INTRODUCTION: Pancreatic cancer is a condition in which malignant (cancer) cells are produce in the tissues of the pancreas a large organ that lies horizontally behind the lower part of your stomach. It is difficult to find and diagnose for the following reasons: There aren't any obvious signs or symptoms in its beginning stages. It typically spreads (metastasizes) quickly and is seldom detected in its early stages, which is a primary reason why it's a leading cause of cancer deaths. Pancreatic cancer often has a poor prognosis (outcome), even when diagnosed early and may occasionally result in diabetes.



TYPES: Several different kinds of cancer can develop in the pancreas. The pancreas contains two different kinds of glands: exocrine and endocrine. The exocrine cells and endocrine cells of the pancreas produce completely different types of tumors. These are far and away the most common kinds of cancer of the pancreas.

Less common forms of ductal cancers of the exocrine pancreas include adenosquamous carcinomas, squamous cell carcinomas, and giant cell carcinomas. These forms are distinguished from each other based on how they look under the microscope. But the type of exocrine pancreatic cancer isn't as important as the stage (extent) of the cancer when it comes to treating the disease.

SYMPTOMS: Early diagnosis is difficult because the signs of the cancer are often non-specific and varied. Usual symptoms include pain in the upper abdomen that typically radiates to the back and is relieved by leaning forward (seen in carcinoma of the body or tail of the pancreas), lack of appetite, significant loss of weight and painless jaundice (yellowing of the eye and skin) related to bile duct obstruction (carcinoma of the head of the pancreas).

The disease is usually discovered during the course of the evaluation of aforementioned symptoms. Patients diagnosed with it typically have a poor prognosis partly because the cancer usually causes no symptoms early on, leading to locally advanced or metastatic disease at the time of diagnosis. Signs and symptoms may not appear until the cancer is quite advanced and surgical removal isn't possible.

Patients typically report the gradual onset of nonspecific symptoms such as anorexia, malaise, nausea, fatigue, and midepigastric or back pain. These initial symptoms can be easily attributed to other processes unless a physician has a high index of suspicion for the possibility of underlying pancreatic carcinoma. Delayed diagnosis is a common problem in patients with pancreatic cancer, with fewer than a third of patients being diagnosed within 2 months of the onset of their symptoms. All of these symptoms can have multiple other causes.

RISK: Age is the most significant risk factor for pancreatic carcinoma. Risk factors include smoking, certain familial cancer syndromes, and familial chronic pancreatitis. Smoking is the most common environmental risk factor for pancreatic carcinoma. Cigarette smoking nearly doubles one's risk, and the risk persists for at least a decade after quitting.

Several studies including one published on 1 June 2007, indicate that B vitamins such as B12, B6, and folate, can reduce the risk of pancreatic cancer when consumed in food, but NOT when ingested in vitamin tablet form. In September 2006, a long-term study concluded that taking Vitamin D can substantially cut the risk of pancreatic carcinoma (as well as other cancers) by up to 50%.

Obesity has been identified as a possible risk factor for pancreatic cancer and may contribute to the higher incidence of this disease among blacks. Alcohol consumption does not appear to be an independent risk factor unless it is associated with chronic pancreatitis. Also, despite early reports to the contrary, coffee consumption does not appear to be an independent risk factor for pancreatic carcinoma.

TREATMENT: The first goal of pancreatic cancer treatment is to get rid of the cancer, when possible. It depends on the stage and location of the cancer as well as on your age, degree of health and personal preferences.

Surgical resection is the only potentially curative treatment for patients with Cancer of the pancreas, although many patients are not candidates for resection. When the disease is advanced and treatments aren't likely to offer any benefits, your doctor may suggest ways to relieve symptoms and make you as comfortable as possible Or...your doctor may recommend a combination of radiation and chemotherapy treatments when your cancer can't be treated surgically.

Clinical trials are studies to test new kinds of treatment, such as new drugs, new approaches to surgery or radiation treatments, and novel methods such as gene therapy. If the treatment being studied turns out to be safer or more effective than are treatments currently used, it will become the new standard of care.

New treatments now under investigation in clinical trials include: Drugs that stop cancer from producing new blood vessels. Cancer treatment vaccines using various strategies to enhance the immune system to help it recognize cancerous cells as intruders.

CONCLUSION: Cancer of the pancreas is a malignant tumor of the pancreas. It is hard to detect and diagnose early and is most often diagnosed with tests and procedures that produce pictures of the pancreas and the area surrounding it. Risk factors include: Age, Male gender, African-American ethnicity, Tobacco smoking, Diets high in red meat, Obesity, Diabetes mellitus.

Also: Chronic pancreatitis has been linked, but is not known to be causal, Helicobacter pylori infection, Occupational exposure to certain pesticides, dyes, and chemicals related to gasoline, Family history, 5-10% of patients have a family history of pancreatic cancer. Alcohol might also be a risk factor. The disease has a five-year survival rate of less than 5 percent, and currently there is no effective chemotherapy or radiation therapy for it.