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
Treatment Options for Recurrent Pancreatic Cancer
Treatment of recurrent pancreatic cancer may include the following:Palliative surgery or stent placement to bypass blocked areas in ducts or the small intestine.Palliative radiation therapy to shrink the tumor.Other palliative medical care to reduce symptoms, such as nerve blocks to relieve pain.Chemotherapy.Clinical trials of chemotherapy, new anticancer therapies, or biologic therapy.Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent 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 clinical trials is available from the NCI Web site.
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
Stage Information for Pancreatic Cancer
The staging system for pancreatic exocrine cancer continues to evolve. The importance of staging beyond establishing whether a tumor is resectable is uncertain since state-of-the-art treatment has demonstrated little impact on survival. However, knowledge of the extent of the disease is necessary to communicate a uniform definition of disease. AJCC Stage Groupings and TNM DefinitionsThe American Joint Committee on Cancer (AJCC) has designated staging by TNM classification.Table 1. Definitions of TNM Stage 0aStageTNMDescriptiona 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, 2010, pp 241-9.b This also includes the pancreatic intraepithelial neoplasia (PanIN)-3 classification.0Tis, N0, M0Tis = Carcinomain situ.bN0 = No regional lymph node metastasis.M0 = No distant metastasis.Table 2. Definitions of TNM Stages IA and
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
General Information About Pancreatic Cancer
Related Summary Note: Another PDQ summary containing information related to pancreatic cancer includes: Unusual Cancers of Childhood (pancreatic cancer in children) Statistics Note: Estimated new cases and deaths from pancreatic cancer in the United States in 2010:[ 1 ] New cases: 43,140. Deaths: 36,800. Note: Some citations in the text of this section are followed by a level of evidence. The ...
Treatment Option Overview for Pancreatic Cancer
Surgical resection remains the primary modality when feasible; on occasion, resection can lead to long-term survival and provides effective palliation.[1,2,3][Level of evidence: 3iA]The role of postoperative therapy (chemotherapy with or without chemoradiation therapy) in the management of pancreatic cancer remains controversial because much of the randomized clinical trial data available are statistically underpowered and provide conflicting results.[4,5,6,7,8]Complications of pancreatic cancer include the following:Malabsorption: Frequently, malabsorption caused by exocrine insufficiency contributes to malnutrition. Attention to pancreatic enzyme replacement can help alleviate this problem. (Refer to the PDQ summary on Nutrition in Cancer Care for more information.)Pain: Celiac axis and intrapleural nerve blocks can provide highly effective and long-lasting control of pain for some patients. (Refer to the PDQ summary on Pain for more information.)The survival rate of patients with
To Learn More About Pancreatic Cancer
For more information from the National Cancer Institute about pancreatic cancer, see the following:Pancreatic Cancer Home PageWhat You Need to Know About™ Cancer of the PancreasUnusual Cancers of ChildhoodDrugs Approved for Pancreatic CancerUnderstanding Cancer Series: Targeted Therapies (Advances in Targeted Therapies)Targeted Cancer TherapiesFor general cancer information and other resources from the National Cancer Institute, see the following:What You Need to Know About™ CancerUnderstanding Cancer Series: CancerCancer StagingChemotherapy and You: Support for People With CancerRadiation Therapy and You: Support for People With CancerCoping with Cancer: Supportive and Palliative CareQuestions to Ask Your Doctor About CancerCancer LibraryInformation For Survivors/Caregivers/Advocates
Stages of Pancreatic Cancer
Tests and procedures to stage pancreatic cancer are usually done at the same time as diagnosis. The process used to find out if cancer has spread within the pancreas or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage of the disease in order to plan treatment. The results of some of the tests used to diagnose pancreatic cancer are often also used to stage the disease. See the General Information section for more information.There are three ways that cancer spreads in the body.The three ways that cancer spreads in the body are:Through tissue. Cancer invades the surrounding normal tissue.Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.When cancer cells break away from the primary
Changes to This Summary (06 / 29 / 2012)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.Editorial changes were made to this summary.This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ NCI's Comprehensive Cancer Database pages.