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:
- 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
- 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
7. How do I live without a Pancreas?
- You can lead a normal life
- You will need to take enzyme supplements and have insulin injections
- Some people require gastric acid suppressing medication e.g. Mylanta