Pancreatic Cancer
(Cancer of the Pancreas)
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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
 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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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)
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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