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PANCREATIC CANCER


The pancreas is located behind the stomach and in front of the spine. Most pancreatic cancers are adenocarcinomas and form in the exocrine cells which produce and release enzymes into the small intestine to help the body digest food. These types of cancer do not secrete hormones or cause any obvious symptoms, making early diagnosis difficult.
 
Another type of pancreatic cancer is caused by neuroendocrine tumors that form in the endocrine cells which produce hormones such as insulin. These cancers generally grow slowly and have better prognosis than exocrine pancreatic cancers.
 
Our goal is to achieve the best treatment for pancreatic cancer according to the genetic characteristics of each patient’s tumor.

SYMPTOMS of pancreatic cancer
Pancreatic cancer may not cause any symptoms at first. The main symptoms are:
  • Jaundice (yellowing of the skin and whites of the eyes).
  • Pale stools.
  • Dark colored urine.
  • Pain in the upper or middle abdomen or back.
  • Unexplained weight loss.
  • Loss of appetite.
  • Extreme tiredness.

DIAGNOSTIC TESTS to detect pancreatic cancer
The process used to determine whether cancerous cells have spread within the pancreas or to adjacent parts of the body is called staging. Any of the following tests and procedures to detect, diagnose and stage pancreatic cancer may be performed simultaneously:
  • Physical examination and review of medical history.
  • Blood chemistry studies.
  • Tumor marker tests.
  • Magnetic Resonance Imaging (MRI) scan.
  • Computerized tomography (CT scan).
  • Positron Emission Tomography scan (PET-CT).
  • Abdominal ultrasound.
  • Endoscopic ultrasound (EUS).
  • Endoscopic retrograde cholangiopancreatography (ERCP).
  • Percutaneous transhepatic cholangiography (PTC).
  • Laparoscopy.
  • Biopsy.
Treatments for pancreatic cancer
Five different types of treatment are available for patients with pancreatic cancer: surgery, radiotherapy, chemotherapy, association of chemotherapy and radiotherapy (chemoradiotherapy), targeted therapy.

New types of treatment are being investigated in clinical trials: therapies directed against molecular targets.

The prognosis (chance of recovery) and treatment options for pancreatic cancer depend on: whether the tumor can be removed by surgery, the cancer stage (size of the tumor and whether cancer has spread from the pancreas to adjacent tissues or lymph nodes, or to other parts in the body), the patient’s general state of health, whether this is the first time the cancer has been diagnosed or whether it is a relapse (recurrence).

Treatment with surgery or chemoradiotherapy is used if the cancer is detected before it has spread. If the cancer has already spread (metastasis), systemic therapies (which act on the whole body) are used. In this case, the aim is to achieve disease control and improve the quality of life and survival. Chemotherapy is the systemic treatment currently available. In recent years, new combinations have been introduced with improved results: gemcitabine and nabPaclitaxel (Abraxane®), FOLFIRINOX, gemcitabine - erlotinib (Tarceva®).