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    Pancreatic Cancer Health Center

    Medical Reference Related to Pancreatic Cancer

    1. Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Miscellaneous Islet Cell Tumors

      VIPomaImmediate fluid resuscitation is often necessary to correct the electrolyte and fluid problems that occur as a result of the watery diarrhea, hypokalemia, and achlorhydria that patients experience. Somatostatin analogs are also used to ameliorate the large fluid and electrolyte losses. Once patients are stabilized, excision of the primary tumor and regional nodes is the first line of therapy for clinically localized disease. In the case of locally advanced or metastatic disease, where curative resection is not possible, debulking and removal of gross disease, including metastases, should be considered to alleviate the characteristic manifestations of VIP overproduction.[1] (Refer to the Treatment Option Overview section of this summary for information about the remaining principles of therapy.)SomatostatinomaComplete excision is the therapy of choice, if technically possible. However, metastases often preclude curative resection, and palliative debulking can be considered to

    2. Cryosurgery for Prostate Cancer - nci_ncicdr0000062957-nci-header

      This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.Pancreatic Cancer Treatment

    3. Pancreatic Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Treatment Option Overview

      There are different types of treatment for patients with pancreatic NETs. Different types of treatments are available for patients with pancreatic neuroendocrine tumors (NETs). Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.Six types of standard treatment are used:Surgery An operation may be done to remove the tumor. One of the following types of surgery may be used:Enucleation: Surgery to remove the tumor only. This may be done when cancer occurs in one place in the

    4. Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Cellular Classification of Pancreatic Neuroendocrine Tumors (Islet Cell Tumors)

      Table 1. Endocrine Tumors of the PancreasIslet CellsSecreted Active AgentTumor and SyndromeACTH = adrenocorticotropin; MSH = melanocyte-stimulating hormone; VIP = vasoactive intestinal peptide; WDHA = watery diarrhea, hypokalemia, and achlorhydria; 5-HT = serotonin.AlphaGlucagonGlucagonoma (diabetes, dermatitis)BetaInsulinInsulinoma (hypoglycemia)DeltaSomatostatinSomatostatinoma (mild diabetes); diarrhea/steatorrhea; gallstonesDGastrinGastrinoma (peptic ulcer disease)A -> DVIP and/or other undefined mediatorsWDHA5-HTACTHMSHCarcinoidCushing syndromeHyperpigmentationInteracinar CellsSecreted Active AgentTumor and SyndromeFPancreatic polypeptideMultiple hormonal syndromesEC5-HTCarcinoid

    5. Pancreatic Cancer - Treatment Options by Stage

      A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.Stages I and II Pancreatic CancerTreatment of stage I and stage II pancreatic cancer may include the following:Surgery.Surgery followed by chemotherapy.Surgery followed by chemoradiation.A clinical trial of combination chemotherapy.A clinical trial of chemotherapy and targeted therapy, with or without chemoradiation.A clinical trial of chemotherapy and/or radiation therapy before surgery.Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage I pancreatic cancer and stage II pancreatic cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about

    6. Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment (PDQ®): Treatment - Health Professional Information [NCI] - General Information About Pancreatic Neuroendocrine Tumors (Islet Cell Tumors)

      Pancreatic neuroendocrine tumors form in hormone-making cells (islet cells) of the pancreas.The pancreas is a gland about 6 inches long that is shaped like a thin pear lying on its side. The wider end of the pancreas is called the head, the middle section is called the body, and the narrow end is called the tail. The pancreas lies behind the stomach and in front of the spine. Anatomy of the pancreas. The pancreas has three areas: head, body, and tail. It is found in the abdomen near the stomach, intestines, and other organs. There are two kinds of cells in the pancreas:Endocrine pancreas cells make several kinds of hormones (chemicals that control the actions of certain cells or organs in the body), such as insulin to control blood sugar. They cluster together in many small groups (islets) throughout the pancreas. Endocrine pancreas cells are also called islet cells or islets of Langerhans. Exocrine pancreas cells make enzymes that are released into the small intestine to help the

    7. Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Insulinoma

      Curative surgical excision, by open laparotomy or laparoscopy, is the treatment of choice when possible. The open surgical approach is used if the tumor is suspected to be malignant, since en bloc lymphadenectomy is performed for malignant tumors without distant metastases. Intraoperative ultrasound aids the localization of tumor extent and the relationship to other anatomic structures.[1]Standard treatment options:Single small lesion in head or tail of pancreas:[1,2,3,4]Enucleation, if feasible. Large lesion in the head of the pancreas that is not amenable to enucleation:[1,2,3,4]Pancreaticoduodenectomy.Single large lesion in body/tail:[1,2,3,4]Distal pancreatectomy.Multiple lesions: occur in 10%, often in association with multiple endocrine neoplasia syndrome type 1 (MEN-1):[1,2,3,4]Distal pancreatectomy with enucleation of tumors in the head of the pancreas.Metastatic lesions: lymph nodes or distant sites:[5,6,7,8,9,10,11,12]Resect when possible.Consider radiofrequency or

    8. Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment (PDQ®): Treatment - Health Professional Information [NCI] - nci_ncicdr0000062794-nci-header

      This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment

    9. Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Treatment Option Overview

      Localized DiseaseIf technically and medically feasible, primary management of endocrine tumors of the pancreas involves surgical resection with curative intent. Given the rare nature of these tumors, surgical approaches are based upon case series and expert opinion rather than randomized controlled trials.[1] The surgical options listed below are based on retrospective series from single reporting centers.[2,3,4][Level of evidence: 3iiD or 3iiiD] Adjuvant therapy has no proven benefit and is, therefore, investigational. There have been no well-controlled trials of adjuvant therapy after complete tumor resection.[5]Surgical Cytoreduction for MetastasesSurgery plays a role even in the setting of metastatic disease. The symptoms of metastatic functional pancreatic neuroendocrine tumors (NETs) may be ameliorated by the reduction of overall tumor burden through surgical debulking.The liver is a common site of metastasis from pancreatic NETs. Because of the slow growth rate of many NETs,

    10. Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage Information for Pancreatic Neuroendocrine Tumors (Islet Cell Tumors)

      Note: The American Joint Committee on Cancer has published the 7th edition of the AJCC Cancer Staging Manual, which for the first time incorporates pancreatic neuroendocrine tumors in the same staging system as pancreatic exocrine tumors.[1] The classification of these tumors as benign versus malignant is not always consistent, so the AJCC recommends that all pancreatic neuroendocrine tumors be staged using this system and reported to cancer registries. It also recommends that the protocol developed by the College of American Pathologists for endocrine pancreatic tumors be used to examine and stage specimens.[2]Definitions of TNMThe American Joint Committee on Cancer has designated staging by TNM classification to define pancreatic neuroendocrine tumors (islet cell tumors).[1]Table 2. Primary Tumor (T)aa Reprinted with permission from AJCC: Exocrine and endocrine pancreas. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer,

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