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Pancreatic Cancer

Treating pancreatic cancers can be challenging. The specialists at the University of Michigan Health Rogel Cancer Center tackle the most complex pancreatic cancers. We provide new treatment strategies that offer hope.

Pancreatic Cancer Care: Why Choose Rogel Cancer Center?

Just 3% of all cancers in the United States are pancreatic cancer, according to the American Cancer Society. Our experienced gastrointestinal cancer experts have the skill and expertise to treat these rare cancers. Program highlights include:

  • Dedicated expertise: Our medical oncologists, radiation oncologists and surgeons work together to develop effective treatment plans for even the most challenging pancreatic cancers. Meet our team.
  • Leading-edge treatments: When pancreatic tumors aren’t immediately operable, our medical oncology and radiation oncology specialists use chemotherapy and radiation therapy to reduce tumor size and help make surgery possible.
  • Focus on healing: We use minimally invasive techniques to help you recover from surgery faster. Quicker recovery means you can move on to the next stage of treatment faster.
  • Emerging therapies: Our research focus means we’re always searching for the newest therapies for pancreatic cancer. We offer access to sophisticated treatments for eligible patients through GI cancer clinical trials.

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About Pancreatic Cancers

Your pancreas plays a key role in digestion and blood sugar regulation. The pancreas sits behind your stomach and includes three sections:

  • Head: Part of the pancreas that is near the liver ducts and intestine
  • Neck: Narrow part of the pancreas that is above blood vessels
  • Body: Middle part of the pancreas
  • Tail: Part of the pancreas that is near the spleen

Two types of cells drive the digestive processes of the pancreas:

  • Exocrine (acinar) cells: Cells located throughout the pancreas that make enzymes that help you digest food.
  • Endocrine cells: Cells that make and release hormones (insulin and glucagon) that help regulate blood sugar. These cells are in small clusters, known as islets of Langerhans, throughout the pancreas.

Each day, exocrine cells in your pancreas make up to two liters of digestive juices. These juices flow through ducts in the pancreas into your small intestine, where they help break down carbohydrates, fats and proteins. Endocrine cells release hormones that tell your liver and muscles when to store sugar and when to release it into your blood.

When exocrine or endocrine cells grow in unusual ways, pancreatic cancers can form.

Pancreatic cancer types include:

Exocrine pancreatic cancer

The most common pancreatic cancers are cancers of the exocrine cells—about 95% of pancreatic cancers begin in these cells. Most tumors that form in the exocrine cells are cancers that begin in pancreatic duct cells (adenocarcinomas).

Endocrine pancreatic cancer

Cancers that develop in the endocrine cells are the least common type of pancreatic cancer. These cancers are pancreatic neuroendocrine tumors, or islet cell tumors, that form in the cells that make hormones.

Ampullary cancer

Tumors can also form in the area where digestive juices from the pancreas flow into the beginning of the small intestine (duodenum). Cancer that forms in this area (the ampulla of Vater) is ampullary cancer.

Diagnosing pancreatic cancers is challenging. You may have symptoms that mimic other illnesses, or you might not have any symptoms at all. Pancreatic symptoms can include:

  • Abdominal or back pain
  • Appetite loss
  • Dark urine
  • Diarrhea
  • Fatigue
  • Jaundice (yellow eyes or skin)
  • Light-colored stools
  • New onset of diabetes
  • Weight loss

Our experts diagnose pancreatic growths and changes in pancreatic function. We begin with a physical examination and may recommend certain tests to diagnose pancreatic cancers. We use:

Imaging tests

Specialists use imaging tests to view the pancreas in greater detail, including:

  • Abdominal ultrasound: Experts move a transducer over the skin of your abdomen. We use sound waves to create detailed pictures of the pancreas and surrounding tissue.
  • Computed tomography (CT) scan: We use a special X-ray test to see many views of the pancreas and whether cancer has spread to other organs.
  • Endoscopic ultrasound: Experts insert a thin lighted flexible instrument (endoscope) with a camera through your mouth or rectum. Sound waves create images of the pancreas.
  • Magnetic resonance imaging (MRI): Specialists use radio waves and magnets to create images that show changes to the pancreas and other organs.

