suggest there's no identifiable link between diet and pancreatic cancer.

Answered: Does having diabetes mean you're at a higher risk for pancreatic cancer?

Sat, 01 Feb 2020 06:57:59 +0000

People with diabetes are not necessarily more likely to get pancreatic cancer but the two have been linked.

Answered: How is pancreatic cancer prevented?

Sat, 01 Feb 2020 06:57:29 +0000

There is no known way to prevent pancreatic cancer.

Answered: How is advanced pancreatic cancer treated?

Sat, 01 Feb 2020 06:53:28 +0000

As pancreatic cancer progresses, the main priority of treatment will shift from extending life to alleviating symptoms, especially pain. Numerous treatments can help protect against the discomfort from advanced pancreatic cancer. For example:

Procedures like bile duct stents can relieve jaundice, thus reducing itching and loss of appetite associated with bile obstruction.
Opioid analgesics can help relieve pain.
Antidepressants and counseling can help treat depression common in advanced pancreatic cancer patients.

Answered: How is a Whipple procedure (pancreaticoduodenectomy) done to treat resectable pancreatic cancer?

Sat, 01 Feb 2020 06:52:33 +0000

During a Whipple procedure, or pancreaticoduodenectomy, a surgeon removes the head of the pancreas and sometimes the body of the pancreas, parts of the stomach and small intestine, some lymph nodes, the gallbladder, and the common bile duct. The remaining organs are reconnected in a new way to allow digestion. The Whipple procedure is a difficult and complicated surgery. Surgeons and hospitals that do the most operations have the best results.

About half the time, once a surgeon sees inside the abdomen, pancreatic cancer that was thought to be resectable turns out to have spread, and thus be unresectable. The Whipple procedure is not completed in these cases.

Answered: What are endocrine and exocrine cells in the pancreas?

Sat, 01 Feb 2020 06:51:54 +0000

Endocrine cells make hormones and are clustered together in groups called islets. They're found mostly in the tail and body sections of the gland. Exocrine cells represent 95% of the cells in the pancreas. They're spread throughout the gland and perform digestive functions.

Answered: Is it possible to detect pancreatic cancer early?

Sat, 01 Feb 2020 06:51:20 +0000

Treating pancreatic cancer is challenging when it's discovered at an advanced stage, as is usually the case. Researchers are seeking methods of early detection, but so far none have proved useful.

Answered: Why is pancreatic cancer usually not detected until late?

Sat, 01 Feb 2020 06:50:42 +0000

Early pancreatic cancers usually cause few symptoms, most of which are vague. Because signs and symptoms of most pancreatic cancer may be mistaken for less-serious digestive problems, the disease is rarely detected before it has spread to nearby tissues or distant organs via the bloodstream or lymphatic system.

Answered: How is surgery used for pancreatic cancer?

Sat, 01 Feb 2020 06:50:09 +0000

Surgery is generally done to attempt to cure pancreatic cancer, but it may also be done to lessen or prevent symptoms. Chemotherapy and radiation are often given together, prior to, after, or even without surgery, to slow pancreatic cancer's growth. Palliative care aims to reduce discomfort for people whose pancreatic cancer cannot be cured.

Answered: What is pancreatic cancer?

Sat, 01 Feb 2020 06:49:35 +0000

Pancreatic cancer is a disease in which malignant (cancerous) cells form in the tissues of the pancreas. The pancreas is a gland located behind the stomach and in front of the spine. The pancreas produces digestive juices and hormones that regulate blood sugar. Cells called exocrine pancreas cells produce the digestive juices, while cells called endocrine pancreas cells produce the hormones. The majority of pancreatic cancers start in the exocrine cells.

Answered: If there is a mass in the pancreas, how do you know if it is cancer?

Sat, 01 Feb 2020 06:49:02 +0000

If imaging studies detect a mass in the pancreas, a pancreatic cancer diagnosis is likely, but not definite. Only a biopsy -- taking actual tissue from the mass -- can diagnose pancreatic cancer. Biopsies can be performed in several ways.

Answered: How is a laparoscopic Whipple procedure different from a regular Whipple procedure?

Sat, 01 Feb 2020 06:48:20 +0000

Some patients may be eligible for a minimally invasive (laparoscopic) Whipple procedure, which is performed through several small incisions instead of a single large incision. Compared to the classic procedure, the laparoscopic procedure may result in less blood loss, a shorter hospital stay, a quicker recovery, and fewer complications.

Answered: How does cigarette smoking affect the risk for pancreatic cancer?

Sat, 01 Feb 2020 06:47:51 +0000

Cigarette smoking is one controllable risk factor for pancreatic cancer. People who smoke are about twice as likely as nonsmokers to get pancreatic cancer.

