pancreas cancer : The Pancreatic and Biliary Disease Cause and Treatment

Causes
The cause of pancreatic cancer is unknown. Smoking seems to be the main preventable risk factor. Patients with chronic pancreatitis are at higher risk of getting pancreatic cancer. It is quite common among patients with a hereditary form of pancreatitis. A hereditary form of pancreatic cancer has also been identified, though it is quite rare. Diabetes has not been shown to be a risk factor.


Screening and Prevention
There is no way to screen for pancreatic cancer, but since smoking is the only known risk factor, quitting is the best and only way to prevent contracting this deadly disease.


Treatment
Once cancer has been confirmed, the doctor will estimate how advanced the cancer is using a process called staging. The cancer's stage guides how the tumor is treated. Here are the four stages of pancreatic cancer:

Resectable: The cancer has involved only the pancreas, a rarity in pancreatic cancer. The doctor may remove the head of the pancreas, part of the small intestine and some surrounding tissue (Whipple procedure). Or the entire pancreas and surrounding organs may come out (total pancreatectomy). Or the body and tail of the pancreas are removed (distal pancreatectomy). Radiation and chemotherapy may also follow surgery. The patient may be invited to take part in a clinical trial to test new treatments and advance medical science.

Locally advanced cancer: The cancer has spread to nearby organs, blood vessels, the intestine or all of these. Removing the tumor isn't usually an option. Treatment typically involves radiation therapy (with or without chemotherapy), surgery or other procedures to reduce symptoms. Depending on the medical center, the patient may be invited to join clinical trials (which use combinations of surgery, radiation and chemotherapy).

Metastatic cancer: The cancer has spread to distant parts of the body (liver, abdomen or lungs). Treatment may involve combinations of chemotherapy, pain relief, and surgery to reduce symptoms, clinical trials (e.g., experimental therapy to fight the cancer).

Recurrent: After successful treatment, the cancer may reappear in the pancreas or another part of the body. Treatment options include any of those used in the metastatic stage, as well as radiation therapy to reduce symptoms.

Since the survival rate is so poor, much pancreatic cancer treatment focuses on relieving pain and discomfort. Endoscopic therapy is an often used, noninvasive way to relieve jaundice and the pain and nausea caused by tumor blockages in the duodenum. Some studies have found stents to work well to relieve the pain and upset stomach that can go with blockages, which also lead to jaundice. Relieving jaundice symptoms improves patients' appetites and emotional well being. Doctors can also relieve biliary blocks by inserting stents in the main pancreatic duct using an endoscope or traditional surgery. One advantage of endoscopic stent treatment is a shorter hospital stay and lower morbidity and mortality.

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