Like all forms of cancer, early detection of pancreatic cancer is key. Unfortunately, it’s difficult to detect early because it often does not cause notable symptoms. When it does, these are some of the most common:
- Pain in the upper abdomen and back
- Nausea and sometimes vomiting
- Loss of appetite or "feeling full"
- Weight loss
- Jaundice (yellowing of the skin)
- Elevated blood sugar levels (diabetes)
Little is known about the risk factors and unfortunately there are no easy early detection methods for this cancer. However, research has shown multiple factors that may increase your risk of developing pancreatic cancer including:
- Age - Most pancreatic cancer occurs in people over the age of 45 (average age 72 years).
- Gender - It affects more men than women.
- Smoking - Smokers are two or three times more likely than non-smokers to develop pancreatic cancer.
- Alcohol Intake - Recent research shows that 3 or more drinks of hard liquor a day showed a 36% increase increase in pancreatic cancer risk.
- Chronic Pancreatitis - Long-term inflammation of the pancreas also has been linked to pancreatic cancer.
- Cirrhosis of the Liver - People with cirrhosis have a higher incidence of pancreatic cancer.
- Obesity and Physical Inactivity - Pancreatic cancer is more common in people who are very overweight or don't get much physical activity.
- Diabetes - It occurs more often in people with diabetes.
- Race - African-Americans are more likely than Asians, Hispanics or Caucasians to be diagnosed with pancreatic cancer.
- Family History - The risk is higher for a person whose mother, father or a sibling has had the disease.
- Some Genetic Syndromes - Certain inherited gene mutations, such as in the BRAC2 gene, increase the risk of pancreatic cancer.
- Workplace Exposures - Exposure to occupational pesticides, dyes, and chemicals used in the metal industry may also increase risk.
Many patients visit their primary care doctor with very non-specific symptoms that may lead to a further evaluation, which could include:
Physical Examination – If you exhibit symptoms, your physician will feel your abdomen for changes in the area around the pancreas, liver and gallbladder. He or she may also check your blood, urine and stool samples for bilirubin, a buildup which can occur when the common bile duct is blocked by a tumor. Tumor markers (proteins that appear in the blood at the time of cancer) called a CA-19-9, can also be helpful in diagnosis and follow-up.
Computerized Tomography (CT) Scan – A CT scan (a type of X-ray that takes very detailed pictures) can be used to detect tumors in the pancreas, lymph nodes and liver, in addition to detecting a blocked bile duct. To have the scan you’ll lie down and slowly be slid through a ring, which takes pictures in sequence. A contrast dye will be injected through an IV so your internal structures can be seen more clearly on the resulting pictures. Together, the pictures create a thorough internal image of your body.
Ultrasound – An ultrasound uses inaudible sound waves which bounce off internal organs and create a picture of the internal body. Mount Carmel uses both external and internal ultrasounds in detecting pancreatic cancer. An external or transabdominal ultrasound is done form on top of the abdomen. An internal or endoscopic ultrasound (EUS) uses a thin tube called an endoscope that’s inserted through the mouth to the small intestine. Endoscopic Retrograde Cholangiopancreatography (ERCP) – In an ERCP, an endoscope is passed through your body by way of your mouth so that a catheter can release a harmless dye that, with the help of an x-ray, can reveal if the ducts are blocked or narrowed.
Percutaneous Transhepatic Cholangiography (PTC) – In a PTC, a harmless dye is injected into your liver through your skin so that an x-ray can show if or where your bile ducts may be blocked.
Biopsy – In a biopsy, a piece of tissue is extracted from the pancreas and examined under a microscope by one of ourpathologists. The tissue can be removed with a needle, during an ERCP or an EUS, or during an abdominal procedure.
PET Scan – We often use PET scans to determine if a cancer can be removed surgically or to determine if there is cancer activity in an organ.
Endoscopic Ultrasound (EUS) – A normal ultrasound uses sound waves which bounce off of internal organs and create a picture of the internal body. For an EUS, Mount Carmel’s highly trained gastroenterologists perform an EGD, where a thin tube is inserted though the mouth to the small intestine. The doctor can then view the mass and the blood vessels of the organs to determine if surgery may be a good option for you. They may also take a biopsy of the mass at this time.