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    Understanding Pancreatic Cancer -- Diagnosis and Treatment

    How Is Pancreatic Cancer Diagnosed?

    To diagnose pancreatic cancer, a doctor will order certain imaging tests, such as a pancreatic ultrasound or a CT scan of the abdomen. Endoscopic ultrasonography (EUS) uses an ultrasound device connected to the end of a small flexible tube that is inserted into the mouth and is about 85% to 90% accurate in diagnosing pancreatic cancer. If necessary, endoscopic retrograde cholangiopancreatography (ERCP) is used. With ERCP, detailed images are obtained by inserting an endoscope into the mouth to the pancreas, injecting a dye, and then taking X-rays. A tissue sample for biopsy can also be extracted through the scope. If a biopsy confirms cancer, further tests are done to determine how far the disease has advanced. Laparoscopy, may be used. In this technique, a small tube with a small video camera and light source is introduced into the abdominal cavity. The tumor can then be seen. Occasionally, exploratory surgery is needed. The surgeon can then study the tumor directly, determine if nearby lymph nodes are cancerous, and take tissue samples for microscopic exam.

    What Are the Treatments for Pancreatic Cancer?

    Pancreatic cancer is very hard to control. But if it is caught early and the cancer hasn't spread beyond the pancreas, it can be treated with surgery. This offers the best outcome for pancreatic cancer. The surgery is called a "Whipple procedure," or pancreaticoduodenectomy, and is named after Dr. George Hoyt Whipple, the surgeon who pioneered it. If possible, the surgeon removes the malignant tumor, leaving as much of the normal pancreas as possible to allow continued pancreatic function. Less often, the entire pancreas must be removed. If a patient undergoes a total pancreatectomy, a lifelong regimen of replacement enzymes and hormones, including insulin, must be administered.

    Unfortunately, pancreatic cancers have subtle, and vague symptoms. Thus the disease is often diagnosed after it has advanced and spread. However, even at later stages, treatment can improve quality of life by controlling uncomfortable symptoms and complications of the disease.

    Depending on the type and stage of pancreatic cancer, patients may be given chemotherapy treatments alone or in combination with radiation. Whether or not the tumor is removed surgically, or has spread to lymph nodes, these therapies may be given after surgery in an effort to extend survival time. These treatments may also be given before surgery to shrink the tumor and make it possible for surgery to be performed or used as a means of relieving symptoms, such as pain. Prescription medications, usually narcotics, are given to help manage pain associated with advanced pancreatic cancer.

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