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Pancreatic Cancer



What is pancreas cancer?


Pancreatic cancer is one of the most serious forms of cancer. Throughout the past few decades, pancreatic cancer incidence and mortality has only marginally declined. It is estimated that nearly 43,000 men and women will receive a diagnosis of pancreatic cancer in 2009 with an expected mortality rate of 35,000. In the United States alone, pancreatic cancer is the fourth-leading cause of cancer-related deaths in both men and women. Part of the gastrointestinal region, the pancreas is a gland in the abdomen behind the stomach and in front of the spine. Surgical resection is the only curative option and this can further be prolonged with chemotherapy.


Cause and symptoms:


The diagnosis of pancreatic cancer can be difficult to make since symptoms often mirror those of many other illnesses, while screening tests are considered unreliable. Symptoms include weight loss, stomach pain, nausea, vomiting and jaundice. The most common risk factor for pancreatic cancer is smoking, while poor diet, obesity, diabetes, and genetics may also play a role. When surgery (resection) can be performed, and if the cancer is contained within the pancreas, survival rates dramatically improve. Early diagnosis is therefore critical. The most sensitive diagnostic test is a high quality CAT scan.




Blood Tests: liver function tests to determine whether a patient is jaundiced (yellow) i.e., whether the pancreas is blocking the bile duct.

Tumor markers: CA 19-9 is a blood tumor marker which is elevated in most patients with pancreatic cancer.

X-rays: a CAT scan provides anatomic detail of the pancreas cancer as well as the relationship to other organs and blood vessels.

Endoscopic Ultrasound: an ultrasound device is inserted in the stomach to carefully evaluate the pancreas. A biopsy can be performed if necessary.




Dr. Bilchik and his colleagues have considerable experience performing pancreas resections. They have applied minimally invasive techniques to enhance the recovery with shorter hospital stays and less pain. The resection of the head of the pancreas (Whipple procedure) is routinely performed often without the need for blood transfusions or intensive care. Great care is taken to perform an oncologic operation with sufficient lymph nodes for sampling. Tumor tissue is also evaluated for molecular markers to tailor the treatment after surgery. Each patient is therefore managed in a multidisciplinary way to make every effort to improve the symptoms and prolong the survival of patients with pancreas cancer. Because of his considerable experience in treating pancreatic cancer, Dr. Bilchik was recently interviewed on CNN by Anderson Cooper AC 360 as an expert.

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