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Pancreatic Cancer
(Cancer of the Pancreas)

Doctor to Patient

Pancreatic Cancer, the Silent Disease

A MedicineNet doctor-editor's perspective on his own struggle with pancreatic cancer

Medical Author: Dennis Lee, MD
Medical Editor: Melissa Conrad Stöppler, MD

Since early pancreatic cancer often doesn't cause symptoms, it's sometimes called the silent disease.I was diagnosed with pancreatic cancer on May 25 of this year. On a routine yearly blood test, I was found to have slightly elevated blood levels of liver enzymes (my alkaline phosphatase, ALT, and AST were mildly elevated). Since I had no symptoms of abdominal pain or weight loss, both my doctor and I felt quite confident that these liver abnormalities were merely due to the statin that I was taking to lower cholesterol. For the sake of completeness, my doctor ordered a liver ultrasound, which showed multiple liver tumors. A subsequent CAT scan of the abdomen done that same afternoon showed an orange-sized mass in the tail of my pancreas with multiple metastases (spread of tumor) in the liver. A liver biopsy confirmed that it was pancreatic cancer.

It was a shock

At the time of my diagnosis, I was a healthy, reasonably fit, 57-year-old newlywed working as a gastroenterologist in a thriving medical practice in South Orange County. My wife and I just bought a new home and were in the process of decorating it and putting in the landscaping.

I have no risk factors for developing pancreatic cancer. I do not drink alcohol, and do not smoke (smoking cigarettes is a risk factor for pancreatic cancer). None of my parents and relatives had pancreatic cancer. I never had diabetes mellitus (diabetes mellitus is another known risk factor). I exercise vigorously almost daily (four days per week of tennis, and one to two days of strength training). I maintained a healthy weight (obesity is also a risk factor for pancreatic cancer).


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Doctor to Patient

What is the pancreas?

The pancreas is a spongy, tube-shaped organ about 6 inches long. It is located in the back of the abdomen, behind the stomach. The head of the pancreas is on the right side of the abdomen. It is connected to the duodenum, the upper end of the small intestine. The narrow end of the pancreas, called the tail, extends to the left side of the body.

The pancreas makes pancreatic juices and hormones, including insulin. Pancreatic juices, also called enzymes, help digest food in the small intestine. Insulin controls the amount of sugar in the blood. Both enzymes and hormones are needed to keep the body working right.

As pancreatic juices are made, they flow into the main pancreatic duct. This duct joins the common bile duct, which connects the pancreas to the liver and the gallbladder. The common bile duct, which carries bile (a fluid that helps digest fat), connects to the small intestine near the stomach.

What is cancer?

Cancer is a group of diseases. More than 100 different types of cancer are known, and several types of cancer can develop in the pancreas. They all have one thing in common: abnormal cells grow and destroy body tissue.

Healthy cells that make up the body's tissues grow, divide, and replace themselves in an orderly way. This process keeps the body in good repair. Sometimes, however, some cells lose the ability to control their growth. They grow too rapidly and without any order. Too much tissue is made, and tumors are formed. Tumors can be benign or malignant.

Benign tumors are not cancer. They do not spread to other parts of the body and are seldom a threat to life. Often, benign tumors can be removed by surgery, and they are not likely to return.

Malignant tumors are cancer. They can invade and destroy nearby healthy tissues and organs. Cancer cells also can break away from the tumor and spread to other parts of the body. The spread of cancer is called metastasis.

Cancer that starts in the pancreas is called pancreatic cancer. When pancreatic cancer spreads, it usually travels through the lymphatic system. The lymphatic system includes a network of thin tubes that branch, like blood vessels, into tissues all over the body. Cancer cells are carried through these vessels by lymph, a colorless, watery fluid that carries cells that fight infection. Along the network of lymphatic vessels are groups of small, bean-shaped organs called lymph nodes. Surgeons often remove lymph nodes near the pancreas to learn whether they contain cancer cells.

Cancer cells can also be carried through the bloodstream to the liver, lungs, bone, or other organs. Pancreatic cancer that spreads to other organs is called metastatic pancreatic cancer.

Pancreas (Pancreatic Cancer)
Picture of pancreas in an article on pancreatic cancer
Cancer that starts in the pancreas is called pancreatic cancer. This picture of the pancreas shows its location in the back of the abdomen, behind the stomach.


Next: What causes cancer of the pancreas? »

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