University of Cincinnati Cancer Institute | UCCI

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Pancreatic Cancer

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UC Health Pancreatic Disease Center is one of the Midwest’s highest-volume pancreatic centers, bringing together nationally recognized experts in pancreatic cancer who will meet with you and treat you in one location. Patients from across the U.S. and other countries seek our specialized services for pancreatic cancer.

We can manage your early or advanced disease, offer you access to leading-edge clinical trials, and provide you with the latest testing and treatment options.

Pancreatic cancer occurs when malignant cells grow out of control in the pancreas, a gland in the abdomen that aids digestion and releases insulin into the bloodstream. Pancreatic cancer is the fourth most common cause of cancer death in the U.S. According to the American Cancer Society, about 46,000 new cases of pancreatic cancer were diagnosed last year and close to 40,000 deaths were reported.

Why Choose UC Health for Your Pancreatic Cancer?

Multiple specialists in one place.

Pancreatic cancer may require a combination of surgery, chemotherapy and radiation therapy. We have surgeons, medical oncologists and radiation therapists who specialize in pancreatic cancer

Our center brings all of our specialists together in one place so they can work together to create a customized care plan that addresses your cancer and your goals for care.

Our program coordinator will help you schedule appointments for the same day within the center so you do not have the stress of traveling to different sites on different days.

Experience that leads to better quality.

UC Health is one of the highest-volume pancreas centers in the Midwest. Studies show that centers with higher volumes and more experience have fewer complications and better long-term outcomes following surgery.

You can be confident in our ability to accurately diagnosis and effectively treat your cancer.

Risk Factors for Pancreatic Cancer

Risk factors include:

  • Age – Most pancreatic cancer occurs in people over the age of 45.
  • Smoking – Heavy cigarette smokers are two or three times more likely than non-smokers to develop pancreatic cancer.
  • Obesity and physical inactivity – Pancreatic cancer is more common in people who are very overweight and in people who do not get much physical activity.
  • Diabetes – Pancreatic cancer occurs more often in people who have diabetes than in those who do not.
  • Gender – More men than women are diagnosed with pancreatic cancer.
  • Race – African-Americans are more likely than Asians, Hispanics or Caucasians to be diagnosed with pancreatic cancer.
  • Family history – The risk for developing pancreatic cancer is higher if a person’s mother, father or sibling had the disease.
  • Workplace exposures – Exposure to occupational pesticides, dyes and chemicals used in the metal industry may increase the risk of pancreatic cancer.
  • Some genetic syndromes – Certain inherited gene mutations, such as in the BRAC2, PRSS or HNPCC genes, increase the risk of pancreatic cancer.
  • Chronic pancreatitis – Long-term inflammation of the pancreas has been linked with increased risk for pancreatic cancer.

Types of Pancreatic Cancer

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.
  • Neuroendocrine tumors – Some neuroendocrine tumors in the pancreas include the following – they may be benign (noncancerous) or malignant (cancerous):
    • 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 that stimulates the stomach to secrete acids and enzymes. Gastrinoma can cause peptic ulcers.
    • Glucagonoma – A tumor that secretes glucagon, a hormone that raises levels of glucose in the blood, often leading to a rash.

Symptoms of Pancreatic Cancer

Each person experiences symptoms differently, and some symptoms may resemble other conditions or medical problems. The most common symptoms include:

  • Pain in the upper abdomen or upper back
  • Loss of appetite
  • Weight loss
  • Jaundice (yellow skin and eyes, and dark urine)
  • Indigestion
  • Nausea
  • Vomiting
  • Extreme fatigue

Diagnosing Pancreatic Cancer

With an accurate diagnosis of your stage and type of pancreatic cancer, we can help you decide on the best action to take in treating your cancer.

Your physician will begin with a thorough history and physical examination and recommend one or more of the following to obtain further information:

