Where in the body is the pancreas?  The word pancreas comes from the Greek pancreas (pan - all + kreas flesh).  The pancreas is an organ normally about the size and shape of a flattened pear, located behind the stomach, below the liver and gall bladder, and between the spleen and the duodenum (the first section of the small intestine).  It is situated next to the mesenteric arteries and veins, which run through the midsection of the body to and from the heart and branch off to supply blood to all of the body’s organs. 

What does the pancreas do?  The pancreas has two functions. It produces the hormones insulin and glucagons, which work together to regulate blood sugar. These hormones are secreted directly into the bloodstream by special cells in the pancreas called islet cells.  The pancreas also produces a substance called pancreatic juice, which is secreted through the pancreatic ducts directly into the duodenum of the small intestine.  Pancreatic juice contains enzymes that are crucial for digestion. 

How many people get pancreatic cancer?  The American Cancer Society (ACS) estimates that over 37,000 men and women in the United States will be diagnosed with pancreatic cancer this year, and, unfortunately, more than 34,000 will die.  Although the ACS recently reported a decline in overall cancer deaths in the U.S., the number of Americans diagnosed with pancreatic cancer each year continues to increase. Pancreatic cancer is the fourth most frequent cause of cancer deaths in the U.S. 

What cells are involved in pancreatic cancer?  In cancer, cells begin to grow out of control, forming tumors, and behaving differently than they normally should.  For instance, cells that normally stay in one place may begin moving out of areas in the body or organ where they should remain and colonizing other areas of the body as they divide, forming secondary tumors (known as metastases). 

In the pancreas, islet cells can become cancerous and form what is known as an endocrinal tumor. This form of pancreatic cancer is rare.  The vast majority of pancreatic cancer cases occur when the cells that line the pancreatic ducts begin growing out of control.  This type of tumor is known as an exocrinal tumor, or adenocarcinoma of the pancreas. 

How is pancreatic cancer detected?  Pancreatic cancer tends to be very aggressive and spreads rapidly over a relatively short period.  Early diagnosis and time to appropriate treatment is crucial to the clinical outcome of the pancreatic cancer patient.  The progress of pancreatic cancer can be roughly broken down into three stages—localized, locally advanced unresectable (inoperable) pancreatic cancer, and metastatic disease.

Less than about 20% of pancreatic cancer cases are detected when the tumor is still localized.  This means that the tumor is confined to the pancreas, without involving the blood vessels near the pancreas known as the mesenteric bundle.  There is no apparent spread to nearby lymph nodes, and no apparent tumor spread (metastases) to other organs, such as the liver.  Provided the general health of the patient can tolerate the procedure, localized pancreatic cancer can be surgically removed. However, because patients often do not exhibit clear symptoms during this stage of the disease, the cancer is often not caught early. 

Approximately 30% of pancreatic cancers are detected when the tumor has become locally advanced.  At this stage, there is involvement of the mesenteric bundle of blood vessels, and/or metastases to nearby lymph nodes.  Oncologists generally diagnose the disease as locally advanced and unresectable once the mesenteric bundle is involved. 

The balance of pancreatic cancer cases are, unfortunately, detected when there are clear signs that the cancer has spread to other nearby and/or distant organs in the body. 

What treatments are available now?  There are several methods of treatment for people with pancreatic cancer, depending on the type and stage of the cancer.  It is vital that patients seek care from experienced hospitals and/or physicians who can explain treatment options, answer questions, and provide the best quality care.  Treatment for pancreatic cancer may include surgery, radiation therapy, chemotherapy, biological therapies and/or complementary and alternative therapies.  Pancreatic cancer patients may receive one or more of these treatments. 

What about clinical trials? Many companies and institutions are studying pancreatic cancer in search of better diagnostics and more effective treatments, as well as prevention measures to help avoid the disease.  If you are visiting this page, you may already know that GenVec is conducting the PACT Phase III trial of its investigational drug, TNFerade™, in patients with locally advanced unresectable (inoperable) pancreatic cancer.  In addition to GenVec's PACT trial, there are many other clinical trials being conducted to try to find better ways to treat this aggressive disease as well. 

Where can I find out more?  There are additional worthwhile informational resources and assistance available for patients, their families, and people interested in finding out more about pancreatic cancer.  The links below are a few suggested sites that may be helpful. 

Links:

For further general information about pancreatic cancer, cancer treatments, and cancer clinical trials, you may wish to visit: 

The American Cancer Society:  http://www.cancer.org

The American Society of Clinical Oncology (ASCO) "People
Living with Cancer" site, pancreatic cancer page:
http://www.plwc.org/portal/site/PLWC/menuitem.6067beb2271039bcfd748f68ee37a01d/?vgnextoid=1357ea7105daa010VgnVCM100000ed730ad1RCRD&vgnextfmt=cancer

The CenterWatch Clinical Trials Listing:  http://www.centerwatch.com/

The Coalition of Cancer Cooperative Groups:  http://www.trialcheck.org/cancertrialshelp/cancertrialshelp.aspx

Emerging Med:  http://www.emergingmed.com/

The Food and Drug Administration (FDA): 
http://www.fda.gov/

The National Cancer Institute:  http://www.cancer.gov/cancertopics/types/pancreatic

The National Institutes of Health Clinical Trials listing:  http://www.clinicaltrials.gov

The Pancreatic Cancer Research Map:  http://www.cancermap.org/pancreatic/

- and one or more of these patient advocacy organizations involved specifically with pancreatic cancer and diseases of the pancreas -

The Hirshberg Foundation for Pancreatic Cancer Research:  http://www.pancreatic.org/site/c.htJYJ8MPIwE/b.640099/k.CC73/Home.htm

The Lustgarten Foundation for Pancreatic Cancer Research:  www.lustgarten.org

The Michael Rolfe Pancreatic Cancer Foundation:  http://www.rolfepancreaticcancer.org/

The National Pancreas Foundation:  www.pancreasfoundation.org

The Pancreatic Cancer Action Network (PanCAN):  www.pancan.org

Pancreatica:  www.pancreatica.org