Pancreatic Cancer

The pancreas is a glandular organ located in the posterior aspect of the abdomen. It lies between the liver and the spleen, and just below and behind the stomach. The pancreas produces digestive enzymes (exocrine function), which are emptied into the small bowel, as well as the hormone insulin (endocrine function), which enters the blood stream.

Adenocarcinoma is a type of cancer that begins in the cells that line the glands and ducts within the pancreas. It accounts for 90% of cancers originating in the pancreas. Other types of cancer, such as islet cell tumors, also originate in the pancreas, but are not included in this overview. This treatment overview deals only with adenocarcinoma of the exocrine pancreas, which will be referred to as pancreatic cancer. There are approximately 37,000 individuals diagnosed with cancer of the pancreas in the United States each year, and approximately 34,000 individuals succumb to the disease annually.

Pancreatic cancer is the fourth leading cause of cancer death in the United States. Pancreatic cancers may cause blockage of the pancreatic and biliary ducts and produce jaundice.. A gastroenterologist may attempt to relieve jaundice using a special procedure where a scope is passed through the stomach into the area of the blockage. This procedure is known as endoscopic retrograde cholangiopancreatography (ERCP). An ERCP can also be used to sample (biopsy) any suspicious lesions in the area. Determining the extent of the spread or the stage of the cancer is of initial importance to determine whether the cancer can be removed surgically.

Determining the stage of the cancer requires a number of tests including CT/MRI scans of the abdomen and other more-specialized procedures. Endoscopic ultrasound (EUS) may be used to determine the size of the cancer and whether surrounding lymph nodes may be enlarged. To exclude the possibility of blood vessel involvement, your physicians may pursue a visceral angiogram or MR angiography, which can detect irregularities in arteries.