Posts Tagged ‘pancreatic cancer symptoms’

Treating Pancreatic Cancer

pancreatic cancer imagePancreatic cancer is a very aggressive disease that is prone to metastasizing or spreading. Unfortunately, it has been rising in incidence in the United States with approximately 50,000 new cases per year. Treatment for pancreatic cancer varies depending on the individual patient, but when determining surgical treatment options we consider these questions: Has the tumor spread? Is it removable? And is the patient in good enough shape to have surgery?

If surgery is an option, the approach for pancreatic cancer is dictated by where the tumor is located, and the surgeon may remove parts or, in rare circumstances, the entire pancreas. Most tumors are diagnosed in the head of the pancreas, and these can be removed with a pancreaticoduodenectomy, also known as the Whipple procedure. The Whipple procedure, an aggressive operation that typically takes between three to six hours to complete, involves removing a third of the pancreas and part of the intestines called the duodenum. However, if the tumor is on the other side of the pancreas then it can be removed with something called a distal pancreatectomy, which involves less reconstruction than the Whipple procedure.

In addition to the standard surgical options, we also utilize technologically advanced, minimally invasive surgical approaches using laparoscopy and robotic surgery. Laparoscopic surgery involves placing medical instruments in the belly through tubes, which results in smaller incisions. This approach can get patients out of the hospital a little faster because of less blood loss and fewer complications than standard surgery. We are also using cutting-edge robotic surgery for pancreatic cancer. This technology can be used in the Whipple procedure and the distal pancreatectomy, and the robot provides the surgeon with incredible dexterity. While traditional laparoscopic instruments do rotate and open and close, the robot has wrists and 3D visualization. This allows the surgeon to see things with good depth perception instead of looking at a flat screen, which can be especially helpful for complex surgeries in confined areas. The surgical robot is a valuable, minimally invasive tool for selective circumstances, although it is not necessary for all pancreatic procedures.

About Dr. Kooby

koobyDavid A. Kooby, MD, FACS, is a board certified surgical oncologist specializing in laparoscopic and open surgical treatment of pancreas, bile ducts, stomach, and colon cancers. Dr. Kooby is a pioneer in minimally invasive and robotic pancreatic surgery, and serves as Professor of Surgical Oncology in the Department of Surgery at Emory University School of Medicine. Dr. Kooby also is the Director of Surgical Oncology at Winship at Emory Saint Joseph’s Hospital and the Director of Minimally Invasive GI Surgical Oncology at Emory University School of Medicine. Dr. Kooby will be co-directing the International Hepato-Pancreato-Biliary Association State of the Art Conference


Pancreatic cancer at Winship
Steve Jobs, pancreatic cancer & the Whipple Procedure 
Intro to Pancreatic Cancer Part I: Stats, Types, & Risk Factors
An Intro to Pancreatic Cancer Part II: Prevention, Diagnosis & Treatment
5 Early-Distress Warnings of Digestive Cancer

Risk Factors and Symptoms of Pancreatic Cancer

The pancreas is a flat, banana-shaped organ that is located behind the stomach. Functionally, it can be regarded as two separate organs based on the chemicals each produces. The exocrine pancreas makes up the largest part of the gland and is responsible for creating enzymes that help break down foods we eat so that they can be used by the body. The endocrine pancreas is composed of groupings of cells that make up a much smaller part of the gland. These cell clusters, called islets, are responsible for producing hormones, such as insulin, that help regulate the amount of sugar in the blood.

What are the risk factors and symptoms of pancreatic cancer? Winship surgical oncologist, Dr. David Kooby answers those questions.

Learn more about Winship Cancer Institute of Emory University.

5 Early-Distress Warnings of Digestive Cancer

pancreatic cancer live chatWhen you think of digestion you probably don’t think about the pancreas, but it sits right behind the stomach and works to provide essential digestive functions. The pancreas, only about 4- 6 inches long, is widely known for producing insulin, an important hormone that regulates blood sugar levels, but it also assists the body in the absorption of nutrients into the small intestine.

Pancreatic cancer increases with age and most people are between 60 to 80 years old when diagnosed. Early pancreatic cancer often does not cause symptoms, however there are five early warning signs that we can all be aware of to better advocate for our health.

