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Pancreatic Cancer Awareness

Our mission is to provide excellent, extensive online resources for pancreatic cancer patients, patient advocates, friends and family members, and medical professionals - thereby also achieving the goal of expanding awareness horizons.


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New Cases in 2007

The American Cancer Society (http://www.cancer.org) predicted that, in 2007, about 37,170 people (18,830 men and 18,340 women) in the United States will have been found to have pancreatic cancer. Pancreatic cancer is the fourth leading cause of cancer death in men and women.

Deaths

An estimated 33,370 Americans died of pancreatic cancer in 2007, according to the ACS.
Over 188,000 people worldwide will die of pancreatic cancer this year.

Only about 24% of patients with cancer of the exocrine pancreas do not die of the disease within 1 year of diagnosis, and only about 4% have not died from the cancer 5 years after diagnosis. Even for those people diagnosed with local disease (has not spread to other organs), the 5-year relative survival rate is only 17%. (This is a huge improvement as two years ago the rate was only 4%.)

The main reason for the poor prognosis (outlook for survival) of cancer of the pancreas is that very few of these cancers are found early. Because the pancreas is located deep inside the body, early tumors cannot be seen or felt by health care providers during routine physical examinations. There are currently no blood tests or other screening tests that can accurately detect early cancers of the pancreas.

Another important reason that most pancreatic cancers are found at an advanced stage is that patients usually have no symptoms until the cancer has spread to other organs.

Rank

Pancreatic cancer is the eleventh most common cancer and the fourth leading cause of cancer death in men and in women. According to National Cancer Institute, The incidence rates of cancer of the liver, pancreas, kidney, esophagus, and thyroid have continued to rise while the four most common cancers have declined.

Brief Anatomy

The pancreas is a gland located in the upper middle portion of the abdomen and is surrounded by the stomach, duodenum (small intestine), spleen and liver. Shaped somewhat like an elongated fish, wide at one end and narrow at the other, it is about six inches long and two inches wide, with three sections: the head, the body and the tail. Among other functions, its islet cells produce insulin, which facilitates the uptake of glucose into cells.

Signs and Symptoms

Diagnosing pancreatic cancer is difficult because there are few early symptoms, and most can also caused by many other digestive disorders. These include:
Pain in the upper abdomen or upper back
Unexplained weight loss (more than 20 pounds)
Jaundice (yellowing) of the skin and the whites of the eyes
Dark urine
Unusually light-colored stool
Abdominal pain, often spreading to the lower back, and/or abdominal enlargement
Enlargement of the gallbladder
Loss of appetite
Nausea and vomiting, sometimes diarrhea
Fatigue/Weakness
Blood clots or fatty tissue abnormalities anywhere in the body
Itching

Risk

Although the causes of pancreatic cancer remain unknown, factors have been identified that increase a person's risk for the disease. These include:

Age:

Risk increases after the age of 50, with most cases diagnosed in people older than 60.

Gender:
Men are more slightly likely to develop cancer of the pancreas than are women.
Race:
African-Americans are more likely than white Americans, Hispanic-Americans, or Asian-Americans to develop this malignancy.
Cigarette smoking:
Cigarette smokers are two or three times more likely than nonsmokers to develop pancreatic cancer.
Chemical carcinogens:
There is evidence that exposure to gasoline, metallurgic fumes and certain pesticides increases the risk of developing pancreatic cancer.
Family history:
The risk for developing pancreatic cancer triples if a person's mother, father, sister, or brother had the disease. Also, a family history of colon or ovarian cancer increases the risk of pancreatic cancer.
Diabetes mellitus:
Pancreatic cancer occurs more often in people who have diabetes than in people who do not.

Stomach surgery:
Risk increases following certain operations to treat ulcers of the stomach or small intestine.

Chronic pancreatitis
Chronic pancreatitis is a painful condition of the pancreas. Some evidence suggests that chronic pancreatitis may increase the risk of pancreatic cancer.

Other studies suggest that exposure to certain chemicals in the workplace or a diet high in fat may increase the chance of getting pancreatic cancer.

Most people with known risk factors do not get pancreatic cancer. On the other hand, many who do get the disease have none of these factors. People who think they may be at risk for pancreatic cancer should discuss this concern with their doctor.

