pancreas cancer : Description of Pancreatic Cancer

Cancer of the pancreas is a disease in which cancer (malignant) cells are found in the tissues of the pancreas. The pancreas is about 6 inches long and is shaped something like a thin pear, wider at one end and narrowing at the other. The pancreas lies behind the stomach, inside a loop formed by part of the small intestine. The broader right end of the pancreas is called the head, the middle section is called the body, and the narrow left end is the tail.

The pancreas has two basic jobs in your body. It produces juices that help you break down (digest) your food, and hormones (such as insulin) that regulate how your body stores and uses food. The area of the pancreas that produces digestive juices is called the exocrine pancreas. About 95% of pancreatic cancers begin in the exocrine pancreas. The hormone-producing area of the pancreas is called the endocrine pancreas. Only about 5% of pancreatic cancers start here. This statement has information on cancer of the exocrine pancreas. For more information on cancer of the endocrine pancreas (also called islet cell cancer) see the PDQ Patient Information Statement on Islet Cell Carcinoma.

Cancer of the pancreas is hard to find (diagnose) because the organ is hidden behind other organs. Organs around the pancreas include the stomach, small intestine, bile ducts (tubes through which bile, a digestive juice made by the liver, flows from the liver to the small intestine), gallbladder (the small sac below the liver that stores bile), the liver, and the spleen (the organ that stores red blood cells and filters blood to remove excess blood cells). The signs of pancreatic cancer are like many other illnesses, and there may be no signs in the first stages. You should see your doctor if you have any of the following: nausea, loss of appetite, weight loss without trying to lose weight, pain in the upper or middle of your abdomen, or yellowing of your skin (jaundice).
If you have symptoms, your doctor will examine you and order tests to see if you have cancer and what your treatment should be. You may have an ultrasound, a test that uses sound waves to find tumors. A CT scan, a special type of x-ray that uses a computer to make a picture of the inside of your abdomen, may also be done. Another special scan called magnetic resonance imaging (MRI), which uses magnetic waves to make a picture of the inside of your abdomen, may be done as well.

A test called an ERCP (endoscopic retrograde cholangiopancreatography) may also be done. During this test, a flexible tube is put down the throat, through the stomach, and into the small intestine. Your doctor can see through the tube and inject dye into the drainage tube (duct) of the pancreas so that the area can be seen more clearly on an x-ray. During ERCP, your doctor may also put a fine needle into the pancreas to take out some cells. This is called a biopsy. The cells can then be looked at under a microscope to see if they contain cancer.

PTC (percutaneous transhepatic cholangiography) is another test that can help find cancer of the pancreas. During this test, a thin needle is put into the liver through your right side. Dye is injected into the bile ducts in the liver so that blockages can be seen on x-rays.

In some cases, a needle can be inserted into the pancreas during an x-ray or ultrasound so that cells can be taken out to see if they contain cancer. You may need surgery to see if you have cancer of the pancreas. If this is the case, your doctor will cut into the abdomen and look at the pancreas and the tissues around it for cancer. If you have cancer and it looks like it has not spread to other tissues, your doctor may remove the cancer or relieve blockages caused by the tumor.

For more information on pancreatic cancer and other diseases of the pancreas, visit www.pancreas.org or the National Pancreas Foundation at www.pancreasfoundation.org. For more information about the University of Pittsburgh divisionof gastroenterology, hepatology and nutrition visit their Web site at http://www.gi.pitt.edu.