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Clinical Specialties - Cancer

Pancreatic Cancer

Gastrointestinal (GI) Cancer MDTPancreatic cancer is a form of cancer that develops in the tissues of the pancreas. The pancreas is located in the abdomen behind the lower part of the stomach and aids in digestion.

It contains both exocrine glands (which produce enzymes that help the body digest food) and endocrine glands (which produce hormones, including insulin, that help control blood sugar levels in the body).

According to the Australian Cancer Council, pancreatic cancer is the tenth most common cancer in men and ninth most common cancer in women in Australia, however it is the fifth most common cause of cancer death over all.

At Sydney Adventist Hospital, our pancreatic cancer experts have the training and expertise to quickly diagnose your disease, explain the range of treatment options available and help you decide on a plan tailored to meet your needs and goals. They have experience with early stage as well as complex cancer; have access to advanced diagnostic tools and a wide range of treatments, including clinical trials. At the same time, our supportive clinicians help you manage side effects to support your quality of life. Explore this section to learn more about pancreatic cancer, its side effects and your treatment options.

About pancreatic cancer

The pancreas is a small gland, around 13cms long, located behind the stomach and joined to the start of the small intestine, called the duodenum. The role of the pancreas in the digestive system is to produce hormones that help regulate blood sugars and enzymes that help the body digest food.

The pancreas has both an exocrine and endocrine function. Most of the cells in the pancreas are exocrine cells, which secrete enzymes that assist in the digestion of food and this is where almost all pancreatic cancers arise . A very small portion of the pancreas is made of endocrine cells, which make hormones such as insulin that control blood-sugar levels.

As many as 20 different types of tumours can be found in the pancreas, with most starting in the pancreas ducts. These cancers are often a type of adenocarcinoma that begins in the tissue lining the gland.

What are the symptoms of pancreatic cancer?

Early detection and diagnosis of pancreatic cancer can be difficult as symptoms tend to be vague and often go unnoticed.

Some people notice the following symptoms as the disease advances:

  • Jaundice (a yellowing of the skin or the whites of the eyes) which can be caused when a tumour blocks the common bile duct
  • Pain in the upper abdomen, stomach or back
  • Loss of appetite
  • Nausea and vomiting
  • Unexplained weight loss
  • Change in bowel behaviour or habits, such as diarrhoea or severe constipation.

If you experience any of these symptoms or have concerns, please contact your general practitioner (GP).

How is pancreatic cancer diagnosed?

Your doctor will undertake or request several tests to confirm a diagnosis of pancreatic cancer and to find out whether it has spread. The results of these tests will help decide on the best treatment approach for you.

Some of these tests could include the following:

  • Blood tests can help reveal levels of a tumour marker called CA19-9, which is produced by some cancer cells, including pancreatic cancer. Blood tests can also show whether your kidney and liver are functioning normally.
  • Diagnostic imaging tests such as CT scans can help identify the precise location and extent of a pancreatic tumour. An MRI scan complements what can be seen on a CT scan. An endoscopic ultrasound (EUS) uses ultrasound waves to obtain highly detailed pictures of the pancreas and an endoscopic retrograde cholangiopancreatography (ERCP) involves the injection of a contrast dye through an endoscope before images are taken which allows doctors to see if the pancreatic duct has narrowed or become blocked.
  • A Biopsy may be performed to confirm a diagnosis and involves physically removing a small bit of tissue from the pancreas for further pathology tests. A biopsy could then determine the type of tumour tissue and whether it’s benign (non-cancerous) or malignant (cancerous).
What are my treatment options for pancreatic cancer?

Treatment for pancreatic cancer depends on the health and age of the patient as well as the location, size and stage of the cancer.

The main treatment for pancreatic cancer is surgery to remove the tumour from the pancreas as well as surrounding tissue. The extent of the surgery will depend on the location and size of the tumour. This can be accompanied by chemotherapy and radiotherapy, especially if the cancer has spread.

For early-stage pancreatic cancer, the most common surgical procedure is the “Whipple procedure” which aims to remove tumours in the head of the pancreas. During the Whipple procedure, the head of the pancreas is removed, as well as the duodenum, gall bladder and parts of the stomach.

When the tumour is in the tail or body of the pancreas, a distal pancreatectomy (type of surgical procedure) is performed. If the cancer is large or in multiple places, complete removal of the pancreas may be required.

For advanced stages of pancreatic cancer, removing the cancer may not be possible. In these instances, chemotherapy is the main form of treatment. Sometimes chemotherapy is given prior to surgery with a view to"downstage" or reduce the tumour burden to make a surgical approach a more feasible option. Other treatment options may include surgery or other procedures to relieve symptoms. This includes endoscopic treatment to insert a tube (called a stent) or double bypass surgery to relieve blockage of the bile duct.

The best treatment plan for you will be determined by our MDT of experts who will assist you through your cancer experience. Make sure you ask them any questions you have, including what support services are available to you. Accessing these support services can help make dealing with your experience at little easier.

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