What are the beginning signs of pancreatic cancer?

Cancer of the Pancreas

What is the pancreas? 

It is a pulpy, flat gland about 5 inches long by a few inches high, which lies far back on the rear wall of the upper abdominal cavity. The part it plays in the body is a vital and specialized one. It manufactures digestive juices which are passed through the pancreatic duct into the intestine for digestion of proteins, fats, and carbohydrates. Insulin, which is essential for the utilization of sugar, is manufactured in the pancreas and deposited directly into the bloodstream. A duct, called the pancreatic duct, runs through the entire length of the pancreas. The pancreas is often referred to as having a head, a body, and a tail. The head fits into the curve of the duodenum on the right, close to the common bile duct, and the tail curves up toward the spleen. At the head of the pancreas there is often a branching of the main pancreatic duct. These ducts are responsible for collecting the digestive juices manufactured by the gland and depositing them through their openings into the small intestine.

What are the beginning signs of cancer of the pancreas? 

A variety of symptoms that can also be the signals of diseases other than cancer of the pancreas, as well as the hidden location of the pancreas, combine to make cancer difficult to diagnose. For this reason, pancreatic cancer is often advanced before it is detected. Cancer in the head of the pancreas, because it involves the common bile duct, usually causes jaundice, and often there is intense itching of the skin. There may be some abdominal pain and discomfort, nausea, diarrhea, belching, a feeling of fullness, and intolerance of fatty foods. Weight loss, loss of appetite, and loss of strength or energy may be other symptoms. The color of the bowel movement may be affected, being foamy, clay colored, or, more rarely, silvery in color. All of these symptoms might also be present when there are cysts or benign tumors in the pancreas. Another set of symptoms can present themselves in cases where the tumor is located in the body portion of the pancreas. Severe back pain may be present as the result of the size of the tumor. The pain may worsen after eating or when lying down and be slightly relieved when bending forward or sitting. The disease is so difficult to diagnose that the majority of patients are treated for 3 to 6 months for other causes before actual diagnosis of the pancreatic cancer is made.

What tests will the doctor need? 

The doctor will usually order barium x-rays, liver function studies, and angiography to determine more clearly where the tumor is located.

Can cysts in the pancreas turn into cancer? 

Rarely will a cyst in the pancreas become cancerous. Usually, cysts can be removed successfully with a good chance of recovery. If allowed to remain they can continue to grow and cause serious problems in pancreatic activity. It is important to remember that all cysts, tumors, or inflammations of the pancreas do not indicate the presence of cancer.

Can the doctor tell whether or not the condition of the pancreas is cancerous before he operates?

Usually he cannot. Benign tumors and growths often grow in the pancreas, causing the cells that produce insulin to overproduce, causing symptoms that include intense hunger, trembling, fainting, confusion, or convulsions. The operation to remove a cyst is a low risk one. However, if the presence of cancerous cells is found, it may be necessary to operate so as to bypass the obstruction or to remove the entire gland. Then it becomes a complicated operation.

What kinds of cancer of the pancreas are there? 

There are two kinds of cancer of the pancreas: islet cell carcinoma of the endocrine pancreas and adenocarcinoma of the exocrine pancreas. Cancer of the endocrine pancreas is a highly treatable and often curable collection of tumors. Cancer of the exocrine pancreas, on the other hand, is much more difficult to treat and is not often curable.

How does the doctor decide if there is cancer in the pancreas? 

The only certain way at present is through a biopsy which in this case requires a laparotomy. However, many experimental programs are under way to help aid better diagnosis, such as endoscopy, ultrasound, CT scans, and CEA. Doctors agree that ultrasound looks promising in diagnosing small pancreatic cancers earlier.

What is a laparotomy? 

A laparotomy is a surgical operation to open the abdominal cavity either to make an inspection or to perform surgery. 

What does the incision look like, and where is it? 

The incision for a laparotomy is about 4 or 5 inches long and is located in the upper abdomen. 

The doctor says I'll need more than one operation. Why? 

Sometimes operations for cancer of the pancreas are done in several steps.

