Pancreatic cancer is the fourth most common cause of cancer death in the United States.
One reason for the often poor outcome of pancreatic cancer is the location of the pancreas deep inside the body. Pancreatic tumors can’t be seen or felt by doctors during routine physical exams, and patients usually have no symptoms until the cancer has spread to other organs.
At the Saint John’s Cancer Institute in Santa Monica, CA, our gastrointestinal cancer surgeons diagnose and treat pancreas cancer with the most advanced therapies available.
We provide focused, personalized care via a team that consists of surgeons, medical and radiation oncologists, radiologists, gastroenterologists, pathologists and specially trained support staff, all to help you make the most informed decision about your care.
As a center for treatment of advanced cancer, we offer innovative treatments, including immunotherapy, against pancreatic cancer.
Diagnosing Pancreatic Cancer
We take a complete medical history and do a physical exam prior to beginning any diagnostic procedures for pancreatic cancer.
If pancreatic cancer is suspected, we might perform any of the following tests in order to make a definitive diagnosis.
- Computed tomography scan (CT or CAT scan)
- Magnetic resonance imaging (MRI)
- Endoscopic retrograde cholangiopancreatography (ERCP)
- Percutaneous transhepatic cholangiography (PTC)
- Pancreas biopsy
- Positron emission tomography (PET)
Types of Pancreatic Cancer
The Pancreas Contains Two Main Types of Cells:
1. Exocrine cells that produce digestive juices
2. Endocrine cells that produce hormones
- Starts in exocrine cells and accounts for 95 percent of pancreatic cancers. It occurs in the lining of the pancreatic ducts.
Islet cell carcinoma
- Originates in the endocrine cells which make hormones such as insulin and glucagon. Most islet cell carcinomas are malignant, but insulin-producing islet cell tumors are often benign (non-cancerous). Islet cell tumors can be:
- Functional (produce high levels of hormones causing symptoms)
- Non-functional (produce no hormones) and symptoms are less obvious.
- Is very rare. This type of pancreatic cancer is found mostly in young children. Isolated sarcomas and lymphomas can also occur in the pancreas. These are very rare.
- Are mostly found in women in their teens and 20s. Patients can present with pain, jaundice (yellowing), weight loss or a mass. These cancers mainly originate in the head of the pancreas. Resection of the tumor is often curative.
- Is a rare type of exocrine tumor that begins where the bile duct from the liver and the pancreatic duct join with the small intestine. Since it causes jaundice, yellowing of the skin and eyes, it may be found earlier than other types of pancreatic cancer and therefore has a better outcome.
Rare types of pancreatic cancer
- Adenosquamous carcinoma
- Squamous cell carcinoma
Benign or malignant tumors
Is a rare pancreatic tumor that secretes insulin, the hormone that lowers glucose levels in the blood.
Is a tumor that secretes above-average levels of gastrin, a hormone that stimulates the stomach to secrete acids and enzymes. Gastrinoma can also cause stomach ulcers and can spread to the liver.
Is a tumor that secretes glucagon, a hormone that raises levels of glucose in the blood, often leading to a characteristic rash.
Benign and pre-cancerous pancreatic lesions
- Advances in imaging technology have dramatically increased the number of small abnormalities that are found in the pancreas. Most of these abnormalities are identified during imaging for another condition. Many of them are benign, fluid-filled cysts and are unlikely to cause symptoms or shorten a person’s life. Others are pre-cancerous and have the ability to turn into pancreatic cancer.
Pancreatic Cancer Stages
Staging is a way of describing where the cancer is located, whether it has spread, and whether it is affecting the functions of other organs in the body.
Diagnostic tests including pathology are used to determine stage which is important to select the most appropriate treatment.
- Refers to cancer in situ, in which the cancer has not yet invaded outside the duct (or tube) in which it started (Tis, N0, M0).
- The tumor is 2 cm or smaller in the pancreas. It has not spread to lymph nodes or other parts of the body (T1, N0, M0).
- A tumor larger than 2 cm is in the pancreas. It has not spread to lymph nodes or other parts of the body (T2, N0, M0).
- A tumor extends beyond the pancreas, but the tumor has not spread to nearby arteries or veins. It has not spread to any lymph nodes or other parts of the body (T3, N0, M0).
- A tumor of any size has not spread to nearby arteries or veins. It has spread to lymph nodes but not to other parts of the body (T1, T2, or T3; N1; M0).
- A tumor has spread to nearby arteries, veins, and/or lymph nodes but has not spread to other parts of the body (T4, N1, M0).
- Any tumor that has spread to other parts of the body (any T, any N, M1).
- Recurrent cancer is cancer that comes back after treatment. If there is a recurrence, the cancer may need to be staged again (called re-staging) using the system above.
Pancreatic Cancer Treatment
Depending on the type and stage, pancreas cancer may be treated in a variety of ways.Learn About Our Treatment Options