  1. Yellow eyes or skin.  The pancreas uses a greenish-brown fluid made in the gallbladder, called bile, to help the small intestine in digestion. If a tumor starts in the head of the pancreas, it can block or press on the bile duct and cause bile to build up. This back-up causes yellow discoloration, called jaundice.
  2. Belly pain.  Pain has been described as distressing, as compared to a sharp cramp or ache. Pain may go away when you lean forward because it and spreads toward the back.
  3. Change in stool.  Pale, floating, smelly stools. Or dark stools. Let your stool be a guide. If a pancreatic tumor prevents digestive fluids from reaching the intestine, the result is an inability to digest fatty foods. Anytime there is a change with digestion then check in with your doctor. It may not be a sign of digestive cancer, but you do need to be aware of your own body function to determine what is or is not “normal.”
  4. Lack of appetite.  Or sudden, unexplained weight loss. A drop in appetite and a tendency to feel full after eating very little is something to be aware of. Again, it may not be alarming but you do need to be aware of your own body function to determine what is or is not “normal.”
  5. Diabetes, especially if unexpected from regular check-ups.  Most diabetes diagnoses are not due to pancreatic cancer; however, research studies show that pancreatic cancer patients have a higher rate of diabetes diagnosis than the general populace. Knowing your family history of pancreatic cancer and having a baseline of regular screening will help your doctor evaluate if additional tests should be done.

Being an advocate for your health starts with healthy behaviors; tobacco use, particularly cigarette smoking, accounts for 20-30% of pancreatic cancer. Knowing risk factors you should avoid (such as smoking) and being aware of what your body is signaling will help you in early detection as well as potential outcome.

Management of cancer requires a multidisciplinary team of healthcare specialists. Winship’s pancreas cancer team includes surgeons, medical oncologists, radiation oncologists, gastroenterologists, pathologists as well as pain specialists, nutritionists and social workers. For patients with early stage pancreatic cancer, the Whipple surgical procedure is the best option for long-term survival. Winship Cancer Institute of Emory University surgeons perform a large number of Whipple procedures every year; a high volume of these procedures directly translates into the expertise needed to perform the procedure safely. According to published data, mortality rates from Whipple surgery are four times lower at hospitals performing a high volume of the procedure, such as Emory. Some patients may be candidates for laparoscopic or robotic surgery, which may improve both recovery and cosmetic appearance after surgery. Winship at Emory surgeons are leading the world in this area as well. If diagnosed with cancer it’s important to get to Winship, first.

Continue learning about pancreatic with a conversation; all are welcome to attend an online open-forum discussion about pancreatic cancer. We will answer your questions about pancreatic cancer risk factors, symptoms and therapy on Tuesday, May 12th, 2015 at noon.

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About Dr. El-Rayes

Dr. El-Rayes, Colon Cancer SpecialistBassel El-Raye, MD, is the Director of the GI Oncology Clinical and Translational Research Program, Associate Cancer Research Director for Clinical Research at Winship Cancer Institute of Emory University and Professor of Hematology and Oncology at Emory University School of Medicine. Dr. El-Rayes earned his bachelor’s degree in biology and doctoral degree from the American University of Beirut. He then completed his residency in internal medicine and fellowship in hematology and medical oncology at Wayne State University, Detroit. He was on faculty at Wayne State University Karmanos Cancer Institute from 2003-2009. Dr. El-Rayes clinical interests include gastrointestinal malignancies specifically pancreatobiliary and neuroendocrine cancers. He is principle investigator on multiple investigator initiated trials. He has served on the gastrointestinal committee for Southwest Oncology Group (SWOG) and Radiation Oncology Cooperative Group (RTOG). He currently serves on the National Cancer Institute Neuroendocrine Tumor (NET) Task Force. He also serves as Co-chair of Hoosier Oncology Group (HOG) Cancer Research Network – Gastrointestinal Clinical Trials Working Group. Dr. El-Rayes is a Georgia Cancer Coalition Distinguished Clinical Scholar. He has published over 90 peer reviewed articles in elite journals including Journal of Clinical Oncology and Cancer Research.