How long does the operation take? 

The operation to remove a localized tumor or cyst of the pancreas takes 1 to 3 hours. If the entire pancreas is to be removed, the operation can take anywhere from 3 to 6 hours.

What happens when the entire gland is removed? 

The operation to remove the entire gland and the adjacent duodenum, called a pancreaticoduodenectomy, is one ofthe most extensive in all surgery. The bile duct and the stomach are both reconnected into the small intestine. This is a highrisk operation, not often performed. It can be successful in those cases in which the tumor has not spread to other organs.

Can a person live with only part of the pancreas or without the pancreas? 

Yes, an active, comfortable existence is possible when medicines are prescribed to substitute for the function of the pancreas.

What happens if the cancer has spread beyond the pancreas?

 If the cancer has spread and is in places where it cannot be removed, the prognosis is very serious.

Would the doctor advise against surgery? 

Since this cancer is so difficult to diagnose, surgery is usually a necessity. If cancer is not the cause, the surgery will determine this happy diagnosis. If cancer is the cause, the doctor can at least relieve the jaundice and the exasperating itching through surgery, even when the cancer cannot be removed. Sometimes, when the patient is elderly or has other health problems which put him in a high risk category, surgery will not be attempted.

What sort of operation is performed? 

If possible, the tumor of the pancreas, the surrounding bile duct, and part of the stomach and intestine are removed, and everything is rejoined. If that is not possible, a new opening is made for the bile, to relieve the jaundice and help in the digestive process.

What are the chances for cure of exocrine cancer of the pancreas? 

Of course it depends upon many factors. However, it is important for the patient with exocrine pancreatic cancer to understand the seriousness of the condition and the risks. Because it is usually found late and has frequently spread to nearby organs, the five year survival rate at the present time is only 2 percent.

Will I need transfusions and other intravenous medication? 

Yes. This is an extremely serious operation. Blood transfusions may be needed during and after the operation. Intravenous feedings, medications, and special drugs will be used to help speed recovery. You will usually not be allowed out of bed until several days after the operation. 

What are the aftereffects when the pancreas is removed? 

The recovery period will be a long one, and a permanent low sugar, low fat diet will be essential. Vitamin K will probably be prescribed. Because of the restricted diet, it is very difficult to gain weight, which makes recovery slower than usual.

When will I be able to get back to work? 

Convalescence will take from 2 to 6 months. Physical exercise should be postponed for 4 to 6 months. About 2 months after the wound is completely healed, you will be able to resume some of your normal activities.

Will radiation therapy or chemotherapy be prescribed? 

Sometimes radiation therapy is used after surgery. In other cases chemotherapy is used, either alone or in combination with the radiation therapy. The drug 5-Fluorouracil has been used with some success; other drugs are being evaluated.

Are most doctors qualified to diagnose and operate for pancreatic cancer? 

This is a difficult diagnosis and a very specialized area. Major medical centers, especially those specializing in cancer treatment, have had more experience than smaller local hospitals. You should ask your doctor to check with the clinical cooperative groups in your area for information on new treatments or to see if you can be admitted into one of the controlled studies being conducted on pancreatic cancer.

Comments

Post a Comment

Popular Posts

Where does Melanoma most often metastasize?

Image
What is malignant melanoma? Malignant melanoma is a less common form of skin cancer . When diagnosed early, it is easily cured. But if it is not found soon enough, it can be very difficult to treat. It is dangerous because, unlike the other skin cancers, it mestastasizes early and spreads quickly. It is one of the more uncontrollable cancers. The cell involved is the melanocyte, the cell which produces melanin, the dark protective pigment of the skin . What is the difference between an ordinary mole and melanoma? An ordinary mole is evenly colored, and either brown, tan or black. It may be flat or raised. It is round or oval and its edges are sharply defined. An ordinary mole is usually less than 6 millimeters in diameter about the size of a pencil eraser. Ordinary moles may be present at birth. Sometimes several appear at the same time, usually on areas of the skin which have been exposed to the sun. Once the mole develops, it usually stays the same size, shape and color for ma...
Read more

