What Is Pancreatitis?
Pancreas is a gland located in your stomach. It produces digestive enzymes and hormones which help break down food into useful substances such as energy, water, and nutrients. The pancreas also secretes digestive juices (hormones) to regulate the digestion of foods. When there are too many acids or carbohydrates in the blood it causes acid reflux disease (ERD). When there are too few acids or proteins in the blood it causes bile duct obstruction (BDO). These diseases cause symptoms such as nausea, vomiting, abdominal pain, diarrhea and weight loss.
The pancreas is a small organ that sits just under your stomach. It contains two lobes: the endocrine portion called the duodenum and the parietal portion called the jejunum. The duodenum is responsible for breaking down food into smaller pieces so that they can be absorbed through the small intestine. The parietal portion of the pancreas controls how much goes into the intestines.
When food passes from your mouth to your stomach, it travels along a tube called the esophagus. It then goes into a storage area called the stomach. Your stomach churns and breaks down solid food with the help of strong stomach acid. Once the food becomes liquid, it passes through a tight bend in the tube called the pylorus.
From there, it enters a long tube called the small intestine.
The pancreas sits just behind your stomach and releases juices that mix with the food as it passes through the small intestine. These juices contain digestive enzymes that help your body absorb important nutrients. Some of these nutrients are fat, cholesterol, and protein.
Your pancreas also releases a hormone called insulin. This is vital for the proper use of sugar and carbohydrates. Without enough insulin the body cannot use sugar for energy and it is stored in the blood. This can cause very low blood sugar levels (hypoglycemia).
Pancreatic cancer is one of the most deadly types of cancer. The pancreas is located deep inside the body, so it is not easy to see problems in this organ. A doctor can sometimes find early signs of pancreatic cancer during a routine medical examination. Other signs of pancreatic cancer include loss of weight and appetite (anorexia), pain or discomfort in the middle or upper abdomen, jaundice, and darkening of the urine.
It is very important to check yourself for signs of pancreatic cancer on a regular basis. The following are some steps you can take:
Have a physical examination every year. Your doctor should listen to your heartbeat and gut sounds, and poke and prod all around your stomach area.
If you have diabetes or a family history of it, get a blood test to measure your blood sugar level every three months.
If you notice any of the following symptoms: loss of appetite or weight loss, itchy skin, fatigue, weakness, or pain in the upper abdomen, see your doctor right away. These could be signs of pancreatic cancer.
Some people choose to have a CT scan (computed tomography) to look for signs of problems in the pancreas and nearby organs. A CT scan takes X-rays of the body and converts them into computerized images. You will be examined by a radiation technician before and after the scan to make sure you are not being exposed to dangerous amounts of radiation.
After the scan, a specially trained physician will look at the images. He or she may notice potential problems that may not have been found during an examination.
The pancreas is located deep inside the body, so it is not easy to examine this organ during a physical examination. Even if a doctor finds a potential problem during the physical examination, it may not be possible to determine whether or not it is serious.
If you have a known family history of pancreatic cancer or genetic disorder that increases your risk for developing cancer, you may choose to have an MRI (magnetic resonance imagery) scan. This non-invasive scan can provide pictures of organs and structures within the body without exposing you to radiation. A specially trained technician will guide you through the scanning process.
Imaging tests can sometimes find signs of pancreatic cancer or potential problems that cannot be detected during a physical examination.
Imaging tests, such as a CT scan or MRI, should be used selectively and only when needed since they involve the use of radiation. These tests may also produce a large number of false positive or false negative results, which means that many people may be needlessly exposed to radiation or not diagnosed with potentially life-threatening conditions.
WHAT ARE THE TREATMENTS FOR PANCREATIC CANCER?
Surgery is the treatment of choice for most early stage pancreatic cancer cases. Some early-stage pancreatic cancer cases can be treated with less extensive surgery, while other more complex cases may require a more extensive procedure.
If the cancer has spread to the lymph nodes, surgery cannot be used as the primary treatment. Chemotherapy and radiation therapy may be used as adjunctive treatments along with surgery. In some cases, palliative care (symptom management) alone may be appropriate.
WHAT ARE THE PROGNOSES FOR PANCREATIC CANCER?
The outlook for a person with pancreatic cancer depends on many factors. The biggest factors are the type of cancer you have, the stage (extent) of the cancer, your age and overall health, and how the cancer responds to treatment.
The average survival time (also called prognosis) for people with pancreatic cancer is generally measured in months. In general, the prognosis is worse for people over the age of 65. The average survival time for people over the age of 65 is about one year.
The outlook is somewhat better for younger people. In general, the average survival time for people between the ages of 40 and 65 is about 18 months. For people under the age of 40, the average survival time is about two years. The treatment you choose also has an effect on your prognosis.
When cancer is found early and treated immediately, the chances of cure are improved.
The outlook for pancreatic cancer is generally poor, especially for people who have the disease at an advanced stage. Late stage pancreatic cancer can be treated, but it is unlikely that the treatment will cure the cancer.
Risk factors for pancreatic cancer are similar to those for other cancers, such as smoking and obesity. The risk factors for pancreatic cancer include:
smoking (current and past)
exposure to asbestos
a diet high in fat
a family history of pancreatic cancer
a diagnosis of diabetes
AGE AND RACE
While any person can develop pancreatic cancer, the cancer is more common in people over the age of 55. It is most commonly diagnosed in people over the age of 70.
PANCREATIC CANCER AND BREAST CANCER
Pancreatic cancer is rarely diagnosed in women. Only about 2% of cases occur in women. Even so, it is the fourth leading cause of cancer death among women. The risk of pancreatic cancer is particularly high in people with a history of certain types of pancreatic tumors, such as pancreatic neuroendocrine tumors or pancreatic ductal adenocarcinoma.
Even less common in men, pancreatic cancer is the seventh most common cause of cancer death among men in the United States.
The overall incidence of pancreatic cancer is on the rise. The average age of people being diagnosed with pancreatic cancer has decreased slightly over the past several years.
The treatment option chosen for pancreatic cancer depends on many factors.
- Protein structure prediction and structural genomics (D Baker, A Sali – Science, 2001 – science.sciencemag.org)
- Structural genomics projects in Japan (S Yokoyama, H Hirota, T Kigawa, T Yabuki… – nature structural …, 2000 – nature.com)
- Completeness in structural genomics (D Vitkup, E Melamud, J Moult, C Sander – nature structural biology, 2001 – nature.com)