Tumours of the pancreas can be benign or malignant (cancer of the pancreas). Benign tumours are rare, and usually affect the islets of Langerhans, which then overproduce insulin, leading to a sharp drop in blood sugar levels (hypo-glycaemia). Cancers of the pancreas are also uncommon, although they have appeared increasingly in the last few years. They are commoner in men than women, usually in later life (from roughly age 40 to 50). The tumour is usually close to the entrance of the tube leading from the pancreas to the intestine. The symptoms are initially vague and ? not necessarily typical. Cancer of the it head of the pancreas is usually accompanied by persistent pain in the Acute pancreatitis can often occur after a heavy meal and high alcohol consumption. Abdomen, loss of weight and jaundice, the latter as a result of pressure on the bile duct. If the tumour is in the tail of the pancreas it produces piercing pain, often radiating to the back, and alleviated by bending, and associated with weight loss and vomiting, but no jaundice. Cancer of the head of the pancreas can also cause narrowing or even closure of the duodenum by obstructing the bile duct (ileus). Because the symptoms of cancer of the pancreas are atypical it is often diagnosed at a late stage, usually after the occurrence of jaundice. Sonography (examination by the use of sound waves) and contrast X-rays can be used in diagnosis, e.g. by introducing a contrast medium from the duodenum. Treatment can be successful only if the tumour is detected at an early stage. The entire head of the pancreas and the duodenum have to be removed. Symptoms can be alleviated by removing the bile duct or by a new method, the introduction of a prosthetic tube to hold the duct open. If the duodenum is closed the stomach must be connected to the upper part of the small intestine.