Oral(Mouth) Cancer: Symptoms, Bleeding, Treatment and Diagnose

Image
What kinds of cancers are found in the mouth? The cancers of the mouth (oral cavity) include the lip, tongue, floor of the mouth, cheeks (buccal mucosa), and gums (gingivae). Who is at high risk to get cancer of the mouth? This cancer is predominantly found in men between the ages of 60 and 70. People who are heavy smokers (more than a pack a day), drink alcohol heavily, are over 45, and have a family history of this kind of cancer are at a higher risk to develop cancers of the oral cavity, the mouth, and the throat. Is cancer of the mouth easy to detect? Yes, it is usually discovered early, since it can be seen easily. White patches ( leukoplakia ), velvety red spots (erythroplasia), or dark patches are symptoms which should be seen by a doctor, who will do a biopsy of them. Many cancers of the mouth are first discovered by dentists. What are the symptoms of oral cancer? The warning signs of oral cancer are as follows: • A lump in the cheek that can be felt with the ...
Read more

Ejaculation and sexual life problems after prostate surgery

Image
Yes. After prostatectomy , the ability to ejaculate through the penis is lost. What happens is that ejaculation occurs but it is directed backward into the bladder , rather than forward through the urethra. The semen remains in the bladder until urination, and is carried out via that route. The man who ejaculates in this manner has the very same sensations during sex that he had before except that there is no discharge through the penis. Can a total prostatectomy be done without impairing the ability to have an erection?  Dr. Patrick C. Walsh, a surgeon at Johns Hopkins University Hospital in Baltimore, Maryland, has developed a way of removing the prostate which preserves potency by bypassing the intricate nerve branches of the pelvic plexus. This technique is now being adopted by many surgeons for patients with early stage prostate cancer. Until the advent of this type of surgery, 90 percent of those having prostatectomies lost their sexual ability, and 2 to 5 percent becam...
Read more

How to know if your ankle is broken? How is a broken ankle treated?

Image
Fractures of the Ankle How do ankle fractures occur?  Ankle fractures are caused by a forceful and excessive twisting of the ankle , either in or out. The twist comes from stumbling, catching the foot in a crevice, or falling, in which the weight of the body is unevenly distributed. Many skiers suffer fractured ankles, and some of the best treatments have been evolved by surgeons practicing near ski slopes. The stress and strain factors in the ankle are so uniform that the pattern of the injury, dislocation and deformity is specific. Many varieties of ankle fractures are grouped together under the name of Pott's fracture. What shall I do, Doctor? I'm at a gas station phone and my wife just fell down and twisted her ankle.  If it is painful and she can't walk, it may be a fracture. Don't manipulate it, don't pull it. Just wrap a towel or pillow around it and take her to a hospital for an X ray. It is best if she does not walk. You can carry her in a chair. ...
Read more

How painful is a bone marrow transplant for the donor

Image
What is a bone marrow transplant?  Bone marrow transplantation is an approach used over the past 10 years for the treatment of acute leukemia and lymphoma. It is a complex procedure and should be undertaken only by physicians with the experience and resources needed to get the best results. When is a bone marrow transplant used?  It may be used in some cases of several types of diseases aplastic anemia (when patients do not have enough red cells to carry oxygen, enough white cells to fight bacteria, or enough platelets to help clotting), in some types of acute and chronic leukemia, for some lymphomas, for severe combined immunodeficiency syndrome, and for certain inherited blood disorders such as thalassemia. A bone marrow transplant replaces a patient's abnormal or diseased marrow with healthy marrow from a donor. Can any leukemia patient undergo a bone marrow transplantation?  No. When patients and doctors consider the possibility of treatment with a bone marr...
Read more

What are the most important side effects of taking female hormones?

