PANCREATIC CANCER
OVERVIEW
(Exocrine, Islet Cell)

Cancer of the pancreas is a disease in which cancer (malignant) cells are found in the tissues of the pancreas. The pancreas is about 6 inches long and is shaped something like a thin pear, wider at one end and narrowing at the other. The pancreas lies behind the stomach, inside a loop formed by part of the small intestine. The broader right end of the pancreas is called the head, the middle section is called the body, and the narrow left end is the tail.

PANCREATIC CANCER (EXOCRINE)

The pancreas has two basic jobs in the body. It produces juices that help break down (digest) food, and also hormones (such as insulin) that regulate how the body stores and uses food. The area of the pancreas that produces digestive juices is called the exocrine pancreas. (The hormone-producing area of the pancreas is called the endocrine pancreas.) About 95% of pancreatic cancers begin in the exocrine pancreas.

The chance of recovery (prognosis) depends on how far the cancer has spread (stage) and on the patient’s general state of health.

Staging

Once cancer of the pancreas is found, more tests will be done to find out if the cancer has spread from the pancreas to the tissues around it or to other parts of the body. This is called staging. The following stages are used for exocrine cancer of the pancreas:

• Stage I: Cancer is found only in the pancreas itself and has not spread to other organs.
• Stage II: Cancer has spread to nearby organs, such as the duodenum or bile duct, but has not entered the lymph nodes.
• Stage III: Cancer has spread to lymph nodes near the pancreas. The cancer may or may not have spread to nearby organs.
• Stage IVA: Cancer has spread to organs, such as the stomach, spleen, or colon, that are near the pancreas, but has not spread distant organs, such as the liver or lungs.
• Stage IVB: Cancer has spread to organs, such as the stomach, spleen, or colon, that are near the pancreas, or to places far away from the pancreas, such as the liver or lungs.
• Recurrent: The cancer has come back (recurred) after it has been treated. It may come back in the pancreas or in another part of the body.

PANCREATIC ISLET CELL Tumors

Islet cell pancreatic cancer, a rare cancer, is a disease in which cancerous cells are found in certain tissues of the pancreas. The islet cells in the pancreas make many hormones, including insulin, which help the body store and use sugars.

When islet cells in the pancreas become cancerous, they may make too many hormones. Islet cell cancers that make too many hormones are called functioning tumors. Other islet cell cancers may not make extra hormones and are called nonfunctioning tumors.

Tumors that do not spread to other parts of the body can also be found in the islet cells. These are called benign tumors and are not cancer. A doctor will need to determine whether the tumor is cancer or a benign tumor.

The chance of recovery (prognosis) depends on how far the cancer has spread (stage) and on the patient’s general state of health.

Staging

Once islet cell pancreatic cancer is found, more tests will be done to find out if cancer cells have spread to other parts of the body. This is called staging. The staging system for islet cell cancer is still being developed. Currently, these tumors are most often divided into one of three groups:

Islet cell cancers occurring in one site within the pancreas;

• Islet cell cancers occurring in several sites within the pancreas;
• Islet cell cancers that have spread to lymph nodes near the pancreas or to distant sites.

A doctor also needs to know the type of islet cell tumor. The following types of islet cell tumors are found:

• Gastrinoma: The tumor makes large amounts of a hormone called gastrin, which causes too much acid to be made in the stomach. Ulcers may develop as a result of too much stomach acid.
• Insulinoma: The tumor makes too much of the hormone insulin and causes the body to store sugar instead of burning the sugar for energy. This causes too little sugar in the blood, a condition called hypoglycemia.
• Miscellaneous: Other types of islet cell cancer can affect the pancreas and/or small intestine. Each type of tumor may affect different hormones in the body and cause different symptoms.
• Recurrent: Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the pancreas or in another part of the body.

AUTHOR: Richard Zmuda
Reviewed by Dan McCrone, MD
cancerpage.com