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Healthcare: Cancer Care

Pancreatic Cancer

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The Elkins Pancreas Center specializes in the treatment of pancreatic cancer, pancreatitis and other pancreatic diseases through pancreatic surgery (Whipple procedure), gene therapy, clinical trials, general surgery, and minimally invasive surgery.

If you or your loved one has been diagnosed with pancreatic cancer or pancreatitis, you are not alone. The Elkins Pancreas Center, a multidisciplinary clinic located in Houston, Texas, is here to help you by:

  • Providing the best care for pancreatic cancer and pancreatitis patients
  • Leading in the discovery of effective new methods to diagnose and treat pancreatic disease
  • Educating patients, their families, Baylor College of Medicine trainees, other physicians, and the community about pancreatic cancer and pancreatitis
  • Approved National Pancreas Foundation Center for pancreatitis and pancreas cancer
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Prevention and Risk Factors

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Preventative steps can help lower your risk of pancreatic cancer. These include eating a healthy diet, limiting alcohol consumption, maintaining a healthy weight and limiting your exposure to toxic chemicals.

Risk factors that can increase your chances of getting pancreatic cancer include age, gender and race as well as conditions like diabetes, chronic pancreatitis, and cirrhosis of the liver.

More About Risk Factors
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Symptoms

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Pancreatic cancer is hard to detect and diagnose for many reasons. When pancreatic cancer is in its early stages, the patient does not usually feel signs or symptoms. When signs are present, they can be associated with many other illnesses. The pancreas is hidden behind other organs, such as the stomach, liver, small intestine, spleen and gallbladder, making it difficult to visualize on radiology tests, and difficult to feel during a physical exam.

Possible signs and symptoms include:

  • Jaundice (yellowing of skin and the whites of the eyes)
  • Severe itching
  • Dark urine and/or light-colored stool
  • Pain in the upper or middle abdomen, sometimes penetrating to the back
  • Unexplained weight loss
  • Loss of appetite
  • Fatigue
  • Nausea and vomiting
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Screening and Diagnosis

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In the process of determining if the signs and symptoms listed above are associated with pancreatic disease, the doctor will order a series of blood tests and radiology tests after performing a thorough physical exam. There is no one test, either blood test or x-ray, that can be ordered to see if pancreatic cancer is present. A series of tests are done, and they may include: a complete metabolic panel, liver panel, serum amylase and serum lipase, and tumor markers (CEA and/or CA19-9) The radiology tests that may be ordered include CT (computed tomography) scan, PET-CT (positron emission tomography) scan, MRI (magnetic resonance imaging), EUS (endoscopic ultrasound), and ERCP (endoscopic retrograde cholangiopancreatography), among others. A diagnostic laparoscopy may also be suggested, which is a surgical procedure involving inserting a scope through a tiny incision in the abdomen and viewing the areas of concern. The surgeon might take a small amount of tissue to send to the laboratory to test for cancer.

After the diagnostic tests have been reviewed, the doctors will provide their recommendations on how best to care for the disease, and provide options for treatment. Pancreatic cancer can be controlled only if it is found before it has spread, when it can be removed with surgery. If the cancer has spread, there are methods available to control the symptoms and complications of this disease.

More about screening
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Treatment

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The stage of your cancer will affect your treatment plan. The stage is determined by the size of the tumor and if it has spread to other parts of the body.

Once staging is defined, treatments can include:

Patients also have access to National Cancer Institute-sponsored clinical trials.

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Tumors Can Be Benign or Malignant

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Benign tumors are not cancer. Usually, doctors can remove them. In most cases, benign tumors do not come back after they are removed. Cells from benign tumors do not spread to tissues around them or to other parts of the body. Most important, benign tumors are rarely a threat to life.

Malignant tumors are cancer. They are generally more serious and may be life threatening. Cancer cells can invade and damage nearby tissues and organs. Also, cancer cells can break away from a malignant tumor and enter the bloodstream or lymphatic system. That is how cancer cells spread from the original cancer (primary tumor) to form new tumors in other organs. The spread of cancer is called metastasis.

Most pancreatic cancers begin in the ducts that carry pancreatic juices. Cancer of the pancreas may be called pancreatic cancer or carcinoma of the pancreas.

A rare type of pancreatic cancer begins in the cells that make insulin and other hormones. Cancer that begins in these cells is called islet cell cancer or neuroendocrine cancer.

When cancer of the pancreas spreads (metastasizes) outside the pancreas, cancer cells are often found in nearby lymph nodes. If the cancer has reached these nodes, it means that cancer cells may have spread to other lymph nodes or other tissues, such as the liver or lungs. Sometimes cancer of the pancreas spreads to the peritoneum, the tissue that lines the abdomen.

When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary tumor. For example, if cancer of the pancreas spreads to the liver, the cancer cells in the liver are pancreatic cancer cells. The disease is metastatic pancreatic cancer, not liver cancer. It is treated as pancreatic cancer, not liver cancer.

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Causes of Pancreatic Cancer

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Cancer of the pancreas is a genetic disease which means that it is caused by changes (or mutations) in DNA. Investigators in The Elkins Pancreas Center are intensely studying these changes. When DNA is damaged, changes occur in the growth of cells. These cells may grow out of control and eventually form a tumor (a mass of malignant cells). These changes can be inherited or they can be acquired. The inherited changes explain why pancreatic cancer runs in some families, and the acquired changes can be the result of random chance or by exposure to carcinogens such as those found in cigarette smoke. 

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Living with pancreatic cancer: Four years and counting with personalized care

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“My friend told me my skin was looking a little orange,” said Catherine Jennings, describing the first sign that something wasn’t quite right with her health.

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Clinical Trials

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Baylor College of Medicine conducts clinical trials that give participants access to the latest, most comprehensive diagnostic and treatment options available. See clinical trials for pancreatic cancer.