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Friday, 17 March, 2000, 17:00 GMT
Pancreatic Cancer
The pancreas is an gland in the abdomen which performs a variety of roles.

It produces pancreatic juices, which help digest food, and is linked to the gallbladder, which empties into the gut just below the stomach.

Other pancreatic cells produce hormones, including insulin, which helps the body regulate the amount of sugar in the blood.

There are two types of pancreatic cancer - carcinoma of the pancreas, and, far more rarely, cancer of the cells which make insulin.

Like many cancers of internal organs, it may produce only minor symptoms until well-progressed, and as a result is hard to treat.

Professor John Neoptolemos, an expert in pancreatic cancer who undertakes research work supported by the Cancer Research UK, said: "Cancer of the pancreas is common in the UK. There are approximately 7,000 new cases each year - but it is one of the most lethal cancers."

"One of the great difficulties is that it's quite a small organ which is deeply seated in the abdomen - it's not easily accessible and diagnosis can be somewhat lengthy - there isn't one single test that will confirm or exclude cancer."

Symptoms depend greatly on the size of the tumour, and where on the pancreas it is located.

It is often the pressure of a large tumour pushing on other organs or parts of the body which is the first clue something is wrong.

If, for example, the tumour expands and blocks the bile duct, another tube carrying digestive juices into the gut, then jaundice can be the result.

The skin and whites of the eyes turn yellowish, and urine may become darker.

Pain is very often a first sign - it may become worse if the patient eats. Other signs include nausea, weight loss and weakness.

The rarer form of pancreas cancer can cause the pancreas to make too much insulin, leading the symptoms a diabetic gets if too much of the drug is taken.

They include dizzynesss, muscle spasms or diarrhoea.

If pancreatic cancer is suspected, there are a number of tests doctors can order to check this.

They involve CT scans, MRI scans or the use of ultrasound. More specific procedures involve swallowing or injecting dye that shows up on x-rays into the ducts.

A biopsy operation is the only sure way to complete a diagnosis. This involves taking a tiny tissue sample from the tumour.

In some cases, a probe is passed through a small cut into the abdomen to see how far the disease has spread.

Occasionally a more serious "laparotomy" operation is needed - this involves making a larger cut so that the surgeon can look more closely at the organs.

Although scientists do not know why many people develop pancreatic cancer, they have identified some circumstances which place people at higher risk.

Smoking is a key risk factor - smokers are up to three times more likely to get the disease.

Diet could also be important, with people who eat too much fat and not enough vegetables at increased risk.

People who have diabetes are also more likely to get pancreatic cancer.

Heavy consumption of alcohol also have an increased risk of pancreatic cancer.

Environmental factors such as working with petrol and some chemicals have also been linked with this cancer, although this has not been proven.

A combination of therapies can either cure the cancer if caught early, or, if not, improve quality of life and reduce pain.

Surgery may be used to take out the diseased area of the pancreas, or even the whole organ.

If other organs, such as the stomach, gut, spleen and gallbladder, are involved, they can be partly or totally removed.

However, this is major surgery and unsuitable for many patients.

Pancreatic cancer patients may also be given radiotherapy or chemotherapy.

See also:

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