Cancer of the Pancreas

Pancreatic cancer can be divided into two types: exocrine and endocrine. Exocrine pancreatic cancer is the more common of the two, and arises from the exocrine glands of the pancreas that make pancreatic enzymes to help digest food. Pancreatic adenocarcinoma comprises about 95% of exocrine pancreatic cancers. Other types of exocrine pancreatic cancer include squamous cell carcinoma, signet ring cell carcinoma, and adenosquamous carcinoma.

Endocrine pancreatic cancer is very uncommon, and comprises about 5% of all pancreatic cancers. They tend to have a more favorable prognosis than exocrine pancreatic cancers.

Risk factors for pancreatic cancer include:

• Smoking
• Being overweight or obese
• Environmental chemicals such as those used in dry cleaning and metal working
• Older age
• Personal history of diabetes
• Personal history of liver cirrhosis
• Personal history of stomach problems, such as H. pylori and ulcers
• African American race
• Family history of pancreatic cancer
• Lack of physical activity
• Heavy alcohol use

Pancreatic cancer is frequently found in later stages, once the tumor has already spread to other organs. Signs and symptoms of pancreatic cancer can include:

• Abdominal pain
• Nausea and vomiting
• Jaundice (yellowing of the skin and eyes)
• Back pain
• Dark urine
• Light-colored stools
• Itchy skin
• Weight loss

Because the pancreas lies deep inside the abdominal cavity, it cannot typically be felt during a physical exam. When pancreatic cancer is suspected, imaging such as a CT scan, MRI, or ultrasound may be used to further investigate. A biopsy is the only way to definitively diagnose pancreatic cancer, which may or may not be an option depending on the size and location of the tumor. There are also blood tests which are often positive in pancreatic cancer, including cancer antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA).

Pancreatic cancer is staged based on characteristics of the tumor, the presence or absence of lymph nodes involved, and the extent of spread of cancer. Pancreatic cancer is given a stage from I to IV, with stage I being confined to the pancreas and stage IV involving spread to other organs. The most common site of spread of pancreatic cancer is to the liver.

Pancreatic cancer has a very poor prognosis, regardless of stage. Stage I pancreatic cancer has a five-year survival rate of about 13%, and stage IV has a five-year survival rate of less than 1%.

Conventional treatment of pancreatic cancer typically consists of surgery, radiation, chemotherapy, or a combination of these. While these treatments can be very effective, those of us in integrative oncology believe that there are other good tools in the arsenal. These include:

• Nutrition
• Supplementation
• Intravenous vitamins/minerals
• Off-label medications
• Visualization
• Prayer

The combination of treatments chosen, whether from the conventional realm or the natural realm, must be done in a very specific and personalized manner. This is when we must blend the science and art of medicine, creating a tailor-made program for each patient and his or her unique case. We feel that this is the best kind of medicine.