Early Detection

There are no blood tests or other screening exams that can conclusively detect early-stage pancreatic cancer. When symptoms are present, tests and exams are performed to rule out other diseases as well as determine whether a person has cancer of the pancreas. These include:
  CT scan or MRI
  Ultrasonography - The ultrasound procedure may use an external or internal device, or both types:
  Transabdominal ultrasound: To make images of the pancreas, the doctor places the ultrasound device on the abdomen and slowly moves it around.

  EUS (Endoscopic ultrasound): The doctor passes a thin, lighted tube (endoscope) through the patient's mouth and stomach, down into the first part of the small intestine. At the tip of the endoscope is an ultrasound device. The doctor slowly withdraws the endoscope from the intestine toward the stomach to make images of the pancreas and surrounding organs and tissues.

  ERCP (endoscopic retrograde cholangiopancreatography) - The doctor passes an endoscope through the patient's mouth and stomach, down into the first part of the small intestine. The doctor slips a smaller tube (catheter) through the endoscope into the bile ducts and pancreatic ducts. After injecting dye through the catheter into the ducts, the doctor takes x-ray pictures. The x-rays can show whether the ducts are narrowed or blocked by a tumor or other condition.

  PTC (percutaneous transhepatic cholangiography) - A dye is injected through a thin needle inserted through the skin into the liver. Unless there is a blockage, the dye should move freely through the bile ducts. The dye makes the bile ducts show up on x-ray pictures. From the pictures, the doctor can tell whether there is a blockage from a tumor or other condition.
  Biopsy - In some cases, the doctor may remove tissue. A pathologist then uses a microscope to look for cancer cells in the tissue. The doctor may obtain tissue in several ways. One way is by inserting a needle into the pancreas to remove cells. This is called fine-needle aspiration. The doctor uses x-ray or ultrasound to guide the needle. Sometimes the doctor obtains a sample of tissue during EUS or ERCP. Another way is to open the abdomen during an operation.

Scientists are learning more about some of the changes in DNA that cause cells in the pancreas to become cancerous.

Because abnormal genes that encourage tumor growth have been found in many pancreatic cancers, scientists are working to find ways to replace these genes with normal ones. The most widely studied gene in cancer is p53.

Biological therapy is also under investigation. Scientists are studying several cancer vaccines to help the immune system fight cancer. Other studies use monoclonal antibodies to slow or stop the growth of cancer.

Experimental treatments that boost the patient's immune reaction to fight pancreatic cancer more effectively are being tested in clinical trials.

Treatment

The 3 main types of treatment for cancer of the pancreas are surgery, radiation therapy, and chemotherapy. Depending on the stage of the cancer, 2 or even all of these types of treatment may be combined at the same time or after one another.
Surgical procedures used to treat pancreatic cancer include:

Total or partial pancreatectomy
-- removal of all or part of the pancreas, plus part of the small intestine, a portion of the stomach, the common bile duct, the gallbladder, the spleen, and nearby lymph nodes.
Whipple procedure
-- Removal of the head of the pancreas, as well as part of the stomach, the lower half of the bile duct, part of the small intestine, and lymph nodes near the pancreas. The gallbladder and part of the common bile duct are removed and the remaining bile duct is attached to the small intestine so that bile from the liver continues to enter the small intestine.

Sometimes the cancer cannot be completely removed. But if the tumor is blocking the common bile duct or duodenum, the surgeon can create a bypass. A bypass allows fluids to flow through the digestive tract. It can help relieve jaundice and pain resulting from a blockage.

The doctor sometimes can relieve blockage without doing bypass surgery. The doctor uses an endoscope to place a stent in the blocked area. A stent is a tiny plastic or metal mesh tube that helps keep the duct or duodenum open.

Chemotherapy and radiation are often used for inoperable pancreatic cancers.

What's New

Clinical Trials

The National Cancer Institute has mortality maps and graphs, as well as other information and resources.



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Top of page    Online resources    More Online resources
FREE monthly drawing    Decker Family    Memorial Page 



Family and Friends of Barbara Decker
Mourn Her Passing

Our friend Barbara Decker died of pancreatic cancer
    at 2:53 a.m. on March 17, 2000.

Email from the Family

Early on St Patrick's Day 2000, just before 3:00 am, Barb passed away.
Her difficult battle is over.
She is now at peace and in God's hands.
God Bless you Barb. We love you so very much.


If you are able to make a donation to any of the cancer research centers/foundations listed on our Online Resources pages,
please do so in the name of Barbara Decker.

Thank you!


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