About Dr. Kooby

David Kooby, MDDavid A. Kooby, MD, FACS, specializes in laparoscopic/robotic and open surgical treatment of liver, bile duct, pancreas, stomach, and colon tumors/cancers. He also has expertise with tumors and diseases of the spleen, adrenal glands, and retroperitoneum. He has taught many national courses on laparoscopic resection of the liver, pancreas, and colon, and is frequently invited to speak at national conferences. He received his MD at the State University of New York, Downstate Medical College, Brooklyn, NY, in 1994; completed his surgical residency at Vanderbilt University, where he won medical student and resident teaching awards. He completed both bench research and clinical fellowships at Memorial Sloan-Kettering Cancer Center, New York, NY. He was recruited by Emory in 2003, and is currently an Associate Professor of Surgery in the Division of Surgical Oncology, Director of Surgical Oncology at Emory/Saint Joseph’s Hospital, and Director of Minimally Invasive GI Surgical Oncology. He serves on several national committees including the task force charged with updating the staging of hepatobiliary malignancies for the American Joint Committee on Cancer’s Cancer Staging Manual, the research and education committee for the American Hepato-Pancreato-Biliary Association, and the Hepatobiliary Working Group for the Society of Surgical Oncology. He is leader in multicenter clinical research and is a national leader in minimally invasive pancreatic surgery.

Related Resources

Bite into a Healthy Lifestyle
An Intro to Pancreatic Cancer Part I: Stats, Types, & Risk Factors
Steve Jobs, Pancreatic Cancer & the Whipple Procedure

Intro to Pancreatic Cancer Part I: Stats, Types, & Risk Factors

Pancreatic Cancer Awareness Month

November is Pancreatic Cancer Awareness Month. Before we dig a bit deeper into pancreatic cancer in this two-part blog post, below are some important stats you should be aware of. According to the National Cancer Institute (NCI) and American Cancer Society:

  • pancreatic cancer is the 4th leading cause of cancer-related death in both men and women in the U.S.
  • 1.41% of men and women born today will be diagnosed with cancer of the pancreas at some time during their lifetime
  • the median age for diagnosis of pancreatic cancer was 72 years old (based on data from ‘04-’08)
  • the median age of death as a result of pancreatic cancer was 73 years old (based on data from ‘04-’08)
  • 0.53% of men will develop cancer of the pancreas between their 50th and 70th birthdays compared to 0.39% for women
  • About 44,030 people (22,050 men and 21,980 women) will be diagnosed with pancreatic cancer.

Pancreatic Cancer Types

According to the Winship Cancer Institute of Emory University, “A pancreatic cancer type is based on the location of the tumor’s origin within the pancreas. More than 95 percent of pancreatic cancers are adenocarcinomas of the exocrine pancreas. Tumors of the endocrine pancreas are much less common and most are benign.”

  • Acinar Cell Cancers: Acinar cell cancers are tumors that form on the ends of the pancreatic ducts.
  • Adenocarcinoma: An adenocarcinoma is a cancer that begins in the cells that line certain internal organs and have secretory properties. In the pancreas, this is a cancer of the exocrine cells that line the pancreatic ducts.
  • Cystic Tumors: Cystic tumors derive their name from the presence of fluid filled sacs within the pancreas. The fluid is produced by the lining of abnormal tissues or tumors. These tumors may lead to cancer in some patients; however, most cystic tumors of the pancreas are benign.
  • Sarcomas: Sarcomas are tumors that form in the connective tissue that bonds pancreatic cells together and are rare.

Pancreatic Cancer Risk Factors

  • Age:  Nearly 90% of those with pancreatic cancer are older than 55 years and over 70% are older than 65.
  • Gender: Pancreatic cancer incidence rates are higher among men than women, but it is possible that this can be attributed to higher tobacco use incidence rates among men.
  • Weight: According to the NCI, “In a pooled analysis of clinical data,  higher body mass index was associated with an increased risk of developing pancreatic cancer, independent of other risk factors.”
  • Cigarette Smoking: According to the American Cancer Society, pancreatic cancer risk is 2-3x higher for smokers than non-smokers. About 20% to 30% of exocrine pancreatic cancer cases are thought to be caused by cigarette smoking.

Next week, we’ll follow up with more information on pancreatic cancer, including steps you can take to lower your risk (prevention), symptoms of cancer of the pancreas, and how pancreatic cancer is diagnosed and treated.

In the meantime, if you have questions about pancreatic cancer, please leave them for us in the comments below. All comment responses will be provided by physicians of Emory Healthcare and/or the Winship Cancer Institute of Emory University.