Pancreatic Cancer

Overview

Pancreatic Cancer Types

The two main types of pancreatic cancer depend on the part of the pancreas where the cancer starts.

• The most common type of pancreas cancer arises from cells that line the pancreatic duct (drainage tube of the pancreas). This type has a poor prognosis if not detected early.
• Cancers arising from the islets of Langerhans, such as pancreatic endocrine tumors, have a better long-term outcome.

Pancreatic Cancer Symptoms

Pancreatic cancer can advance to a late stage before you begin to notice symptoms. Symptoms of pancreatic cancer can vary widely, but may include:

• Jaundice (yellowing of the eyes and skin)
• Pain in the belly area or middle of the back
• Unexplained weight loss
• Digestive problems
• Swollen gallbladder
• Blood clots
• Diabetes

How We Can Help

Accurate diagnosis ensures effective treatment. IU Health is one of the most respected health systems in the nation for the diagnosis and multidisciplinary treatment of all types and stages of pancreatic cancer.

Our particular expertise in biopsy (taking a sample of tissue), several kinds of imaging and endoscopic ultrasound (EUS) allow us to locate tumors, take biopsies and direct accurate, effective treatment. Physicians throughout the U.S. use diagnostic procedures developed at IU Health to accurately diagnose and treat different types of pancreatic cancer.

Treatment

IU Health oncologists use highly specialized methods to detect, diagnose, stage and treat pancreatic cancer. Your physician will focus on patient- and family-centered care that combines their expertise with your needs and requests. They will develop the most effective plan for treating your pancreatic cancer.

Treatments include:

• Surgery. Whenever possible, we remove pancreatic tumors. We use a variety of surgical techniques (laparoscopic, open, robotic, etc.). Laparoscopic and robotic surgery use specialized instruments inserted through small incisions. These smaller incisions result in less pain and shorter recovery times. Several different types of surgery exist for pancreatic cancer.
• Chemotherapy
• Immunotherapy
• Radiotherapy
  • Cone-beam computer tomography (CBCT)
  • Four-dimensional CT simulation
  • Image guided radiation therapy (IGRT). This technique uses imaging done during treatment to guide precisely targeted radiation directly to the tumor.
  • Intensity modulated radiation therapy (IMRT). Careful variations in the intensity of the radiation beam allow your physician to focus radiation on all parts of a pancreatic tumor with minimal effect on sensitive tissues around it.
  • Stereotactic body radiation therapy (SBRT). This targeted technology allows your physician to send a beam of radiation into the tumor with minimal effect on normal tissue.
  • Three-dimensional conformal radiotherapy
• Endoscopic ultrasound-assisted cancer treatments. If you need radiation therapy, your physician may use endoscopic ultrasound (EUS) to place markers during image guided radiation therapy to ensure the targeted radiation. For some cancers, your physician can use EUS to inject chemotherapy, ethanol and other medicines directly into a cyst, lesion or lymph node to improve outcomes or ablate (destroy) a pancreatic cyst.
  • Cancer staging. EUS will help your physician stage the cancer. EUS provides better tumor and tissue visualization and helps your physician determine the involvement of surrounding blood vessels and organs. EUS allows your gastroenterologist to see if you will benefit from tumor removal (resection).
  • Research. Physicians at IU Health discovered many of the early insights into advanced uses of endoscopic ultrasound. They continue to conduct and participate in clinical research that evaluates the role EUS can play in managing benign and malignant pancreatic, disorders. With EUS, IU Health physicians harvest tissue samples for pancreatic cancer studies. Their research also assesses new technologies and devices to develop the emerging field of interventional EUS.
• Endoscopic retrograde cholangiopancreatography (ERCP) This procedure advances a camera into the small intestine. IU Health physicians helped pioneer the use of this technique over 30 years ago in the United States. If the tumor in the pancreas obstructs the bile duct, yellowing of the skin (jaundice) may result. If this occurs, surgeons can place a stent into the duct to allow bile to drain from the liver.
• Accurately imaging and staging pancreatic cancer requires sophisticated technology in addition to ERCP and EUS. At IU Health, we routinely use high-resolution computed tomography (CT) scan. This provides three-dimensional pictures of the inside of your body.