Laboratory tests

Rogel Cancer Center specialists use certain laboratory tests to diagnose pancreatic tumors. These tests may include:

  • Blood tests: We check levels of blood sugar (glucose), glucagon, insulin and other substances that may indicate cancer is present.
  • Stool analysis: Specialists check stool samples for high levels of salt (sodium) and potassium or fat that may indicate abnormal pancreatic function.

Laparoscopy

Our experts may recommend laparoscopy. We insert a thin lighted instrument (laparoscope) through a small incision in your abdomen to take tissue or fluid samples (biopsy). Pathology specialists examine these samples under a microscope to check for cancer cells.

Pancreatic Cancer Treatment at Rogel Cancer Center

Rogel Cancer Center specialists are experts in developing personalized strategies to treat complex pancreatic cancers. We offer:

Pancreatic cancer surgery

Pancreatic cancer surgery is the best option for preventing the spread (metastasis) of these cancers. For tumors that are removable (resectable tumors), Rogel Cancer Center offers:

  • Distal pancreatectomy: Surgeons remove the body and tail of the pancreas. We may also remove your spleen. With the distal pancreatectomy, your pancreas can still make digestive juices and insulin.
  • Total pancreatectomy: Experts remove the entire pancreas and some surrounding tissue. This surrounding tissue includes the gallbladder, lymph nodes, spleen and portions of your small intestine. If needed, we may remove part of the stomach. We may also remove the tube carrying bile from the liver to the gallbladder (common bile duct).
  • Whipple procedure: Surgeons remove a portion of the pancreas (head), the gallbladder and the bile duct, part of the small intestine, and, if needed, portions of the stomach. With the Whipple procedure, your pancreas can still make digestive juices and insulin.

When tumors can’t be fully removed, surgeons may do surgery to improve function and manage symptoms (palliative surgery). Experts may recommend:

  • Biliary bypass: Surgeons create a new route for bile to travel between the liver and small intestine when there are blockages in the bile duct.
  • Endoscopic stent: Experts insert a tube (stent) to relieve built-up bile in a blocked bile ducts.
  • Gastric bypass: Surgeons create a direct pathway form the stomach to the small intestine when tumors block food’s movement from the stomach.

Radiation therapy for pancreatic cancer

Not all pancreatic tumors are resectable at the time of diagnosis. Our radiation oncology experts use radiation therapy to reduce tumor size and help make surgery possible. In tumors that aren’t made resectable by radiation therapy, we also use external beam therapy to manage symptoms.

You may have radiation therapy every day for several weeks. We may also combine radiation therapy with chemotherapy (chemoradiation) to destroy cancer cells.

Systemic therapy for pancreatic cancer

Our experts may recommend medications that travel through your bloodstream to destroy cancer cells. You may have these medications before or after surgery or radiation therapy to treat some pancreatic cancers. We use:

  • Chemotherapy: Powerful drugs that work throughout your body to kill cancer cells or stop them from growing
  • Hormone therapy: Medications that remove or block hormones that fuel neuroendocrine pancreatic tumors
  • Targeted therapy: Specialized drugs that target specific cancer cells while sparing your body’s healthy cells

Multidisciplinary Pancreatic Cancer Care

The specialists at Rogel Cancer Center work together to treat all types of pancreatic cancer in our multidisciplinary clinics. Our specialist team offers access to expert diagnoses and the most advanced treatments for pancreatic cancers. The multidisciplinary approach at Rogel Cancer Center ensures you benefit from our team’s years of training, skill and experience.

Find GI Cancer Support Services

We’re there for you at every step, from pancreatic cancer diagnosis to treatment and beyond. When you or a loved one has pancreatic cancer, our GI cancer support services can help.

Request an Appointment

Learn more about how we diagnose and treat all pancreatic cancer types at Rogel Cancer Center. Call 734-647-8902 to make an appointment.