Liver, Biliary, & Pancreatic Disorders

There are several types of pancreatic cancers, including the following:

• adenocarcinoma of the pancreas - the most common pancreatic cancer, which occurs in the lining of the pancreatic duct.
  
  
• cystadenocarcinoma - a rare pancreatic cancer.
  
  
• acinar cell carcinoma - a rare pancreatic cancer.

Some benign (non-cancerous) tumors in the pancreas include the following:

• insulinoma - a rare pancreatic tumor that secretes insulin, the hormone that lowers glucose levels in the blood.
  
  
• gastrinoma - a tumor that secretes above average levels of gastrin, a hormone which stimulates the stomach to secrete acids and enzymes. Gastrinoma can cause peptic ulcers.
  
  
• glucagonoma - a tumor that secretes glucagon, a hormone which raises levels of glucose in the blood, leading to a rash.

What is a risk factor? A risk factor is anything that may increase a person's chance of developing a disease. It may be an activity, such as smoking, diet, family history, or many other things. Different diseases, including cancers, have different risk factors. Although these factors can increase a person's risk, they do not necessarily cause the disease. Some people with one or more risk factors never develop the disease, while others develop disease and have no known risk factors. But, knowing your risk factors to any disease can help to guide you into the appropriate actions, including changing behaviors and being clinically monitored for the disease.

What causes pancreatic cancer?

While there are no known causes of pancreatic cancer, there are known risk factors. Risk factors for pancreatic cancer include the following:

• diabetes
• cigarette smoking
• chronic pancreatitis

What are the symptoms of pancreatic cancer?

The following are the most common symptoms of pancreatic cancer. However, each individual may experience symptoms differently. Symptoms may include:

• pain in the upper abdomen
  
  
• poor appetite
  
  
• jaundice - yellowing of the skin and eyes.
  
  
• weight loss
  
  
• indigestion
  
  
• nausea
  
  
• vomiting
  
  
• diarrhea
  
  
• fatigue
  
  
• itching
  
  
• enlarged abdominal organs such as the liver, spleen, and gallbladder

The symptoms of pancreatic cancer may resemble other medical conditions or problems. Always consult your physician for a diagnosis.

How is pancreatic cancer diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for pancreatic cancer may include the following:

• ultrasound (Also called sonography.) - a diagnostic imaging technique which uses high-frequency sound waves to create an image of the internal organs. Ultrasounds are used to view internal organs of the abdomen such as the liver spleen, and kidneys and to assess blood flow through various vessels.
  
  
• computed tomography scan (CT or CAT scan) - a diagnostic imaging procedure using a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.
  
  
• magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
  
  
• endoscopic retrograde cholangiopancreatography (ERCP) - a procedure that allows the physician to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas. The procedure combines x-ray and the use of an endoscope - a long, flexible, lighted tube. The scope is guided through the patient's mouth and throat, then through the esophagus, stomach, and duodenum. The physician can examine the inside of these organs and detect any abnormalities. A tube is then passed through the scope, and a dye is injected which will allow the internal organs to appear on an x-ray.
  
  
• percutaneous transhepatic cholangiography (PTC) - a needle is introduced through the skin and into the liver where the dye (contrast) is deposited and the bile duct structures can be viewed by x-ray.
  
  
• pancreas biopsy - a procedure in which a sample of pancreatic tissue is removed (with a needle or during surgery) from the body for examination under a microscope.
  
  
• special blood tests

Treatment for pancreatic cancer:

Specific treatment for pancreatic cancer will be determined by your physician based on:

• your age, overall health, and medical history
• extent of the disease
• type of cancer
• your tolerance of specific medicines, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

Treatment may include:

• surgery
  Surgery may be necessary to remove the tumor - a section or entire pancreas and/or the small intestine.
  
  
• radiation therapy
  Radiation therapy uses high-energy rays to kill or shrink cancer cells.
  
  
• chemotherapy
  Chemotherapy uses anticancer drugs to kill cancer cells.
  
  
• medication
  Medication to control pain and/or to treat itching.
  
  
• oral enzyme preparations
  
  
• insulin treatment

Long-term prognosis for individuals with pancreatic cancer depends on the size of the tumor, lymph node involvement, and degree of metastases (spreading) at the time of diagnosis.