Wellness Wednesday: Facing Pancreatic Cancer

Steve Jobs. Patrick Swayze. Michael Landon. Alan Rickman.

instagramshareablegraphicThese are just a few of the celebrities who have died from pancreatic cancer.

November is National Pancreatic Cancer Awareness Month. Pancreatic cancer is the deadliest major cancer among all Americans. The five-year survival rate after diagnosis is just 7%. The reason for the low survival rate is because it is hard to detect until it has already spread to other areas of the body.

What is the Pancreas?

You’ve heard of the pancreas. You probably know it’s important. You know it has something to do with digestion and you maybe even heard talk about it around the topic of diabetes.

17194But what is it and what does it do?

The pancreas is a gland located in the abdomen. It is about six inches long and is shaped like a pear. It is surrounded by the stomach, small intestine, liver, spleen and gallbladder. The pancreas is both an exocrine gland and endocrine gland and has two main functions—digestion and blood sugar regulation.

Exocrine glands are glands that produce and secrete substances by way of ducts. Examples include the salivary glands and sweat glands. The exocrine cells of the pancreas produce enzymes that help with digestion. When food enters the stomach, exocrine cells release the pancreatic enzymes into the main pancreatic duct. The pancreatic duct carries these enzymes and other secretions, collectively called pancreatic juice. Both the main pancreatic duct and the common bile duct connect with the duodenum, where they aid with the digestion of fats, carbohydrates and proteins.

Endocrine glands are glands that produce and secrete substances directly into the blood rather than through a duct. Examples include the thyroid gland, pituitary gland and adrenal glands. The endocrine cells of the pancreas produce hormones, which are substances that control or regulate specific functions in the body. The two main pancreatic hormones are insulin and glucagon. Insulin lowers blood sugar levels while glucagon raises blood sugar levels. Together, these two main hormones work to maintain the proper level of sugar in the blood.

As you can imagine, if the pancreas is not functioning properly, it can cause a number of conditions including diabetes or hyper- and hypothyroidism.

What is Pancreatic Cancer?

pancreaticcancerPancreatic cancer begins when abnormal cells within the pancreas grow out of control and form a tumor. More than 95% of pancreatic cancers are classified as exocrine tumors. These tumors start in the exocrine cells. Within this category, the vast majority of tumors are adenocarcinomas. The following table describes the different types of pancreatic exocrine tumors. Click here to learn about types of exocrine tumors in the pancreas.

Pancreatic neuroendocrine tumors (pancreatic NETs or PNETs) account for less than 5% of all pancreatic tumors. They may be benign or malignant and they tend to grow slower than exocrine tumors. They develop from the abnormal growth of endocrine cells in the pancreas. Steve Jobs was diagnosed with this type of tumor in 2004 and lived for another seven years.

Pancreatic neuroendocrine tumors are either functional (produce hormones) or nonfunctional (produce no hormones). The majority of PNETs are nonfunctional tumors.  Click here to learn about types of endocrine tumors in the pancreas.

Symptoms of Pancreatic Cancer

Click to enlarge

The problem with diagnosing pancreatic cancer is that it is hard to find early. The pancreas is deep inside the body, so early tumors can’t be seen or felt by health care providers during routine physical exams. And patients often have no symptoms until the cancer has already spread to other organs.

Sometimes when a person has pancreatic cancer, the levels of certain proteins in the blood go up. These proteins, called tumor markers, can be detected with blood tests. But these proteins don’t always go up when a person has pancreatic cancer, and even if they do, the cancer is often already advanced by the time.

People with pancreatic cancer may show signs of jaundice—a yellowing of the eyes and skin—as one of their first symptoms. They may also begin to have pain in the abdomen or back. Cancers that start in the body or tail of the pancreas can grow fairly large and start to press on other nearby organs, causing pain. If the cancer blocks the bile duct, bile can build up in the gallbladder, making it larger. Sometimes a doctor can feel an enlarged gallbladder during a physical exam. It can also be seen on imaging tests. Other symptoms include unexplained weight loss, fatigue, loss of appetite and dark urine.

Having one or more of the symptoms below does not mean you have pancreatic cancer. In fact, many of these symptoms are more likely to be caused by other conditions. But if you notice something different or have several of these symptoms, it is important to talk to your physician.

Pancreatic Cancer Risks

Some people might be at increased risk of pancreatic cancer because of a family history of the disease (or a family history of certain other cancers). Sometimes this increased risk is due to a specific genetic syndrome. Some of the gene changes that increase pancreatic cancer risk can be tested for. Knowing if you are at increased risk can help you and your doctor decide if you should have tests to look for pancreatic cancer early, when it might be easier to treat. But determining whether you might be at increased risk is not simple.

The American Cancer Society strongly recommends that anyone thinking about genetic testing talk with a genetic counselor, nurse or doctor qualified to interpret and explain the test results before they proceed with testing. It’s important to understand what the tests can and can’t tell you, and what any results might mean, before deciding to be tested.

What Can You Do?

facebook-sharing-photoThere is no absolute way to prevent pancreatic cancer. Some risk factors such as family history can’t be controlled. But there are things you can do that might lower your risk.

  • Don’t smoke
  • Stay at a healthy weight
  • Limit alcohol intake

If you are worried about family risk factors or if you have some of the symptoms above, talk to your doctor. There is a very good chance that it is something else entirely. But a professional can look through your medical history and make recommendations as to next steps.

The only way to improve survival rates is to promote awareness, healthy living and regular health checkups, and to keep funding research into this disease.

Sources: American Cancer Society, NCI, Pancreatic Cancer Action Network

More Information:

American Cancer Society

National Cancer Institute

Pancreatic Cancer Action Network

Know Your Pancreas [PDF]

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