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Cancer, Pancreas


Related Terms


  • Cancer of the Pancreas
  • Carcinoma of the Pancreas
  • Pancreatic Cancer

Differential Diagnoses


  • Cancer of another organ that has metastasized to the pancreas
  • Cancer of the bile duct
  • Harmless (benign) growth of the pancreas
  • Inflammation of the pancreas (pancreatitis)

Specialists


  • Endocrinologist
  • Gastroenterologist
  • General Surgeon
  • Oncologist
  • Radiology Oncologist

Comorbid Conditions


  • Digestive disorders (e.g., Crohn's disease or colitis)
  • Prolonged malnutrition
  • Systemic diseases such as diabetes

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Factors Influencing Duration


Factors that may influence the length of disability include the site and stage of the tumor at initial diagnosis. For individuals with pancreaticoduodenectomy or Whipple procedure, duration depends on extent of resection. Disability may be permanent.

Medical Codes


ICD-9-CM:
157 - Cancer, Pancreas
157.0 - Neoplasm, Head of Pancreas, Malignant
157.1 - Neoplasm, Body of Pancreas, Malignant
157.2 - Neoplasm, Tail of Pancreas, Malignant
157.3 - Malignant Neoplasm of Pancreas; Pancreatic Duct; Duct Of: Santorini, Wirsung
157.4 - Malignant Neoplasm of Pancreas; Islets of Langerhans; Islets of Langerhans, Any Part of Pancreas
157.8 - Malignant Neoplasm of Pancreas; Other Specified Sites of Pancreas; Ectopic Pancreatic Tissue; Malignant Neoplasm of Contiguous or Overlapping Sites of Pancreas Whose Point of Origin Cannot be Determined
157.9 - Cancer, Pancreas, Part Unspecified

Treatment


Staging is carried out to determine how widespread the cancer is, and whether it has spread to other parts of the body. Based on the stage of pancreatic cancer, treatment usually requires an integrated approach involving surgery, radiation therapy, and chemotherapy. In general, surgery to cure the cancer is only possible in individuals whose tumor is localized to the head of the pancreas. This occurs in only 10% of cases. Removal of the tumor and head of the pancreas, duodenum, part of the stomach, common bile duct, and surrounding lymph nodes (pancreaticoduodenectomy or Whipple's procedure) may be done if the cancer has not spread into other organs (metastasis).

Pancreatic cancer in the tail or body of the organ usually presents as more advanced disease than cancer of the head of the pancreas. Surgery on these tumors is designed to reduce the discomfort of the disease (palliative treatment) but not to produce a cure. Partial or complete removal of the pancreas (pancreatectomy) along with various surgical bypass procedures that allow continued secretion of digestive juices into the intestine (cholecystoenterostomy or pancreaticojejunostomy) could be performed. These individuals will need insulin and/or a pancreatic enzyme supplementation depending on how much of the pancreas remains following surgery.

Radiation therapy may be used in addition to surgery or as the primary treatment for tumors that cannot be surgically treated. When radiation therapy is the primary treatment, it is most often used to relieve painful symptoms and make individuals more comfortable. In these cases, surgery may become necessary to alleviate jaundice or bowel obstructions caused by liver complications. Most clinical studies indicate that chemotherapy has little impact on survival or quality of life in individuals with pancreatic cancer. The compound gemcitabine (2',2'-difluorodeoxycytidine), however, improves pain control, weight gain, and survival times. This compound is now the drug of choice for treatment of advanced pancreatic cancer because it is tolerated well by most individuals. Pain control is a major concern for individuals with pancreatic cancer.

Source: Medical Disability Advisor






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