Pancreatic cancer

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(Redirected from Cancer of the pancreas)

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 OMIM           = 260350 |
 MedlinePlus    = 000236 |
 eMedicineSubj  = med |
 eMedicineTopic = 1712 |
 DiseasesDB     = 9510 |

}} Pancreatic cancer (also called cancer of the pancreas) is represented by the growth of a malignant tumour within the small pancreas organ. Each year about 31,000 individuals in the United States are diagnosed with this condition, with more than 60,000 in Europe.

Contents

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Types

  • Template:ICDO: The most common form of this disease is known as adenocarcinoma of the pancreas. It is one of the most lethal forms of cancer with few victims still alive 5 years after diagnosis, and complete remission still extremely rare.
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Risk factors

Risk factors for pancreatic cancer include [1]:

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Diagnosis

Early diagnosis of pancreatic cancer is difficult because the symptoms are so non-specific and varied. Common symptoms include abdominal pain, loss of appetite, significant weight loss, painless jaundice and dilatation of the gallbladder (=Courvoisier sign), digestive problems, and depression.

Jaundice occurs when the tumour grows and pressure obstructs the common bile duct (cf. anatomy of the pancreas). Tumours of the head of the pancreas (approximately 60% of cases) will more easily give rise to such symptoms.

Courvoisier's law is sometimes used to distinguish pancreatic cancer from gallstones.

Pancreatic cancer is usually discovered during the course of the evaluation of these symptoms by e.g. abdominal CT. Endoscopic ultrasound (EUS) is another procedure that can help visualize the tumor and obtain tissue to establish the diagnosis.

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Treatment

Treatment of pancreatic cancer depends on the stage of the cancer [2] Recent advances have made resection of tumors that were previously unrescetable due to blood vessel involvement possible. The Whipple procedure is the most common surgical treatment for cancers involving the head of the pancreas.

Stage Description App. % of cases Treatment options Median survival
Local/resectable Disease is confined to the pancreas and is clearly separated from surrounding blood vessels 15 Surgery; postoperative chemotherapy and/or radiation may also be offered 17 months
Locally advanced / unresectable Disease encases or compresses surrounding blood vessels, or has directly extended into adjacent structures 40 Chemotherapy (most commonly gemcitabine-based) and/or radiation. In very rare instances, cancers that respond well to initial treatment may subsequently be surgically resected. 8-9 months
Metastatic Evidence of extrapancreatic spread to distant organs (liver, lungs, etc.) 45 Chemotherapy (most commonly gemcitabine-based); investigational trials 4-6 months

Recent advances in the treatment of pancreatic cancer: For number of years, treatment of pancreatic cancer was limited to 5-FU alone. Then Gemcitabine was introduced. Gemcitabine had no survival advantage in pancreatic cancer compared to 5-FU, but the drug was FDA approved for pancreatic cancer based on better improvement in symptoms compared to 5-FU.

Targeted therapy using several new drugs is showing significant improvements in the treatment of pancreatic cancer. New drugs for the treatment of pancreatic cancer include: erlotinib, cetuximab, bevacizumab, tipifarnib. These drugs hold promise for the future treatment of patients with pancreatic cancer.

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Prognosis

Patients diagnosed with pancreatic cancer typically have a poor prognosis because the cancer usually causes no symptoms early on, leading to metastatic disease at time of diagnosis. Median survival from diagnosis is around 6 months; 5-year survival is 5% [3]. With 31,000 new diagnoses in the United States every year, and 28,200 deaths, mortality approaches 100%.

Pancreatic cancer occasionally may result in diabetes. The insulin production is hampered and it has been suggested that the cancer can also prompt the onset of diabetes and vice versa. [4]

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Prevention

Prevention of pancreatic cancer consists of avoiding risk factors when possible [5]. Cigarette smoking is considered to be the most significant and avoidable risk factor for pancreatic cancer. Maintaining a healthy weight and exercising may be helpful. Additionally, increasing consumption of fruits, vegetables, and whole grains while decreasing red meat intake is recommended.

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Victims of pancreatic cancer (survivors)

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Victims of pancreatic cancer (all deceased)

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External links

Health science - Medicine - Gastroenterology - edit
Diseases of the esophagus - stomach
Halitosis | Nausea | Vomiting | GERD | Achalasia | Esophageal cancer | Esophageal varices | Peptic ulcer | Abdominal pain | Stomach cancer | Functional dyspepsia
Diseases of the liver - pancreas - gallbladder - biliary tree
Hepatitis | Cirrhosis | NASH | PBC | PSC | Budd-Chiari syndrome | Hepatocellular carcinoma | Acute pancreatitis | Chronic pancreatitis | Pancreatic cancer | Gallstones | Cholecystitis
Diseases of the small intestine
Peptic ulcer | Intussusception | Malabsorption (e.g. celiac disease, lactose intolerance, fructose malabsorption, Whipple's disease) | Lymphoma
Diseases of the colon
Diarrhea | Appendicitis | Diverticulitis | Diverticulosis | IBD (Crohn's disease, Ulcerative colitis) | Irritable bowel syndrome | Constipation | Colorectal cancer | Hirschsprung's disease | Pseudomembranous colitis

Template:Tumorsde:Pankreaskarzinom lt:Kasos vėžys nl:Alvleesklierkanker ja:膵癌 fi:Haimasyöpä sv:Pankreascancer zh:胰腺癌

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