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  Pancreatic cancer

Pancreatic cancer is a malignancy of the pancreas organ. The pancreas is long glandular organ positioned near the stomach. The purpose of the pancreas is to produce juices which are secreted into the small intestines for digestion and hormones such as insulin, glucagon and somatostatin into the blood. In the United States, 32,000 people are diagnosed with pancreatic cancer; in Europe over 60,000 people are diagnosed. The prognosis of this cancer is extremely poor, with remission rarely lasting more than five years.

Pancreatic cancer
Pancreatic cancer


There are two types of pancreatic tumors one is an adenocarcinomas, which occur in 95% of patients, the other is neuroendocrine tumors which occur in 5 %of patients.

Symptoms

Diagnosis is challenging because there a many symptoms that can indicate other conditions. Symptoms are abdominal pain, loss of appetite, painless jaundice and significant weight loss. Because of the ambiguity of these symptoms, diagnosis is often made in the later stages of the growth of the cancer. Jaundice is present when the tumor obstructs the bile duct of the liver. Tumors which cause jaundice occur in 60% of diagnosed patients.

Risk factors for pancreatic cancer are age, being male, African descent or ethnicity, smoking, diets that are high in meat, obesity, diabetes, daily exposure to certain chemicals, dyes and pesticides, a family history, Helicobacter pylori infection and chronic pancreatitis. These are risk factors that increase the chances of getting pancreatic cancer, they are not known causes of pancreatic cancer.

Diagnosis

Pancreatic cancer is usually diagnosed via ultra sound or medical imaging. Blood tests that determine liver function, can indicate a blocked duct. Carbohydrate antigen 19.9 is a tumor marker detected in blood tests that is commonly elevated in patients with pancreatic cancer. Endoscopic ultrasound is used to perform a biopsy and determine the location of the tumor. A biopsy evaluated by a pathologist will indicate if the tumor is cancerous or not.

Part of diagnosis is staging the cancer. There are three defined stages of pancreatic cancer, local/respectable, locally advanced/unresectable and metastatic. Local respectable pancreatic cancer is defined as being located solely on the pancreas and is clearly detached from local blood vessels. Locally advanced/unresectable pancreatic cancer is defined when the cancer incases or pushes against local blood vessels and has spread into organs, glands surrounding the pancreas. Metastatic pancreatic cancer is defined by pancreatic cancer that is detected in other organs that are ‘far’ away from the pancreas, such as the liver and lungs.

Treatment

Treatment is determined by the stage of the cancer. Chemotherapy drugs that are commonly prescribed are fluorouracil, gemcitabine and erlotinib. Local/resectable pancreatic cancer is usually treated with surgery, post-op chemotherapy and possible radiation. This stage of pancreatic cancer is detected in 15% of diagnosed cases and has a median survival rate of 17 months. Locally advanced / resectable pancreatic cancer is treated with chemotherapy and radiation. This tumor is difficult to remove or surgically treat. This stage of pancreatic cancer is typical for 40% of diagnosed patients. The median survival rate is 8 – 9 months.

Metstatic pancreatic cancer is treated with chemotherapy and investigational drug trials. This stage of pancreatic cancer is typical at diagnosis for 45% of patients. The median survival rate for this stage of pancreatic cancer is 4-6 months. Unfortunately, pancreatic cancer has the number one fatality rate of all cancers and is number 4 in cancer death for men and women in the United States.

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