Patient Info

Pancreatic Conditions

Pancreatic Cancer

Pancreatic Cancer mostly arise from cells that line the Pancreatic ducts and usually occur at the head of the Pancreas. Organs and tissues in the body are made up of cells Cells normally repair and reproduce. This process can go wrong and the cells can reproduce without stopping eventually they produce a lump called a tumour.

The Pancreas
Cancer of the Pancreas what is it?
What causes it?
What happens in Pancreatic Cancer?
How will it be diagnosed?
How will it be treated?
How do I live without a Pancreas?

1. The Pancreas

What is it?

A solid gland that is 20-25 cm long
It can be divided into 5 parts; head, uncinate process, neck, body and tail

What does it do?

Produces 30 or so enzymes that help us digest carbohydrates, proteins and fats by breaking them down into small pieces to allow our intestines to absorb them
Produces insulin and glucagon which help us maintain the amount of glucose (sugar) in our blood and the rest of our body

Where is it?

Firmly attached to the back of the abdominal cavity behind the stomach
The head is attached to the duodenum. The duodenum is the first part of the small intestine, into which the stomach empties
The main Pancreatic duct opens into the duodenum allowing the release of enzymes into the intestines
The head is below the right ribcage
The body and tail lie at an angle so that the tail is beneath the left rib cage

What diseases affect the Pancreas?

There are two main conditions:

Pancreatitis (inflammation of the Pancreas)
Cancer of the Pancreas

2. Cancer of the Pancreas what is it?

Organs and tissues in the body are made up of cells
Cells normally repair and reproduce
This process can go wrong and the cells can reproduce without stopping
Eventually they produce a lump called a tumour
There are two types of tumour

Benign (does not spread to other parts of the body)
Malignant (can spread to distant sites and may also invade and destroy surrounding tissue. It usually spreads via the bloodstream or the lymphatic system)

There are many different types on cancer; one form is cancer of the Pancreas
Pancreatic Cancer mostly arise from cells that line the Pancreatic ducts and usually occur at the head of the Pancreas

3. What causes it?

Little is known
Cigarette smoking has been linked
It is more common in people over 60 and in men
Cronic Pancreatitis is also a possible cause
It does not run in families

4. What happens in Pancreatic Cancer?

If the cancer is in the head of the Pancreas, it may block the bile duct, which carries bile from the liver to the intestine
Bile is thus trapped in the body and so the skin and whites of the eyes become yellow. Urine becomes dark yellow and your stools go pale. (Link to Liver and Bile Duct). This is called jaundice
It may also block the Pancreatic duct, resulting in poor digestion, loose bowel motions and weight loss
There may be pain in the upper abdomen and the back

5. How will it be diagnosed?

Specific tests for the Pancreas include:

Ultrasound

Sound waves create a picture of the abdomen including the Pancreas
You can't eat or drink for 6 hours before the scan
Procedure involves applying a gel to your stomach and using an instrument that produces sound waves to generate an image
It is totally painless and quick

Computerised Tomography (CT)

CT scans use x-rays to create a picture of the abdomen
You can't eat or drink for 6 hours prior to the test
You will be asked to drink a liquid so that the pictures are clearer
You will lie on a couch and move through a doughnut-shaped machine
It is totally painless but does involve lying still for around 30-50 minutes

Magnetic Resonance Imaging (MRI)

This is similar to CT but will use magnestism instead of x-rays to create a picture
You must lie still inside a metal cylinder and it may take up to an hour
Procedure is completely painless

ERCP (Endoscopic retrograde cholangioPancreatography

You can't eat or drink for 6 hours prior to the procedure
Allows an x-ray of the Pancreatic and bile ducts
You will be given a sedative
A thin, flexible tube, called an endoscope, will be passed through your mouth into your stomach and into your duodenum
The doctor will look down the endoscope to see the ducts. A dye can be injected via the endoscope into the duct to allow an x-ray to be taken

Biopsy

Only certain method of diagnosis is biopsy
Anaesthetic is applied to the skin
A needle is inserted through the skin to take a small piece of the Pancreas
The small piece is analysed

6. How will it be treated?

Treatment involves either removing the tumour ot relieving the jaundice
The cancer can be removed surgically if it has not spread beyond the Pancreas
Surgery may also be used to unblock the bile duct or the bowel
The surgery may require removal of the entire Pancreas (total Pancreatectomy). Alternatively, part of the Pancreas along with part of the stomach, duodenum,common bile duct and surrounding lymph nodes (Whipples Operation) may be removed. If the cancer is in the tail of the Pancreas, a left Pancreatectomy can be performed. This involves removal of the spleen as well
Bypass surgery involves bypassing a bile duct obstruction by joining the gall bladder (or the bile duct) to another part of your intestine (the jejenum - the part of the intestine after the duodenum). This is called a cholecystojejunostomy
If the cancer blocks the duodenum, the jejenum can be attached to the stomach, thus bypassing the duodenum. This is called a gastrojejunostomy
The jaundice can also be treated via ERCP or PTC