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Unusual Cancers of Childhood (PDQ®): Treatment - Patient Information [NCI] - Unusual Cancers of the Abdomen

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The pancreas has two main jobs in the body:

  • To make juices that help digest (break down) food. These juices are secreted into the small intestine.
  • To make hormones that help control the sugar and salt levels in the blood. These hormones are secreted into the bloodstream.

The risk of pancreatic cancer is increased by having Beckwith-Wiedemann syndrome or Cushing syndrome.

Symptoms and Diagnostic and Staging Tests

Most pancreatic tumors do not secrete hormones and there are no symptoms of disease. This makes it difficult to diagnose pancreatic cancer early.

Pancreatic tumors that do secrete hormones may cause symptoms. The symptoms depend on the type of hormone being made.

If the tumor secretes insulin, symptoms that may occur include the following:

  • Weakness.
  • Feeling very tired.
  • Low blood sugar. This can cause blurred vision, headache, and feeling lightheaded, tired, weak, shaky, nervous, irritable, sweaty, confused, or hungry.
  • Coma.

Other symptoms caused by tumors that make hormones include the following:

  • Watery diarrhea.
  • Abnormal sodium (salt) level in the blood: Having a low sodium level can cause confusion, sleepiness, muscle weakness, and seizures. Having a high sodium level may cause weakness, tiredness, confusion, paralysis, coma, and seizures.
  • A lump in the abdomen.
  • Weight loss for no known reason.
  • Pain in the abdomen.

If cancer is in the head of the pancreas, the bile duct or blood flow to the stomach may be blocked and the following symptoms may occur:

  • Jaundice (yellowing of the skin and whites of the eyes).
  • Blood in the stool or vomit.

Check with your child's doctor if you see any of these problems in your child. Other conditions that are not pancreatic cancer may cause these same symptoms.

Tests to diagnose and stage pancreatic cancer may include the following:

  • Physical exam and history.
  • X-ray of the chest.
  • CT scan.
  • MRI.
  • PET scan.
  • Biopsy.

See the General Information section for a description of these tests and procedures.

Other tests used to diagnose pancreatic cancer include the following:

  • Endoscopic ultrasound (EUS): A procedure in which an endoscope is inserted into the body, usually through the mouth or rectum. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. A probe at the end of the endoscope is used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. This procedure is also called endosonography.
  • Endoscopic retrograde cholangiopancreatography (ERCP): A procedure used to x-ray the ducts (tubes) that carry bile from the liver to the gallbladder and from the gallbladder to the small intestine. Sometimes pancreatic cancer causes these ducts to narrow and block or slow the flow of bile, causing jaundice. An endoscope (a thin, lighted tube) is passed through the mouth, esophagus, and stomach into the first part of the small intestine. A catheter (a smaller tube) is then inserted through the endoscope into the pancreatic ducts. A dye is injected through the catheter into the ducts and an x-ray is taken. If the ducts are blocked by a tumor, a fine tube may be inserted into the duct to unblock it. This tube, called a stent, may be left in place to keep the duct open. Tissue samples may also be taken and checked under a microscope for signs for cancer.
  • Percutaneous transhepatic cholangiography (PTC): A procedure used to x-ray the liver and bile ducts. A thin needle is inserted through the skin below the ribs and into the liver. Dye is injected into the liver or bile ducts and an x-ray is taken. If a blockage is found, a thin, flexible tube called a stent is sometimes left in the liver to drain bile into the small intestine or a collection bag outside the body. This test is done only if ERCP cannot be done.
  • Laparoscopy: A surgical procedure to look at the organs inside the abdomen to check for signs of disease. Small incisions (cuts) are made in the wall of the abdomen and a laparoscope (a thin, lighted tube) is inserted into one of the incisions. Other instruments may be inserted through the same or other incisions to perform procedures such as removing organs or taking tissue samples to be checked under a microscope for signs of disease.
  • Laparotomy: A surgical procedure in which an incision (cut) is made in the wall of the abdomen to check the inside of the abdomen for signs of disease. The size of the incision depends on the reason the laparotomy is being done. Sometimes organs are removed or tissue samples are taken and checked under a microscope for signs of disease.
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