The pancreas is a gland located in the upper abdomen that produces hormones such as insulin and enzymes that help the body digest its food and regulate sugar.

Pancreatic cancer claims more than 36,000 lives each year, the fourth-leading cause of cancer death in the United States. Unfortunately, about 80 percent of patients present to a physician with metastatic or locally advanced disease, preventing the possibility of a cure with surgical treatment.

Risk factors:

Risk factors for pancreatic cancer include:

• age; incidence of pancreatic cancer increases after age 50
• smoking
• a diet heavy in meat and fat
• chronic pancreatitis
• diabetes

Symptoms:

In the beginning, pancreatic cancer causes only vague symptoms. Often middle-aged patients will have recently developed diabetes with another obvious cause or have had changes in their bowel movements.

As the disease progresses, symptoms may include:

• pain in the upper abdomen or back
• nausea and vomiting
• loss of appetite
• weight loss
• jaundice (yellow skin and sclera of the eyes)
• weakness
• change in color of urine and stool (urine may turn the color of tea; stool may turn gray or chalky white)
• new onset of diabetes or a sudden change in blood sugar control in diabetics

Treatment:

Pancreatic cancer is difficult to cure, even when diagnosed at an early stage. For patients who are candidates for surgery, there is a 20 percent chance of cure if the cancer can be completely removed. It is very important to obtain a consultation with a surgeon at a high-volume pancreatic surgery center to determine whether surgery with a Whipple procedure, for pancreatic head tumors, or a distal pancreatectomy, for pancreatic body/tail tumors, is feasible.

After recovery from surgery, patients are almost always recommended to undergo chemotherapy and radiation therapy.

In the remaining population of patients who are not surgical candidates, treatment is generally focused on palliative care using chemotherapy alone or in combination with radiation therapy. Pancreatic cancer is not curable at this stage. Pain can be controlled with nerve blocks and jaundice can be relieved with endoscopic stents.

Nearly all pancreatic cancer patients require multidisciplinary treatment from a team of cancer specialists. This team includes the surgeon, a gastroenterologist, and medical and radiation oncologists. Patients can contact a surgeon directly through the Section of Gastrointestinal Surgery, the Section of Surgical Oncology, and the Multidisciplinary Gastrointestinal Oncology Center. Because of the difficulty in treating this disease, our patients are often encouraged to participate in one of UAB's clinical trials to help in the fight against pancreatic cancer.

UAB is on the nation's forefront in diagnosing and treating pancreatic cancer. We are one of the few very busy centers, which brings expertise in all areas needed to diagnose and treat pancreatic cancer. UAB is also heavily funded and involved in scientific research aimed at earlier diagnosis and treatment of pancreatic