Pancreatic cancer occurs when there is an uncontrolled growth of abnormal cells in the pancreas, which often begins in the pancreatic ducts. The pancreas is an organ that is about 6 inches long and is located deep in your belly between your stomach and backbone in the upper part of your abdomen. Your liver, intestine, spleen and stomach surround your pancreas.
What is Pancreatic Neuroendocrine Cancer?
Pancreatic neuroendocrine tumors (islet cell tumors) are uncommon cancers with about 1,000 new cases per year in the United States. Pancreatic neuroendocrine tumors account for 3% to 5% of pancreatic malignancies, and overall have a better prognosis than the more common pancreatic exocrine tumors. Surgery is the only curative treatment modality.
Pancreatic neuroendocrine tumors originate in the islet cells. The islets make important hormones, such as insulin and glucagon, and release them directly into the blood. Insulin reduces the amount of sugar in the blood, while glucagon increases it. Five-year survival rate for pancreatic neuroendocrine cancer is about 55% when the tumors are localized and resected, but only about 15% when the tumors are not resectable. Overall 5-year survival rate is about 42%.
The vast majority of tumors found in the pancreas are adenocarcinomas, which is more commonly referred to as pancreatic cancer. Many pancreatic exocrine tumors ("PET") are found through imaging studies Exocrine tumors are by far the most common type of pancreas cancer.
How is Pancreatic Neuroendocrine Cancer Diagnosed?
Because the pancreas is deep inside the body, the doctor cannot see or feel tumors during a routine physical examination. Imaging studies, such an abdominal ultrasound or an abdominal CT scan, are diagnostic for pancreatic neuroendocrine cancer.
Blood tests can elevate the function of the liver and other organs that may be affected by a pancreatic tumor. Bilirubin is a chemical that may reach high levels in patients with pancreatic cancer due to blockage of the common bile duct by a tumor. Often lab results in pancreatic cancer show a high bilirubin (yellowish bile pigment found in the serum) and elevated liver function enzymes. Live enzyme tests (LFT) are a group of blood tests that detect inflammation and damage to the liver. Liver enzyme tests, including ALT, AST, alkaline phosphatase; true LFTs include PT, INR, albumin and bilirubin.
What are the Stages of Pancreatic Cancer?
There are three stage classifications for pancreatic neuroendocrine cancer:
- Potentially resectable,
- Locally advanced,
Stage I pancreatic tumors are found only in the pancreas.
Stage II pancreatic tumors invade nearby tissue, but not nearby blood vessels. The cancer may have spread to the lymph nodes.
Stage III pancreatic tumors involve regional lymph nodes, but show no evidence of distant metastasis.
Stage IV-A pancreatic cancer include tumors which have spread into the stomach, spleen, large bowel or the adjacent large blood vessels and which involve regional lymph nodes, but show no evidence of spreading to distant organs, such as the liver or lungs.
Stage IV-B pancreatic cancer includes pancreatic tumors of any kind with lymph node status of any kind and evidence of distant metastasis. Advanced pancreatic cancer stage includes evidence of metastatic spread (typically to the liver, peritoneum or lungs).
Have Questions about Pancreatic Cancer?
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