Pancreatic cancer

Your pancreas helps your body digest food, absorb nutrients and produce insulin and digestive enzymes. Insulin regulates blood sugar levels and digestive enzymes break down dietary proteins, fats and carbohydrates. These proteins, fats and carbohydrates are the building blocks of tissues and energy.

Pancreatic cancer occurs when the cells in the pancreas develop changes in their DNA, causing them to grow uncontrollably and sometimes form tumors. As such, pancreatic cancer can take a toll on the very foundation of your digestive system and your ability to actively engage in everyday life. There are several risk factors that can increase your likelihood of developing pancreatic cancer, including:

• Age 65 or older
• Chronic inflammation of the pancreas (pancreatitis)
• Diabetes
• Family history of genetic syndromes, including a BRCA2 gene mutation, Lynch syndrome and familial atypical mole-malignant melanoma (FAMMM) syndrome
• Family history of pancreatic cancer
• Obesity
• Smoking

Most pancreatic cancer begins in the cells that line the ducts of the pancreas. Less frequently, however, it can form in the hormone-producing cells of the pancreas. These differences highlight the several distinct types of pancreatic cancer that can affect you.

Exocrine pancreatic cancer we treat

Tumors that affect exocrine functions are the most common type of pancreatic cancer. Exocrine functions in the pancreas include secreting digestive enzymes and water in the gastrointestinal tract to assist in digestion. While most pancreatic tumors are malignant, benign tumors, called cystadenomas, can also affect exocrine functions.

The types of exocrine pancreatic tumors include:

• Acinar cell carcinoma — This type of tumor develops in pancreatic enzyme cells.
• Adenocarcinomas — These typically start in gland cells located in the pancreatic ducts.
• Adenosquamous carcinomas — These types of tumors are rare, but very aggressive, encompassing a mixture of squamous cells, which thinly line the digestive tract, and adenomatous cysts, which are benign tumors.
• Ampullary cancer — This rare cancer starts where the bile duct and pancreatic duct meet the duodenum of the small intestine.
• Giant cell carcinomas — Otherwise referred to as undifferentiated carcinomas, these tumors are categorized this way for being considerably larger than traditional adenocarcinomas.
• Squamous cell carcinomas — These form in the pancreatic ducts are composed of purely squamous cells.

Endocrine pancreatic cancer

Endocrine functions of the pancreas include releasing hormones that control blood sugar (glucose), including insulin and glucagon. Tumors that affect the endocrine functions of the pancreas are called neuroendocrine, or islet-cell tumors, and are fairly uncommon.

Types of tumors include:

• Glucagonomas — These tumors affect pancreatic cells that produce glucagon, which is generated when your blood sugar is low.
• Gastrinomas — Most gastrinomas start in the widest part of the pancreas, known as the head, and produce large amounts of gastrin, which controls the amount of acid in your stomach.
• Insulinomas — This type of tumor causes your body to produce an exorbitant amount of insulin, which causes your blood sugar to drop to dangerous levels.
• Somatostatinomas — These tumors produce an excess amount of somatostatin, which controls the production of other hormones in the pancreas.
• Vipomas — Vipomas produce large amounts of vasoactive intestinal peptide (VIP), which helps control the secretion of water, salts, enzymes, and gastric acid during the digestive process.

Most of these tumors are benign, but nonfunctioning tumors are more likely to be malignant, islet-cell carcinomas.

Pancreatic tumors can be very aggressive cancers, so you need an aggressive team to match. At our hospitals, we have dedicated pancreatic cancer specialists who work to understand your unique condition so that a personalized treatment plan can be formed, using one or a combination of several treatments to get you back to the kind of living which you have grown accustomed.

Chemotherapy

Chemotherapy uses drugs to destroy cancer cells. It is typically most effective when used in conjunction with radiation therapy and surgery. The experienced medical oncologists within our cancer care programs are extremely knowledgeable in targeting tumors and work to ensure you can go through the care process with as little invasive treatment as possible.

Pancreatic cancer surgery

Surgery is often the recommended course of action to remove a pancreatic cancerous tumor. The surgical programs at our hospitals are home to some of the most skilled surgeons in the region. These fellowship-trained hepato-pancreato-biliary (HPB) surgeons also offer advanced minimally invasive surgical techniques, which provide you with less pain, less scarring, a quicker recovery and shorter hospital stay. We use several types of surgical strategies for excising pancreatic tumors, including:

• Distal pancreatectomy — In this procedure, your surgeon may remove part of the pancreas and the spleen.
• Total pancreatectomy — With a total pancreatectomy, the surgeon may remove your entire pancreas, part of the stomach, part of the small intestine, the bile duct, gallbladder, spleen and nearby lymph nodes.
• Whipple procedure — This is the most common surgery for pancreatic cancer. Your surgeon may remove part of the pancreas, part of the stomach, part of the small intestine, and the gallbladder and common bile duct.

Radiation therapy

Radiation therapy is a treatment that uses X-rays to destroy cancer cells and shrink tumors. Our hospital oncology programs are home to specialized radiation therapists who work with specific tumor types. Using advanced technologies such as focused ultrasound to treat your condition, our specialists offer complete care services, coordinating with your surgeon, medical oncologist, navigator and primary care physician to ensure precise and accurate treatment.

We understand a cancer diagnosis can be overwhelming. That’s why we provide the utmost cancer care, including access to a dedicated nurse navigator, who guides you through each step of the way, from diagnosis to treatment to survivorship. Our specialized pancreatic cancer nurse navigators initiate and facilitate timely communication with each member of your care team, provide education, resources, emotional support and access to support groups and community resources.