Pancreatic Cancer

Pancreatic cancer: Pancreatic tissue is characterized by two kinds of cells: exocrine pancreatic cells and neuroendocrine pancreatic cells. Exocrine cells produce and release enzymes that help the small intestine digest food. Neuroendocrine cells, eg, islet cells, produce hormones like insulin and glucagon, which regulate blood sugar levels.

Pancreatic tumors most often arise from the exocrine pancreatic cells and, because they do not secrete hormones (like the neuroendocrine cells), there are usually no noticeable symptoms, making them extremely difficult to diagnose in the early stages of the disease. Malignant neuroendocrine tumors—which release excess hormones into the blood stream causing a range of symptoms—generally have a better prognosis than pancreatic cancers arising from the exocrine cells. Some of the signs and symptoms of pancreatic cancer are:

  • Diarrhea
  • Indigestion
  • A lump in the abdomen
  • Abdominal or back pain
  • Yellowing of skin and whites of the eyes (sclerae)
  • Stomach ulcers
  • Gastroesophageal reflux
  • High or low blood sugar levels
  • Fast heartbeat
  • Blood clots
  • Unexplained weight loss

Diagnostic testing generally involves physical examination, taking the patient’s history, blood analysis, testing for tumor markers, medical imaging, and tissue biopsy. Because pancreatic cancer is often hard to detect until later stages, treatment is sometimes done at the same time as diagnosis (exploratory laparotomy) in order to limit the spread of cancer. Many patients with advanced-stage pancreatic cancer should consider participating in a clinical trial. Standard treatments for pancreatic cancer are:

  • Surgery
  • Radiation therapy
  • Chemotherapy
  • Chemoradiation therapy
  • Targeted therapy