Fortunately, the reverse is also true. After quitting smoking, the risk for pancreatic cancer steadily falls, eventually falling to the same risk as a nonsmoker after 10 to 15 years.

Answered: What do studies on the effect of diet on the risk of pancreatic cancer show?

Sat, 01 Feb 2020 06:47:15 +0000

Numerous studies have tried to identify which foods, if any, contribute to developing pancreatic cancer. The results don't allow any firm conclusions: A typical American diet, high in fat and smoked or other processed meats, has been associated with pancreatic cancer in some but not all studies.
A healthy diet rich in fresh fruits and vegetables seemed to protect against pancreatic cancer in some but not all studies.
In experiments, lab rats fed a high-protein, high-fat diet were consistently found to develop pancreatic cancer. However, laboratory data doesn't necessarily apply to people.

Answered: How does DNA damage lead to pancreatic cancer?

Sat, 01 Feb 2020 06:46:42 +0000

_{No one knows exactly how the process of DNA damage leading to pancreatic cancer occurs. Analyzing pancreatic cancers removed by surgery shows certain mutations that occur in nearly all cases, and others that vary between people.}

_{Some of these mutations occur randomly. Others occur in response to things we do or experience in the environment. Some mutations may be inherited. When enough mutations accumulate, a cell becomes malignant and a tumor begins to grow.}

Answered: Which pancreatic cancer locations show symptoms early?

Sat, 01 Feb 2020 06:46:10 +0000

In general, symptoms appear earlier from cancers in the head of the pancreas, compared to those in the body and tail.

Answered: Where can I find information on clinical trials for pancreatic cancer?

Sat, 01 Feb 2020 06:45:26 +0000

The following websites offer information and services to help you find a pancreatic cancer clinical trial that is right for you:

TrialCheck: This website, developed by the nonprofit Coalition of Cancer Cooperative Groups, is an unbiased cancer clinical trial matching and navigation service enabling patients to search for cancer trials based on disease and location. National Cancer Institute : This website lists more than 6,000 cancer clinical trials and explains what to do when you find one that you think is right for you. ClinicalTrials.gov: This website offers up-to-date information for locating federally and privately supported clinical trials for cancer.
CenterWatch: This web site lists industry-sponsored clinical trials that are actively recruiting patients.
Pancreatic Cancer Action Network : This website offers free, personalized, confidential clinical trial searches.

Answered: What tests are used to diagnose pancreatic cancer?

Sat, 01 Feb 2020 06:44:39 +0000

After taking down your health history and performing a physical exam, the doctor may order several tests to determine the cause of your problem or extent of the condition, including:

CT scan
MRI
Endoscopic ultrasound
Laparoscopy
Endoscopic retrograde cholangiopancreatography
Percutaneous transhepatic cholangiography
Biopsy

Answered: What are early signs of pancreatic cancer?

Sat, 01 Feb 2020 06:43:16 +0000

In a very small number of people with pancreatic cancer, early symptoms might be present that could lead to an earlier diagnosis. Unfortunately, researchers have been unable to identify any predictable pattern.

Answered: What are pancreatic neuroendocrine cancers?

Sat, 01 Feb 2020 06:42:28 +0000

Pancreatic neuroendocrine tumors arise from a separate group of hormone-producing cells in the pancreas. Like adenocarcinoma, islet cell cancers are generally diagnosed with imaging and biopsy. These types of tumors may cause no symptoms or symptoms related to hormones secreted by the tumor.

Answered: What symptoms of pancreatic cancer may arise as the cancer progresses?

Sat, 01 Feb 2020 06:41:18 +0000

Symptoms that may arise as pancreatic cancer progresses include: Significant weight loss accompanied by abdominal pain -- the most likely warning signs.
Vague but gradually worsening abdominal pain that may decrease when leaning forward and increase when lying down. Pain is often severe at night and may radiate to the lower back.
Digestive or bowel complaints such as diarrhea, constipation, gas pains, bloating, or belching.
Nausea, vomiting, and loss of appetite.
Jaundice, which is usually painless and is indicated by yellowish discoloration of the skin and eye whites, very dark urine, and light-colored stools.
Sudden onset of glucose tolerance disorder, such as diabetes.
Black or bloody stool, indicating bleeding from the digestive tract.
Overall weakness.
Enlarged liver and gallbladder.
Itching.
Blood clots in the legs.
Mental status changes, such as a new onset of depression.

Answered: How can the timing of diagnosing pancreatic cancer affect the outcome?

Sat, 01 Feb 2020 06:39:56 +0000

Unfortunately, pancreatic cancers have subtle and vague symptoms. Thus the disease is often diagnosed after it has advanced and spread. However, even at later stages, treatment can improve quality of life by controlling uncomfortable symptoms and complications of the disease.

How effective is a pancreatic cancer diet?

