The pancreas is a gland that lies deep in the abdomen behind the stomach, near the intestines, and on top of the spine. It is responsible for producing juices that help digest food and for making hormones such as insulin (regulates blood sugar levels). Pancreatic cancer (cancer of the pancreas) is a serious disease, being the fourth leading cause of cancer-related deaths in the United States. The January 17, 2007, issue of JAMA includes an article about treatment of pancreatic cancer. This Patient Page is based on one previously published in the December 14, 2005, issue of JAMA.
Jaundice—yellowing of the skin and the whites of the eyes
Unintended weight loss
Upper abdominal pain
Loss of appetite
Because of its location, pancreatic cancer is difficult to detect. In addition to considering your medical history and performing a physical examination, your doctor may order certain tests.
Blood tests to evaluate liver function
Ultrasound of the abdomen—sound waves to help detect blockages of the pancreatic or bile ducts
Computed tomography scan—a computerized x-ray with injected dye showing a detailed picture of the abdomen to detect blockages of the pancreatic and bile ducts and any abnormal masses
Magnetic resonance imaging or magnetic resonance cholangiopancreatography—a picture of the abdomen using magnetic waves to detect masses or blockages
Endoscopic retrograde cholangiopancreatography—a procedure performed by a gastroenterologist (doctor who specializes in digestive diseases) in which a lighted scope is placed down the throat through the stomach and into the intestine. Dye is then injected to visualize the pancreatic and bile ducts. Biopsies (removal of samples of tissue for diagnosis) may also be performed. For endoscopic ultrasound, the scope is used along with ultrasound to help detect a mass.
Percutaneous transhepatic cholangiopancreatography may be performed by a radiologist (doctor who specializes in using radiation to diagnose and treat disease). A needle is placed into the liver from outside the body. Dye is then injected into the hepatic ducts of the liver in order to detect any masses in the pancreatic or bile ducts.
Surgery is the first choice for treating pancreatic cancer. However, for many patients surgery is not possible due to the location of the cancer or advanced stage of the disease. Chemotherapy (drugs that kill cancer cells) or radiation therapy (high-energy x-rays that kill cancer cells) may be offered after surgery or at times when surgery is not possible. A number of treatments are available to help relieve the symptoms of pancreatic cancer such as pain, jaundice, and weight loss.
Pancreatic Cancer Action Networkhttp://www.pancan.org
National Cancer Institutehttp://www.cancer.gov
American Cancer Societyhttp://www.cancer.org
To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish. A Patient Page on pancreatitis was published in the June 16, 2004, issue.
Sources: National Cancer Institute, American Cancer Society
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 203/259-8724.
Brender E, Burke A, Glass RM. Pancreatic Cancer. JAMA. 2007;297(3):330. doi:10.1001/jama.297.3.330