Pancreatic cancer is a disease in which cancerous cells form in the tissues of the pancreas. This disease accounts for only 2% of cancers diagnosed in the United States each year; however, it is the fifth leading cause of cancer death in this country.
St. Anthony's Hospital has the most advanced and accurate technology available to diagnose pancreatic cancer, including endoscopic ultrasound. Our gastroenterologists, pathologists and radiologists are able to pinpoint the exact extent of the disease, improving your chances for successful treatment.
For a free referral to one of our physicians, call (727) 825-1111.
Pancreatic cancer often does not cause symptoms in the early stages and may not appear until the disease is advanced. Signs you may have pancreatic cancer include:
- Pain in the abdomen or in upper/middle back
- Unexplained weight loss
- Change of color in urine and stool: Urine may turn orange or the color of iced tea. Stool may turn yellow or reddish, or become grey or chalky-white.
- Loss of appetite
- Nausea, vomiting or indigestion
- Fatigue (extreme tiredness)
- Sudden-onset diabetes or change in blood-sugar control in diabetics
These symptoms do not always mean you have pancreatic cancer. However, it is important to discuss any of these symptoms with your doctor, since they may signal other health problems.
One or more of the following tests may be used to find out if you have pancreatic cancer and if it has spread. These tests also may be used to find out if treatment is working.
- Computed tomography scan (CT or CAT scan): A CT scan provides detailed images of organs, bones, muscles and fat.
- Positron emission tomography (PET) scans: A nuclear medicine procedure used to detect cancer cells.
- Magnetic resonance imaging (MRI) scans: A diagnostic procedure used to create detailed images of organs and body structures.
- Ultrasound: Use of sound waves to view internal organs
- Percutaneous transhepatic cholangiography (PTC): An X-ray image that allows visualization of contrast in the bile duct and surrounding areas.
Endoscopic ultrasound (EUS): A special endoscope with an ultrasound probe and a small needle at the end is placed through the mouth and esophagus and into the first part of the small intestine. EUS produces images of the pancreas and other organs. Surgical instruments may be inserted through the endoscope to remove tissue to examine under a microscope.
Endoscopic retrograde cholangiopancreatography (ERCP): A procedure that allows the doctor to diagnose and treat problems in the liver, gallbladder, bile ducts and pancreas.
Blood tests: There are no specific blood tests that can be used to detect pancreatic cancer. When you are first diagnosed your doctor may order general blood, urine and stool tests to determine your overall health. Your doctor may also check special cancer blood markers (CA 19-9 and CEA) that are sometimes high in pancreatic cancer patients.
Pancreas Biopsy: A procedure to remove (with a needle or during surgery) of a small piece of pancreatic tissue for examination under a microscope.
During this process, you may be referred to a medical oncologist. If you are diagnosed with pancreatic cancer, your doctor will run further tests to determine how advanced the cancer is. These include imaging tests such as MRI, x-ray, and CT scans, as well as blood tests. Your doctor may also use a laparoscope, which is a lighted tube and video camera, to explore your pancreas. The laparoscope is inserted through an incision in your abdomen, and the camera transmits images for your doctor to review.
In general, the stages of pancreatic cancer are categorized like this.
Stage I: Cancer is in the pancreas only.
Stage II: The cancer has spread beyond the pancreas and to the blood vessels as well as possibly the lymph nodes.
State III: The cancer has spread beyond the pancreas to adjacent tissue, organs, and possibly lymph nodes.
Stage IV: The cancer has spread well beyond the pancreas to other areas, such as the lungs and liver.
Treatment for pancreatic cancer will be determined by your doctor based on your health and medical history, type of cancer, location and extent of disease, tolerance for specific treatments and the patient’s opinion and preferences.
Surgery for pancreatic cancer may be used to help treat the cancer or to help relieve symptoms such as blocked bile ducts or intestine. Types of surgery for pancreatic cancer include:
- Whipple procedure (Pancreaticoduodenectomy)The is used if tumors are in the head of the pancreas, and it involves taking out the pancreas head, along with your gallbladder and parts of your small intestine and bile duct. The surgeon may remove part of your stomach, too. Then the remaining areas of your stomach, intestines, and pancreas are reconnected. This procedure requires a long recovery, often 10 or more days in the hospital and weeks at home. Also, you may experience nausea and vomiting after this surgery.
- Distal pancreatectomy removes the tail of the pancreas and a part of the body of the pancreas. The spleen is typically is removed as well.
- Total pancreatectomy, which removes the entire pancreas and the spleen, was once used for tumors in the body or head of the pancreas. This type of operation is not done often.
- Palliative surgery may be performed for more advanced cancers. These procedures are performed to relieve problems such as a blocked bile duct but not as a cure for the disease.
- Minimally Invasive Pancreas Surgery or laparoscopic surgical techniques can sometimes be used in pancreatic surgery, depending upon factors such as location of the tumor. Laparoscopic procedures are performed with small incisions in the abdomen through which telescope-guided instruments are placed. Conventional surgeries require a longer incision and wider opening of the abdomen. With laparoscopic procedures, surgeons are generally able to reduce blood loss and risk of infection for the patient.
Special equipment is used to send high energy focused x-rays into a part of the body to kill cancer cells. Radiation treatments are given 3-5 days a week for several weeks. The treatments are painless and may be given alone or in combination with surgery and/or chemotherapy.
Targeted Drug Therapy
There are some drugs available that specifically attack cancer cells and block the chemicals that allow them to grow and divide. Your doctor may suggest targeted drug therapy in conjunction with other therapies. Many of these therapies are available through a clinical research trial. Your doctor can determine if you are a candidate for participation.
Chemotherapy involves the use of special drugs to kill cancer cells. The medical oncologist recommends individualized treatments for each patient. Chemotherapy may be given alone or in combination with surgery and radiation therapy.
Often a diagnosis of pancreatic cancer comes when the disease is very advanced. It this is true for you, you should take time to consider your options. One possibility is supportive care where you will be given medications and treatments to keep you comfortable as your cancer progresses. Talk to the people around you, and make the best decision for your condition.
Follow-up: Keep Watch
After your treatment for pancreatic cancer, it's important that you watch your body and remain as healthy as you can. Your doctor will schedule follow-up appointments to check for any recurrences of the cancer. Be sure to tell your doctor if you experience any new symptoms or medical issues.
Most of all, take time to enjoy your life and the people close to you. Join a cancer survivors' support group, where you can share information and tell your story. Never hesitate to accept help and encouragement from your community.
For more information about pancreatic cancer care and screenings at St. Anthony’s Hospital Cancer Center, please call (727) 825-1253.
St. Anthony's Cancer Center
1201 Fifth Ave. N., Suite 130
St. Petersburg, FL 33705
Phone: (727) 825-1253
Fax: (727) 825-1332