Pancreatic cancer, while less commonly diagnosed than other forms of cancer, can be difficult to treat, especially since it can be hard to detect in its early stages. According to the American Cancer Society, about 64,000 people in the United States will be diagnosed with pancreatic cancer this year. Treatment options range from immune and radiation therapies, to chemo and surgery, though surgery is required to cure pancreatic cancer.
The pancreas is located in your abdomen, between your stomach and spine. Its function is to make hormones that control your blood sugar levels as well as enzymes that aid in digestion. When someone has pancreatic cancer, a tumor, or tumors, have formed in the pancreas.
Unfortunately, pancreatic cancer often doesn't cause any symptoms in its earliest stages, when it's most treatable. Symptoms often arise when the tumors have grown, or metastasized, and begin affecting other organs within your digestive system. Some signs of pancreatic cancer can include jaundice, or yellowing of the eyes and skin; abdomen or back pain; weight loss; poor appetite; nausea and vomiting; gallbladder or liver enlargement and blood clots. It’s important to speak to your health care provider if you are experiencing any of these symptoms.
There are some risk factors that correlate to pancreatic cancer, including smoking or using tobacco; obesity; diabetes; especially sudden-onset diabetes; exposure to pesticides or other chemicals and chronic pancreatitis, or inflammation in the pancreas.
In order to completely remove tumor(s) from the pancreas, surgery is necessary. Patients who have large tumors may undergo neoadjuvant therapy prior to surgery, which uses chemotherapy and immunotherapy to shrink the tumors, making the surgery safer. This also prevents any circulating tumor cells from planting themselves in other places in the body, and prevents further tumor progression.
There are multiple surgical procedures that can be performed, and they're dependent on the location of the tumor.
- A distal pancreatectomy is used for for tumors in the body and tail of the pancreas; the left half of the pancreas is removed, along with the spleen.
- The entire pancreas is removed in a total pancreatectomy. This procedure is used rarely, because the pancreas is a vital organ that works to help digest food and manage blood sugar. Removing it completely requires lifelong insulin and enzyme replace.
- If you're a Grey's Anatomy fan, you might recognize the Whipple procedure. The Whipple operation is relatively long, but is life-saving when done safely and effectively by specially-trained surgeons. The Whipple is used when the tumor is located in the head of the pancreas. It’s a complex surgery that removes the pancreatic head, the first part of the small bowel, or duodenum, and the end segment of the bile duct with the gallbladder. Then, the surgeon connects the stomach, bile duct and pancreatic body to the small bowel.
Mohamed Elgamal, M.D., is a surgical oncologist at MyMichigan Health.
