“Cancer of the pancreas is a genetic disease that is the fifth most common cause of death in both men and women. Pancreatic cancer affects approximately 28,000 Americans each year, or five out of 100,000 people” (Mayo Clinic, 1998). According to physicians at Johns Hopkins Medical Institute, “pancreatic cancer is the challenge of the twenty-first century. ” So, where exactly is the pancreas located in our bodies, and what does it do? The pancreas is a gland found behind the stomach that is shaped somewhat like a fish. The pancreas is about six inches long and less than two inches wide, and it extends across the abdomen.
The pancreas consists of two separate glands inside the same organ, the exocrine gland and the endocrine gland. The exocrine gland makes pancreatic juice that has enzymes to break down fats and proteins in foods so the body can use them. Most of the cells in the pancreas are part of the exocrine system. A smaller number of cells in the pancreas are endocrine cells. These cells are arranged in clusters called islets. Islets make hormones that help balance the amount of sugar in the blood. So, how does the pancreas create cancer?
Both the exocrine and endocrine cells of the pancreas can form tumors. Exocrine pancreas tumors are much more common. However, not all of these tumors are cancerous. A small number of these tumors are benign. Pancreatic cancer involves important factors such as signs, symptoms, causes, survival and death rates, and treatment for this disease. How many people in the United States are affected by this cancer? The American Cancer Society predicts that, in 2005, about 32,180 people in the US will be found to have pancreatic cancer and about 31,800 will die of the disease.
The five?year survival rate after diagnosis for exocrine pancreatic cancer is 4 percent. This kind of cancer is the fourth leading cause of cancer death. About one out of four patients with cancer of the exocrine pancreas will live at least one year after the cancer is found, and about only one in twenty five will survive for five years or more. According to Professor John Neoptolemos, “There are approximately 7,000 new cases each year – but it is one of the most lethal cancers. ” The main reason for the low survival rate from pancreatic cancer is due to its difficulty in finding this cancer early.
By the time a person has symptoms, the cancer has often reached a large size and spread to other organs. Because the pancreas is deep inside the body, the doctor cannot see or feel tumors during a routine physical exam. There are currently no blood tests or other tests that can easily find this cancer early in people without symptoms. Tests for certain genes in people with a family history of the disease can help tell if they are at higher risk for cancer. There are some new tests for finding pancreatic cancer early in people with a strong family history of the disease, but these tests are complicated and expensive.
Some symptoms of pancreatic cancer include jaundice, a yellow color of the eyes and skin caused by a substance buildup in the liver, pain in the belly area or in the middle of the back, significant weight loss over a number of months, loss of appetite, digestive problems including nausea, vomiting, pain that tends to be worse after eating, a swollen gallbladder that is enlarged, blood clots that form in the veins or cause problems with fatty tissue under the skin, and diabetes.
If the doctor has any reason to suspect pancreatic cancer, certain tests will be done to see if the disease is really present. The exam will focus mostly on the abdominal area. The doctor will usually check the lymph nodes or the liver for swelling and the skin and white part of the eyes for jaundice. What causes pancreatic cancer, and how can it be prevented? Although the cause for pancreatic cancer cannot be determined, several risk factors have been linked to the disease. The risk of this cancer goes up with age.
Almost all patients are older than fifty. The risk is more common to men having this cancer more often than women. Race wise, African Americans are more likely to have this cancer than whites. The risk of this cancer is higher among smokers. Heavy smoking raises the risk two to three times. About three out of ten cases of pancreatic cancer are thought to be caused by smoking. A diet high in meats and fat may raise the risk of this cancer. Eating more fruits and vegetables seems to offer some protection. Being obese might also increase the risk.
Pancreatic cancer is also more common in people with this disease. Some chemicals such as certain bug sprays, dyes, or gasoline products may raise the risk of this cancer if exposed to on an everyday basis. Cancer of the pancreas seems to run in some families. Changes in DNA that increase the risk for certain other cancers also increase the risk of this cancer. Having too much stomach acid or having bacteria called H. pylori in the stomach may also increase the risk of pancreatic cancer. So, can this harmful disease be prevented?
There is no sure way to prevent cancer of the pancreas at this time. For now, the best advice is to avoid smoking and to eat a healthy diet with plenty of fruits, vegetables, and whole grains. Keeping a healthy weight and exercising are important in an everyday lifestyle. Cutting down on red meats, especially those that are processed or high in fat is also beneficial advice in reducing the chances of getting pancreatic cancer. How is pancreatic cancer treated? The three main types of treatment for cancer of the pancreas are surgery, radiation therapy, and chemotherapy.
Depending on the stage of the cancer, two or even all of these treatments may be combined. There are two general types of surgical treatments used for cancer of the pancreas, curative and palliative surgery. Potentially curative surgery is used when imaging studies tell the surgeon that it is possible to remove all the cancer. Palliative surgery may be performed if imaging studies indicate that the tumor is too widespread to be completely removed. This surgery is done to relieve symptoms or prevent certain complications, such as blockage of the bile ducts or the intestine by the cancer.
Several studies have shown that removing only part of the cancer does not allow patients to live longer. Pancreatic cancer surgery is one of the most difficult operations a surgeon can do. It is also one of hardest for patients to undergo. The postoperative recovery is very slow, and there may be many complications and it may take several weeks for patients to recover. Intraoperative electron beam radiation therapy is also an approach to treating patients with cancers of the pancreas that is being studied at some cancer centers.
With this treatment, external beam radiation therapy using electrons is delivered from a machine in the operating room, while the operation is in progress. The advantage to this approach is that the doctors can move nearby organs aside temporarily and deliver a large dose of radiation to the pancreas without doing much damage to other organs in the area. So far though, intraoperative therapy hasn’t been shown to help patients live any longer than does standard external beam radiation therapy. Chemotherapy is the most commonly used treatment for the cancer of the pancreas.
Chemotherapy kills cancer cells but also damages some normal cells. Therefore, careful attention must be given to avoiding or minimizing side effects, which depend on the type of drugs, the amount taken, and the length of treatment. Researchers are continually searching for solutions into the causes and treatment of pancreatic cancer in many medical centers throughout the world. As cancer researchers and non profit agencies, such as the National Cancer Institute and the American Cancer Society, look to the future, molecularly targeted diagnosis and treatment will help eliminate cancers and the painful side effects.
Innovative imaging technology will make diagnosis and treatment more accurate and less persistent. New Nanotechnology promises to enable more precise therapies with far fewer adverse side effects. More and more people are benefiting from the medical advances that have improved both quality of life and length of survival for cancer patients. These strategic investments towards curing cancer provide vision and direction for the nationwide community of researchers, public health workers, healthcare providers, advocates, and patients working to defeat cancer.