Pancreatic cancer -- the fourth leading cause of cancer death in the United States -- occurs when malignant cells develop in the pancreas. The National Cancer Institute estimated that in 2012, approximately 43,920 people will be diagnosed with pancreatic cancer, and 37,390 people will die from the disease. Within the first year of diagnosis, 75 percent of pancreatic cancer patients die, according to the Pancreatic Cancer Action Network.
The pancreas is a central component to one's digestive system. At about 6 inches in length, it secretes hormones and juices that aid in digesting food. When abnormal mutations develop in the DNA of the pancreas, as with other cancers, the cells grow uncontrollably until they become a tumor. Various factors increase your risk of developing the disease: smoking, obesity, diabetes and a family history of pancreatic cancer. It afflicts more people of African descent than other races.
If the cancer begins in the duct of the pancreas, it is called pancreatic adenocarcinoma or pancreatic exocrine cancer. If it begins in the pancreas' hormone-producing cells, it is called islet cell cancer or pancreatic endocrine cancer, reports the Mayo Clinic.
People rarely detect signs of the disease in its early stages. They typically only manifest when the disease reaches an advanced state. These signs include upper abdominal pain, appetite loss, depression, weight loss, jaundice, digestive problems, gallbladder enlargement and blood clots, according to the American Cancer Society.
Diagnosis necessitates a thorough physical exam that focuses on the abdomen as well as imaging tests (a CAT scan, MRI, ultrasound and more) and blood tests. If these demonstrate a strong likelihood of pancreatic cancer, a surgeon will perform a biopsy. The most common type performed is a fine needle aspiration (FNA) biopsy, in which the doctor inserts a needle into the pancreas to retrieve small tissue samples.
If one is diagnosed, John Affronti, gastroenterologist at Loyola University Medical Center, recommended seeking treatment at a center that offers a multidisciplinary approach. This enables the patient to benefit from oncologists, gastroenterologists, radiologists, surgeons and other specialists all at the same time.
Even when caught early, pancreatic cancer spreads rapidly. Treatments include chemotherapy, targeted therapy, immunotherapy, radiation therapy and a variety of surgeries: stents, biliary and gastric bypass, total pancreatectomy, distal pancreatectomy and Whipple procedure, the most commonly performed surgery. Dr. Gerard Aranha, a surgical oncologist at Loyola University Medical Center, said under certain circumstances, the Whipple procedure (pancreaticoduodenectomy), could cure the disease.
The Pancreatic Cancer Action Network explained that the surgeon removes the head of the pancreas, portions of the duodenum and stomach, the gallbladder and the nearby lymph nodes. Next, the surgeon reconnects the remaining pancreas with the digestive organs. "Many patients who could benefit from a Whipple procedure are not being offered the operation," Aranha said.
New chemotherapy drugs are shrinking some advanced tumors, once considered inoperable, to surgically-removable sizes, explained Margo Shoup, a surgical oncologist at Loyola University Medical Center.