  • Ultrasound (also called sonography) – A diagnostic imaging technique that 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, pancreas, spleen and kidneys and to assess blood flow through various vessels. The ultrasound may be performed using an external or internal device:
    • Transabdominal ultrasound – The physician places an ultrasound device on the abdomen to create the image of the pancreas.
    • Endoscopic ultrasound (EUS) – At UC Health, we have a physician who specializes in endoscopic ultrasound (EUS). The physician inserts an endoscope, a small, flexible tube with an ultrasound device at the tip, through the mouth and stomach, and into the small intestine. As the physician slowly withdraws the endoscope, sound waves create images of the pancreas to tell us the size of a tumor and how far it has grown into surrounding tissue.
    • Computed tomography scan (CT or CAT scan) – A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal images (often called slices) 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. At UC health, we have radiologists who specialize in interpreting images of the GI tract and can recognize subtle details to give you an accurate diagnosis.
    • 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 helps your physician to diagnose and treat problems in the liver, gallbladder, bile ducts and pancreas. The procedure combines X-ray and an endoscope – a long, flexible, lighted tube. The scope is guided through the 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 inserted through the skin and into the liver, where a dye is deposited and bile duct structures connected to the liver 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) for examination under a microscope.
    • Special blood tests
    • Positron emission tomography (PET) – A type of nuclear medicine procedure. A tiny amount of a radioactive substance, called a radioactive tracer, helps evaluate the function of a particular organ or tissue, as well as its biochemical properties. PET may detect biochemical changes in an organ or tissue that can identify a disease process before other imaging techniques can detect anatomical changes.

Treating Pancreatic Cancer

If you have pancreatic cancer, we develop a treatment plan with you to address the type and stage of your cancer, as well as your goals for care. Treatment options include surgery, chemotherapy, radiation therapy or a combination of these.

Surgery

Our surgeons who specialize in pancreatic cancer often can perform minimally invasive laparoscopic and robot-assisted surgeries to remove cancerous tissue in the pancreas and surrounding organs. These procedures use smaller incisions than open surgeries and result in less blood loss and fewer complications following surgery.

Types of surgery for pancreatic cancer include:

  • Whipple procedure – The most common procedure for pancreatic cancer is the Whipple procedure, which removes the head of the pancreas (where most pancreatic cancer occurs), part of the small intestine, the gall bladder, part of the stomach, and lymph nodes near the head of the pancreas.
  • Distal pancreatectomy – If the tumor is located in the body and tail of the pancreas, both of these sections of the pancreas will be removed, along with the spleen, an organ that filters blood and aids the immune system. At UC Health, we often can limit the surgery to removing only the cancerous areas of the pancreas. We spare the spleen and its important functions, an option not offered at other medical centers in our area.
  • Total pancreatectomy – The entire pancreas, part of the small intestine and stomach, the common bile duct, the spleen, the gallbladder and some lymph nodes will be removed. This type of operation is not common.
  • Palliative surgery – For more advanced cancers, surgery may be performed to relieve pain and symptoms such as a blocked bile duct.

Radiation Therapy

Radiation therapy can be given in two forms – external beam or stereotactic body radiation.

External radiation (external beam therapy) – a treatment that precisely sends high levels of radiation directly to the cancer cells. The machine is controlled by the radiation therapist. Since radiation is used to kill cancer cells and to shrink tumors, special shields may be used to protect the tissue surrounding the treatment area. Radiation treatments are painless and usually last a few minutes.

Stereotactic body radiation therapy (SBRT) can be used to shrink or destroy your tumor if you are not a candidate for surgery or you do not wish to receive surgery. We can direct 2-D and 3-D radiation beams precisely, from multiple angles to kill cancer cells while minimizing damage to healthy cells. This allows us to provide higher-dose treatments in a shorter span of time, reducing the number of trips you have to make to receive treatments.

Chemotherapy and Targeted Therapy

At the UC Health Pancreatic Disease Center, we can analyze the genetic makeup of tumors to predict which chemotherapy or targeted therapy is most likely to benefit you. This genomic analysis is unique in the Greater Cincinnati area and can help ensure that you receive only treatments that have a chance of improving your length or quality of life.

Chemotherapy can be given in pill form or through an IV to kill cancer cells throughout the body. At UC Health, we offer novel chemotherapy agents not generally available at other cancer treatment facilities in the Greater Cincinnati area. Our oncologists also offer access to the latest medications available through clinical trials.

Targeted therapy creates a special combination of drugs that will combat your pancreatic tumor and spare healthy cells. We study a sample of your tumor and use the latest data available to decide which drugs will work best to eliminate the cancer.

Clinical Trials

We have ongoing clinical trials across all disciplines – surgery, medical oncology, radiation therapy – for pancreatic cancer.

UC Health’s Pancreatic Disease Center

UC Health Pancreatic Disease Center is nationally recognized for the diagnosis, treatment and management of pancreatitis and pancreatic cancer. Patients travel from across the nation to receive responsive, innovative care from our trusted team of compassionate physicians and staff.

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