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The incidence of pancreatic cancer has increased throughout this century.
It is the fourth most common cancer in men.
It is the fifth most common cancer in women.
Eighty percent of pancreatic cancer occurs in people over age 50.
Unlike other cancers, such as colon or breast, it is difficult to detect in it's early stages.
- Dull, continuous abdominal pain (less pain when leaning forward, more when lying down)
- Pain in the middle of your back
- Jaundice (yellowing of skin and whites of eyes), often accompanied by itching of the skin
- Rapid weight loss
- Chronic nausea or diarrhea
- Enlarged liver and gallbladder
- Clay or light colored stools
While it can seldom be explained why one person gets pancreatic cancer and another doesn't, it is clear that the disease is not contagious. No one can "catch" cancer from another person.
Although scientists do not know exactly what causes cancer of the pancreas, they are learning that some things increase a person's chance of getting this disease. Smoking is a major risk factor. Research shows that cigarette smokers develop cancer of the pancreas two to three times more often than nonsmokers. Quitting smoking reduces the risk of pancreatic cancer, lung cancer, and a number of other diseases.
Types of pancreatic cancer
Cancers of the pancreas are divided into groups according to their position within the pancreas and the type of cell that the cancer has started from.
Between 7 and 8 out of 10 of all pancreatic cancers occur in the head of the pancreas (see diagram of the pancreas).
Nearly all pancreatic cancers start from the cells in the inner lining of the pancreatic ducts. These are the channels through which the digestive juices produced by the pancreas flow out into the small bowel. This type of cancer is called adenocarcinoma.
There are other very rare tumours that can affect the pancreas. These include:
- A group of conditions called neuroendocrine tumours, which produce hormones
- A type of lymphoma – a cancer arising from lymphatic tissue in the pancreas
- Pancreatic sarcoma, which develops in the tissue that holds together the cells of the pancreas.
- History of your symptoms
- Physical examination
- Lab tests for anemia and blood sugar
- Endoscopic retrograde cholangiopancratogram (ERCP)
- CT scan or MRCP
Treatment for pancreatic cancer depends on a number of factors. Among these are the type, size, and extent of the tumor as well as the patient's age and general health. A treatment plan is tailored to fit each patient's needs.
Cancer of the pancreas is curable only when it is found in its earliest stages, before it has spread. Otherwise, it is very difficult to cure. However, it can be treated, symptoms can be relieved, and the quality of the patient's life can be improved.
Pancreatic cancer is treated with surgery, radiation therapy, or chemotherapy. Researchers are also studying biological therapy to see whether it can be helpful in treating this disease. Sometimes several methods are used, and the patient is referred to doctors who specialize in different kinds of cancer treatment.
Surgery may be done to remove all or part of the pancreas. Sometimes it is also necessary to remove a portion of the stomach, the duodenum, and other nearby tissues. This operation is called a Whipple procedure. In cases where the cancer in the pancreas cannot be removed, the surgeon may be able to create a bypass around the common bile duct or the duodenum if either is blocked.
Radiation therapy (also called radiotherapy) uses high-powered rays to damage cancer cells and stop them from growing. Radiation is usually given 5 days a week for 5 to 6 weeks. This schedule helps to protect normal tissue by spreading out the total dose of radiation. The patient doesn't need to stay in the hospital for radiation therapy.
Radiation is also being studied as a way to kill cancer cells that remain in the area after surgery. In addition, radiation therapy can help relieve pain or digestive problems when the common bile duct or duodenum is blocked.
Chemotherapy uses drugs to kill cancer cells. The doctor may use just one drug or a combination. Chemotherapy may be given by mouth or by injection into a muscle or vein. The drugs enter the bloodstream and travel through the body. Chemotherapy is usually given in cycles; a treatment period followed by a recovery period, then another treatment period, and so on.
Smoking is the most generally accepted risk factor for cancer of the pancreas. Adenocarcinomas -- the glandular-cell growths that account for about 95 percent of pancreatic tumors -- are two to three times more common in heavy smokers than in nonsmokers.
Genetic alterations involved in pancreatic cancer include activation of the K-ras oncogene and inactivation of tumor-suppressor genes such as p16 and p53. Pancreatic cancer has the highest frequency of K-ras mutations among all human cancers. This frequency of K-ras mutations, which resembles those in bladder and lung cancers, may be associated with smoking.
Other possible risk factors include the following:
About 10 percent of patients with pancreatic cancer report a family history of the disease. A few hereditary syndromes, including familial atypical multiple mole melanoma syndrome, familial breast cancer, Peutz-Jeghers syndrome, and hereditary pancreatitis account for a small percentage of pancreatic cancer cases.
Mutations in the breast cancer susceptibility gene BRCA2 have been found in some families with familial pancreatic cancer.
A diet high in meat and fats is possibly associated with a higher risk of pancreatic cancer. Recent research has suggested obesity and physical inactivity as additional risk factors.
Advancing age: Most patients diagnosed with pancreatic cancer are between the ages of 60 and 80. The disease can occur in younger people, however -- particularly those with a family history of the disease.
More men than women are diagnosed with pancreatic cancer; however, incidence has been rising in women in recent years.
There may be an association between pancreatic cancer and diabetes, although it has not been proven.
Chronic pancreatitis has also been associated with pancreatic cancer, but the exact nature of the association is still under study.
Occupational exposure to carcinogens (e.g., asbestos, pesticides, dyes, and petrochemicals) has been associated with pancreatic cancers.
How common is cancer of the pancreas?
Cancer of the pancreas (also known as "pancreatic cancer") is a relatively rare form of cancer. Approximately 7,400 people are diagnosed with the condition each year, and overall it accounts for 3% of all cancer cases.
Pancreatic cancer tends to affect people between 60-80 years of age. Approximately 63% of people diagnosed with cancer of the pancreas are over 70 years of age. Men tend to be slightly more affected than women.
Cancer of the pancreas is a very serious form of cancer, which is both difficult to detect and to treat. Because pancreatic cancer causes very few symptoms in its early stages, the condition is often not diagnosed until the cancer is relatively advanced.
If your pancreatic cancer cannot be cured, then there is a range of other treatments available that can help to slow the growth of the tumour and ease any symptoms you may be experiencing.
Who is at risk for pancreatic cancer?
People with exposure to carcinogens (cancer causing agents) are at an increased risk.
Though rare, heredity can play a role.
Pancreatic cancer is three to four times more common in people who smoke.
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