About Pancreatic Cancer
What is the pancreas?
The pancreas is a gland about 6 inches long, shaped like a thin pear lying on its side. The wider end of the pancreas is called the head, the middle section is called the body, and the narrow end is called the tail.
Where is the pancreas?
The pancreas is in a deep location and lies behind the stomach and in front of the spine. It has two main jobs in the body, to produce:
- Digestive enzymes that help digest (break down) food.
- Hormones, such as insulin and glucagon, that help control blood sugar levels.
- These hormones help the body use and store the energy it gets from food.
What is Pancreatic Cancer?
The term pancreatic cancer usually refers to the common pancreatic ductal adenocarcinoma.
Worldwide there are around 250,000 new cases each year; in Europe that figure is more than 70,000. The numbers of deaths and mortality for pancreatic cancer closely reflect the numbers of people being diagnosed. In the UK in 2008, 8,085 people were newly diagnosed and in 2009 8,047 people died.
Pancreatic cancer affects men and women equally with a slight bias towards younger men and older women. 1/3 of all cases occur in those under the age of 65.
Pancreatic cancer occurs when malignant cells form in the pancreas. The disease progresses rapidly but there are usually vague symptoms of pancreatic cancer in the early stages. Pancreatic cancer is often undetected until it has spread to other areas of the body (metastasized). Jaundice (yellowing of the skin and whites of the eyes) weight loss and abdominal pain can be the first signs pancreatic cancer.
There are two main 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.
By far the commonest type of pancreatic cancer arises from the cells that line ducts in the pancreas that carry the digestive fluids from the gland into the intestine. This type is called a ductal adenocarcinoma.
There are other uncommon tumours that can affect the pancreas. These include a group of conditions called ‘neuroendocrine tumours’ that sometimes produce hormones; a type of lymphoma – a cancer arising from the lymphatic tissue in the pancreas; various cystic tumours and ‘pancreatic sarcoma’ which develops in the tissue that holds the pancreatic cells together. There are also tumours arise from other tissues, such as the bile duct (cholangiocarcinoma), Ampulla of Vater, Ampullary adenocarcinoma, or duodenal adenocarcinoma, which may present with similar symptoms but which have different treatments and importantly very different prognosis.
80% of pancreatic cancers occur in the head portion of the gland, less commonly in the body (15%) and tail (5%).
The following video clip is an interview with Dr Diane Simeone – a specialist in the USA at the American Association for Cancer Research (AACR) Annual Meeting in Chicago 2012. Dr Simeone gives an overview of pancreatic cancer, it’s symptoms and treatments along with an insight into current stem cell research.
The causes of pancreatic cancer are not known. However, major risk factors for pancreatic cancer include smoking, obesity, diabetes and hereditary conditions associated with predisposition to cancer.
Patients whose immediate family members have had pancreatic cancer have a risk factor up to two times higher than the normal population – see hereditary pancreatic cancer.
There are several ways to treat pancreatic cancer:
- Surgery for pancreatic cancer: to remove the cancer.
- Chemotherapy, or a combination of chemotherapy and radiotherapy.
- Surgical bypass of the cancer.
- Insertion of an expandable metal or plastic stent in the bile duct (often to relieve jaundice symptoms)
- Symptom control and optimisation of quality of life
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