Pancreatic Cancer

Pancreatic cancer occurs when cancer develops within the pancreas gland (which is located behind the stomach). The pancreas is responsible for secreting enzymes which are responsible for digest the food we eat and also produce hormones (insulin and glucagon) which are responsible for maintaining normal blood sugar (glucose) levels.

What are the related symptoms of pancreatic cancer?

Pancreatic cancer often produces very little symptoms early in the disease. By the time patients seek help, the disease is often found to be inoperable and therefore, incurable as results from chemo- and radiotherapy have been disappointing. Signs and symptoms of pancreatic cancer may include:

• Loss of appetite
• Unintended weight loss
• Jaundice, when you have painless yellowing of the eyes and skin
• Itchiness (pruritis) secondary to the jaundice
• Pale or grey fatty stool
• Dark-coloured urine
• Nausea and vomiting
• Pain in the upper abdomen as the tumour presses against the nerves

Diagnosis is usually based on a combination of imaging tests such as ultrasound, computer tomography (CT), magnetic resonance imaging (MRI); blood tests such as CEA and CA 19-9 and surgical biopsy or fine-needle aspiration biopsy (FNAB).

What are the treatment options for pancreatic cancer?

Surgery is still the mainstay of treatment and offers the only realistic chance of cure. If imaging tests indicate that the tumour is resectable and the patient is physiologically fit for major surgery, the patient will be offered a resectional procedure in the form of either a pancreatic-duodenectomy (Whipple procedure) for a tumour in the head of the pancreas or distal pancreatectomy with splenectomy for tumours of the body or tail of the pancreas.

• Whipple procedure:
  This is a procedure done for cancers which affect the head of the pancreas. During this procedure, Dr Cooper will remove the pancreas head, and in some cases, he may remove the whole pancreas along with a portion of the stomach, duodenum, lymph nodes, bile duct and gallbladder.
• Distal pancreatectomy:
  During this procedure, Dr Cooper will remove the tail of the pancreas. In some cases a more extensive resection of the pancreas along with the spleen may be necessary. This can be done in a minimally invasive (laparoscopic) manner or with open surgery. A laparoscopic spleen preserving distal pancreatectomy is ideal to remove small neuroendocrine tumours.