Image
Would the doctor prescribe estrogen if my ovaries were removed because of cancer?  No. If there is any sign of a cancerous condition, estrogen would probably not be prescribed.  What is the estrogen controversy?  Estrogen is a female hormone produced by the ovaries. Scientists have also developed chemical estrogen. Both regulate the development of female sexual characteristics. For a number of years, estrogens have been prescribed for women during and after menopause to make up for the decline in this hormone normally produced by the ovaries. Estrogen has been found helpful in relieving symptoms associated with menopause, such as hot flashes, in overcoming drying of vaginal tissues and in retarding osteoporosis (thinning of bones). However, the use of estrogen during and after menopause has been linked to an increase in endometrial cancer (cancer of the lining of the uterus), and it may be linked to other cancers as well. At this time,scientists do not agree a...
Read more

What is the symptoms of a head concussion? Is concussion a brain injury?

Image
Head Injuries The brain is man's most vital possession. Recent details about organ transplants have centered on the definition of death. These discussions have emphasized that, even though the heart may continue to beat, the individual is considered dead if there is no brain activity. Nature provides a thick scalp and skull to protect the brain and further encloses it in envelopes called the meninges. Some injuries to the head may be trivial, others may be fatal. The surgeon who is called upon to evaluate the patient with a head injury tackles the problem from within out. Damage to the brain and its envelope is most important; injury to the skull is of concern in only some instances. Bleeding from the scalp is the most apparent manifestation of injury but is the least important. Survival and the late effects of a head injury depend on the extent of the injury to the brain and not to its coverings. The best possible supportive medical crre is provided to those who will reco...
Read more

How is a broken or cracked rib treated?

Image
Chest Injuries The chest consists of the bony thorax and the organs that lie within it. The thorax comprises twelve ribs on each side of the chest, each of which attaches to the bony spine in the back and to the chest bone ( sternum ) in front. Each chest cavity has a smooth delicate lining ( pleura ) within which the lung rhythmically expands and deflates. The diaphragm is the dome shaped muscle that seals off the lower end of the chest from the abdomen. Its upand down motion provides the bellows action for the expansion of the lungs that fills them with air. The function of the lungs is to provide ventilation. Air is moved in to provide oxygen, and carbon dioxide is moved out as a waste product. The heart is in its own envelope in the center of the chest, behind the breastbone. The heart functions solely as a pump. It circulates the blood into the lung for oxygenation and delivers oxygenated blood to the entire body. The chest also harbors the large blood vessels and the br...
Read more

The most important difference between Hodgkin's disease and non-hodgkin's lymphoma

Image
Hodgkin's Disease and Non-Hodgkin's Lymphoma What are lymphomas? Lymphomas are cancers that affect the white blood cells of the immune system. They are characterized by the abnormal growth of lymphocytes, the infection fighting cells in the lymph nodes, spleen, and thymus. The tonsils, stomach, small intestine, and skin may also be affected. Lymphomas are usually classified as Hodgkin's disease, the most common form, or non-Hodgkin's lymphoma. There are also other rare forms of the disease, such as mycosis fungoides, a primary skin lymphoma. Burkitt's lymphoma , rare in most of the world, is the most common childhood cancer in central Africa and is one of the fastest growing human cancers. What is the role of the lymph system in the body?  The lymph system is made up of nodes and thin walled tubelike veins along which the nodes lie. Its job is to help fight diseases and infection, and it serves as part of the body's drainage system. Lymph nodes are ...
Read more

Common Hand Injuries: Treatment for swollen hand due to injury

Image
Hand Injuries Most of us earn our living with our hands. The goal of the treatment of hand injuries is maximum preservation of function. In terms of possible permanent disability, there is no minor surgery in this area. The magnitude of the problem is apparent in the frequency with which it appears in the statistics of the Workmen's Compensation Board and insurance companies. The best treatment is prevention. One must be constantly alert to the possibility of punctures, door slams, burns, pressure injuries, and the perverse potential of certain mechanical tools. Failing this, early treatment to prevent infection is best. There are relatively clearly defined methods of managing various types of injury. The patient can describe the site of the injury by indicating its relation to the various creases in the palm or to the knuckles and nails on the back of the hand. Physicians can treat all hand and finger injuries under some form of nerve blocking anesthesia, so the patient feels...
Read more