Pancreatic cancer, also called pancreatic carcinoma, is cancer of the pancreas. The pancreas is an organ located behind the stomach, which makes and releases enzymes that help the body absorb food, especially fats. The pancreas also makes the hormones insulin and glucagon, which help control your blood sugar levels.
Management of Pancreatic Cancer at MedStar Georgetown
Pancreatic cancer is a challenging disease, often advanced at the time of diagnosis, requiring strategic planning with sophisticated care. Our pancreatic cancer experts work as a multidisciplinary team to attack the cancer from all angles. Surgeons, medical oncologists, gastroenterologists, radiation oncologists, interventional radiologists, radiologists, nutritionists, social workers and a dedicated nurse navigator provide exceptional, personalized diagnosis and treatment for pancreatic cancer patients. Learn more about pancreatic cancer treatment at Georgetown in Washington, D.C.
Pancreatic Cancer Symptoms
A tumor may grow in the pancreas without any noticeable symptoms at first, which can mean that the cancer is at a more advanced stage when it is first found.
Early symptoms of pancreatic cancer include:
- Pain or discomfort in the upper part of your abdomen
- Loss of appetite
- Weight loss
- Jaundice (a yellowing of your skin and whites of your eyes)
- Dark urine and clay-colored stools
- Fatigue and weakness
- Nausea and vomiting
Pancreatic Cancer Diagnosis
Your doctor will perform a thorough physical examination and ask you about your medical history. Your doctor may order one or more of the following tests to confirm the diagnosis:
- Abdominal computed tomography (CT) scan, an imaging method, uses X-rays to create cross-sectional pictures of your abdominal area.
- Magnetic resonance imaging (MRI) scan of the abdomen, also an imaging method, uses powerful magnets and radio waves to create a detailed image of your abdominal area.
- Endoscopic retrograde cholangiopancreatography, or ERCP, uses an endoscope to show stones or tumors in your bile ducts.
- Endoscopic ultrasound, an imaging procedure, uses a small, flexible microscope to examine the inside of your body and guide the collection of tissue samples.
- Pancreatic biopsy, a procedure in which your doctor takes a sample of tissue or material through the duodenum (the first part of the small intestine), the bile ducts, pancreas or pancreatic duct. The doctor sends the sample(s) to be tested for cancer.
Your doctor may also order the following blood tests:
- Liver function tests evaluate how well your liver is working, because pancreatic cancer may affect your liver function.
- Serum bilirubin measures the amount of bilirubin in your blood. Bilirubin is a fluid produced by the liver.
- Tumor markers are specific proteins that are produced by some malignant tumors.
Whipple Procedure at MedStar Georgetown
The standard procedure for pancreatic cancer found in the head of pancreas that has not spread is called a pancreaticoduodenectomy or a Whipple procedure. Only highly skilled surgeons should perform this complex procedure. Studies have shown that the best results are achieved when the surgery is performed at hospitals with a high volume of these cases per year. At MedStar Georgetown, our skilled surgeons perform more than the national average number of Whipples every year (80–100). Learn more about the Whipple procedure. Many times, pancreatic cancer is advanced when it is first found; in most cases, this means that the tumors cannot be removed surgically.
Nonsurgical Treatment for Pancreatic Cancer
If the tumor has not spread out of the pancreas, but it cannot be removed surgically, it is called locally advanced. Your doctor may recommend:
- Radiation medicine, including conventional radiation medicine and/or CyberKnife®. Radiation medicine uses high-powered X-rays to destroy cancer cells.
- Chemotherapy, which uses powerful drugs to kill cancer cells.
These two treatments may be given together, at either the same time or one right after the other. If the tumor has metastasized (spread to other organs), chemotherapy is the primary treatment and radiation treatment may be used.
Biliary Obstruction
Sometimes, the tumor causes a blockage of the tubes that transport bile. In this case, the patient experiences biliary obstruction, which must be relieved. Your doctor may recommend one of two approaches:
- Surgery
- Placement of a biliary stent, a tiny metal tube, during the ERCP
