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Screening, Diagnosis and Treatment Options

Screening and Diagnosis: Get Checked
If your doctor suspects pancreatic cancer, there are several tests he or she can run. You may undergo more than one of these.

CT scan: During a computerized topography (CT) scan, your doctor will be able to study your organs and detect any abnormalities.

MRI: Your doctor can view your pancreas and other internal organs by using magnetic resonance imaging (MRI).

Ultrasound: An ultrasound is another way for your doctor to see your pancreas. It uses high-frequency sound waves to create images of the organ.

Endoscopic procedures: Your doctor may recommend an endoscopic ultrasound (EUS), which takes pictures of your pancreas from inside your abdomen. A thin tube called an endoscope is inserted through your throat and down toward your abdomen. Then an ultrasound device is passed through the endoscope to take the images. During this test, your doctor may also take tissue samples for biopsy.

Another option is an endoscopic retrograde cholangiopancreatography (ERCP). This procedure uses an endoscope that is inserted down your throat and into your abdomen. Then dye is inserted by a catheter through the endoscope. Next an x-ray is taken, and the dye helps your doctor see the opening of your pancreas and the bile ducts. During an ERCP, a tissue sample an also be taken for biopsy.

Biopsy: Your doctor can collect a tissue sample during an EUS or ERCP, or he may do a small needle aspiration. This involves inserting a needle through your skin and into your pancreas. The procedure is done under a local anesthetic.

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: Get Better
What do I do? That may be the first question you ask yourself. A diagnosis of pancreatic cancer is serious, and you need to weigh all your options. Take time to write down all your questions and meet with your doctor to discuss them. Be sure to bring a friend or family member with you for support as well as to remember details.

Depending on how advanced your cancer is, your doctor will recommend various treatment options. The main goal is to eliminate the cancer, but if that is not possible, other treatments can help you relieve symptoms and feel more comfortable. Since pancreatic cancer can be difficult to treat, don't hesitate to get a second, or third, opinion about your condition and your options.

Surgery: There are different surgeries for pancreatic cancer, based on where the tumors are located.

  • The Whipple procedure 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.
  • A distal pancreatectomy is used if you have tumors in the tail of your pancreas. The procedure involves removing the tail, a small part of the pancreas body, and perhaps your spleen.

Both of these surgeries carry a risk of infection and bleeding.

Chemotherapy: This therapy involves the delivery of cancer-killing drugs via pills or an IV. Most treatments are given in cycles so your body has time to recover between them. For pancreatic cancer, chemotherapy is most often used when the disease has spread from the pancreas and to nearby organs. It is often used after surgery to kill any remaining cancer cells, and it can be used in conjunction with radiation. Depending on which drugs are used, you may experience hair loss, nausea, and fatigue during your treatment cycles.

Radiation therapy: This treatment uses high-energy x-rays to pinpoint and kill cancer cells. Radiation can be helpful before or after surgery, and it is often used in conjunction with chemotherapy when surgery is not an option. Many people report nausea and fatigue after receiving radiation therapy.

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.

Supportive Care: 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 on pancreatic cancer care and screenings at The Cancer Center at St. Anthony’s Hospital, please call (727) 825-1253.

St. Anthony's Cancer Center
1201 5th Ave. N., Suite 130
St. Petersburg, FL 33705
Phone: (727) 825-1253
Fax: (727) 825-1332