Diagnosis & Treatment of Pancreatic Cancer
According to the American Cancer Society, approximately 38,000 people are diagnosed each year with pancreatic cancer and 34,000 of those diagnosed will die. It is the fourth leading cause of deaths from cancer, and the prognosis for those diagnosed is rarely in their favor. As with any cancer, the sooner a person is diagnosed, the sooner they can receive treatment.
Diagnosis
If your doctor feels you may have pancreatic cancer, he will order a series of tests to confirm it. One of the tests performed is an MRI; during this test, the patient will enter a machine in the shape of a tunnel, surrounded by magnets. The machine tracks the magnetism of the body, producing images of the pancreas. An abdominal ultrasound is also performed, and may be the first test performed if the patient is experiencing abdominal pain and/or jaundice. This test uses high-frequency waves that resonate off the pancreas, and are then translated by the computer into an image. If a tumor is discovered, a CT scan is considered necessary to obtain more information. An abdominal CT scan is often the test of choice when a doctor needs a solid diagnosis. It has the ability to discover small tumors the ultrasound may have missed, and is considered the most accurate test when determining whether the tumor is localized in the pancreas, or has spread to other areas of the body.
Biopsy
Once any of the above-mentioned imaging tests has detected an abnormality in the pancreas, the doctor will order a biopsy. A biopsy of the pancreas will help the doctor determine what stage the cancer is in, thus allowing the oncology team to decide on the best route of treatment. Two types of biopsies can be performed; a needle biopsy involves inserting a needle into the abdomen and removing a small piece of the pancreatic tissue. The second is a laparoscopy. In this procedure, a small device called a laparoscope is used to remove the tissue. If the biopsy shows the tumor to be malignant (cancerous), the oncologist, the radiation oncologist and the endocrinologist will confer and decide on what treatment will benefit the patient the most.
Staging
While deciding on the treatment for the patient, the oncology team will take into consideration the stage of the cancer. The stage tells them how advanced the pancreatic cancer is and how aggressively it needs to be treated. Stage one cancer is generally treated through surgery, removing part of the pancreas. Stage two is more advanced, but is still localized in the pancreas. In stage three, the cancer is not only in the pancreas, but has also spread to surrounding organs.
Surgery
This is most commonly used to treat stage one cancer. Depending on its severity, the doctor may only need to remove part of the pancreas. If a more extensive surgery is required, a process called the Whipple procedure may be used. During this process, the doctor will not only remove the head of the pancreas, but also some of the surrounding structures, such as the spleen, bile duct and gallbladder. Some patients may need combination therapy in addition to the surgery to increase the patient's survival rate. This includes chemotherapy and radiation.
Chemotherapy
This type of treatment relies on the use of drugs to kill the cancer cells in the pancreas and surrounding areas. The drugs may be given through an IV, or taken orally. Depending on the condition of the patient, it may be given on an outpatient basis or could require the patient to stay in the hospital. Because the drugs travel through the bloodstream, chemotherapy is considered a systemic treatment. The drugs used during this treatment are specifically designed to destroy dividing cancer cells, however they can also destroy healthy cells that divide as well. This results in a negative effect on the body at times, causing unpleasant side effects for some.
Radiation
This treatment utilizes radioactive substances that include high-energy rays. A special machine is used to emit these rays, allowing the radiation oncologist to direct the rays only to the pancreas or other affected areas. The goal of radiation therapy is to destroy the cancer cells while damaging the least amount of healthy cells as possible. There are, however, side effects that accompany this treatment as well.
Biological
This treatment is also known as immunotherapy because it uses drugs designed to help boost the body's own immune system to fight the cancer. Common biological drugs used are Interferon and Monoclonal, both of which contain antibodies designed to work with the patient's body to block the growth of cancer cells.
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