Sat, 01 Feb 2020 06:38:46 +0000

Answered: How common is pancreatic cancer?

Sat, 01 Feb 2020 06:38:20 +0000

In about 46,000 people per year in the U.S., pancreatic cancer will arise, grow, and spread, often before it's ever discovered. As with many types of cancer, the causes of pancreatic cancer are mysterious. Although certain risk factors have been identified, the story is far from complete.

Answered: What are some hormonal imbalances of pancreatic cancer?

Sat, 01 Feb 2020 06:37:47 +0000

A few rare types of pancreatic cancer cause hormonal imbalances that produce their own symptoms, which might include:

If you experience any of these symptoms, call your doctor for a full physical exam.

Episodes of weakness, sweating, rapid heartbeat, irritability, or skin flushing related to low blood sugar
Severe watery diarrhea
A new, unusual skin rash
Severe gastrointestinal symptoms, such as stomach pain and watery diarrhea, which do not respond to antacids or ulcer medications

Answered: What can reduce the risk of developing pancreatic cancer?

Sat, 01 Feb 2020 06:36:53 +0000

Exercising, keeping a healthy weight, and not smoking should somewhat reduce the risk of developing pancreatic cancer.

Answered: How do pancreatic neuroendocrine cancers develop?

Sat, 01 Feb 2020 06:36:12 +0000

Answered: What are complications of the Whipple procedure?

Sat, 01 Feb 2020 06:35:32 +0000

Immediately after the Whipple procedure, serious complications can affect many patients. One of the most common of these include the development of false channels (called fistulas) and leakage from the site of the bowel reconnection. Other possible surgical complications include:

Infections
Bleeding
Trouble with the stomach emptying itself after meals

Answered: What is it like for patients after the Whipple procedure?

Sat, 01 Feb 2020 06:34:31 +0000

At first, patients can eat only small amounts of easily digestible food after a Whipple procedure. They may need to take pancreatic enzymes -- either short-term or long-term -- to assist with digestion. Diarrhea is a common problem during the two or three months it usually takes for the rearranged digestive tract to fully recover.

Answered: What are the stages of pancreatic cancer?

Sat, 01 Feb 2020 06:33:37 +0000

Doctors use stages to describe the extent of a cancer's spread during treatment. The stages of pancreatic cancer are used to guide treatment and to classify patients for clinical trials. The stages of pancreatic cancer are:

Stage 0: No spread. Pancreatic cancer is limited to a single layer of cells in the pancreas. The pancreatic cancer is not visible on imaging tests or even to the naked eye.
Stage I: Local growth. Pancreatic cancer is limited to the pancreas, but has grown to less than 2 centimeters across (stage IA) or greater than 2 centimeters (stage IB).
Stage II: Local spread. Pancreatic cancer has grown outside the pancreas, or has spread to nearby lymph nodes.
Stage III: Wider spread. The tumor has expanded into nearby major blood vessels or nerves, but has not metastasized.
Stage IV: Confirmed spread. Pancreatic cancer has spread to distant organs.

Answered: How is pancreatic cancer surgery described?

Sat, 01 Feb 2020 06:32:15 +0000

Since surgery has risks, doctors first determine whether pancreatic cancer appears to be removable by surgery, or resectable. Pancreatic cancer is then described as follows: Resectable: On imaging tests, pancreatic cancer hasn't spread (or hasn't spread very far), and a surgeon feels it might all be removable. About 10% of pancreatic cancers are considered resectable when first diagnosed.
Locally advanced (unresectable): Pancreatic cancer has grown into major blood vessels on imaging tests, so the tumor can't safely be removed by surgery.
Metastatic: Pancreatic cancer has clearly spread to other organs, so surgery cannot remove the cancer.

Answered: How is radiation therapy done to treat pancreatic cancer?

Sat, 01 Feb 2020 06:31:23 +0000

In radiation therapy, a machine beams high-energy X-rays to the pancreas to kill pancreatic cancer cells. Radiation therapy is done during a series of daily treatments, usually over a period of weeks.

Answered: What clinical trials are done for pancreatic cancer?

Sat, 01 Feb 2020 06:30:51 +0000

New pancreatic cancer treatments are constantly being tested in clinical trials. You can find out about clinical trials for the latest treatments for pancreatic cancer on the web sites of the American Cancer Society or the National Cancer Institute.

Answered: How is chemotherapy or radiation therapy used to treat resectable pancreatic cancer?

Sat, 01 Feb 2020 06:29:38 +0000

_{Chemotherapy or radiation therapy (or both) can also be used in conjunction with surgery for resectable and unresectable pancreatic cancer in order to: Shrink pancreatic cancer before surgery, improving the chances of resection}
_{Prevent or delay pancreatic cancer from returning after surgery}