Pancreatic Cancer (cont.)
Francis W. Nugent, MD
Dr. F.W. Nugent is a medical oncologist specializing in gastrointestinal cancers with a special interest in pancreatic cancer. Dr. Nugent graduated from Middlebury College with a bachelors degree in religion before graduating from Albany Medical College. He presently serves as vice-chairman of medical oncology at the Lahey Clinic in Burlington, Massachusetts.
Keith E. Stuart, MD
Dr. Keith E. Stuart is a medical oncologist specializing in the study and treatment of cancers involving the gastrointestinal tract, with a special interest in tumors involving the liver. He was educated at Harvard University (graduating magna cum laude) and Albert Einstein College of Medicine and did his medical training at the New England Deaconess Hospital.
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
In this Article
- Pancreatic cancer facts
- What does a pancreas do?
- What is cancer?
- What is pancreatic cancer? What are the types of pancreatic cancer?
- What are pancreatic cancer causes and risk factors?
- What are pancreatic cancer symptoms and signs?
- How is the diagnosis of pancreatic cancer made?
- How do health care professionals determine the stage of pancreatic cancer?
- What is the treatment for resectable pancreatic cancer?
- What is the treatment for locally advanced unresectable pancreatic cancer?
- What is the treatment for metastatic pancreatic cancer?
- What are the side effects of pancreatic cancer treatment?
- What is the survival rate with pancreatic cancer?
- What research is being done on pancreatic cancer?
- Is complimentary or alternative medicine effective in pancreatic cancer treatment?
- Is it possible to prevent pancreatic cancer?
- Where can people get support when coping with pancreatic cancer?
- Where can people find additional information about pancreatic cancer?
- Find a local Oncologist in your town
What are pancreatic cancer symptoms and signs?
Because the pancreas lies deep in the belly in front of the spine, pancreatic cancer often grows silently for months before it is discovered. Early symptoms and/or first signs can be absent or quite subtle. More easily identifiable symptoms develop once the tumor grows large enough to press on other nearby structures, such as nerves (which causes pain), the intestines (which affects appetite and causes nausea along with weight loss), or the bile ducts (which causes jaundice or a yellowing of the skin and can cause loss of appetite and itching). Symptoms in women rarely differ from those in men. Once the tumor sheds cancer cells into the blood and lymph systems and metastasizes, additional symptoms usually arise, depending on the location of the metastasis. Frequent sites of metastasis for pancreatic cancer include the liver, the lymph nodes, and the lining of the abdomen (called the peritoneum). Unfortunately, most pancreatic cancers are found after the cancer has grown or progressed beyond the pancreas or has metastasized to other places.
In general, the signs and symptoms of pancreatic cancer can be produced by exocrine or endocrine cancer cells. Many of the signs and symptoms of exocrine pancreatic cancer result from blockage of the duct that travels through the pancreas from the liver carrying bile to the intestine. Symptoms of exocrine pancreatic cancer include
- dark urine,
- itchy skin,
- light-colored stools,
- pain in the abdomen or the back,
- poor appetite and weight loss,
- digestive problems (pale and/or greasy stools, nausea, and vomiting),
- blood clots, and
- enlarged gallbladder.
The signs and symptoms of endocrine pancreatic cancers are often related to the excess hormones that they produce and consequently to a variety of different symptoms. Such symptoms are related to the hormones and are as follows:
- Insulinomas: Insulin-producing tumors that lower blood glucose (sugar) levels can cause low blood sugars that result in weakness, confusion, coma, and even death.
- Glucagonomas: Glucagon-producing tumors can increase glucose levels and cause symptoms of diabetes (thirst, increased urination, diarrhea and skin changes, especially a characteristic rash termed necrolytic migratory erythema).
- Gastrinomas: Gastrin-producing tumors trigger the stomach to produce too much acid, which leads to ulcers, black tarry stools, and anemia.
- Somatostatinomas: Somatostatin-producing tumors result in other hormones being overregulated and producing symptoms of diabetes, diarrhea, belly pain, jaundice, and possibly other problems.
- VIPomas: These tumors produce a substance called vasoactive intestinal peptide (VIP) that may cause severe watery diarrhea and digestive problems along with high blood glucose levels.
- PPomas: These tumors produce pancreatic polypeptide (PP) that affects both endocrine and exocrine functions, resulting in abdominal pain, enlarged livers, and watery diarrhea.
- Carcinoid tumors: These tumors make serotonin or its precursor, 5-HTP, and may cause the carcinoid syndrome with symptoms of flushing of the skin, diarrhea, wheezing, and a rapid heart rate that occurs episodically; eventually, a heart murmur, shortness of breath, and weakness develop due to damage to the heart valves.
Nonfunctioning neuroendocrine tumors don't make excess hormones but can grow large and spread out of the pancreas. Symptoms then can be like any of the endocrine pancreatic cancers described above.
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