• 1.What are the symptoms of Pancreatic Cancer?
• 2.What diagnostic tests are used to determine the presence of pancreatic cancer?
• 3.What else can be done to diagnose Pancreatic Cancer?
• 4.What can be done for the pain that is associated with Pancreatic Cancer?
• 5.How is Pancreatic Cancer treated?
• 6.What can be done if surgery is not possible?
• 7.What about chemotherapy?

Pancreatic cancer usually does not cause symptoms early on. The cancer may grow for some time before it causes pressure in the abdomen, pain or other problems. In many cases, the cancer has spread outside the pancreas by the time it is found. When symptoms appear, they depend on the location and size of the tumor.

If the tumor blocks the common bile duct so that bile cannot pass into the intestines, the skin and whites of the eyes may become yellow, and urine may become dark. This condition is called jaundice. Pain often develops in the upper abdomen and sometimes spreads to the back. Cancer of the pancreas can also cause nausea, loss of appetite, depression, weight loss, and weakness. These symptoms may be caused by cancer or by other, less serious problems. Only a doctor can correctly diagnose the cause of the symptoms. 

 There are several different tests that can be used to diagnose pancreatic cancer:
Ultrasonography
This method uses high-frequency sound waves that are above the human audible range. An instrument sends sound waves into the patient’s abdomen, and the echoes that the sound waves produce as they bounce off internal organs creates a picture called a sonogram. Healthy tissues and tumors produce different echoes.
CT scanning Computed Tomography)
This method of testing involves the use of an x-ray machine which is linked to a computer. The patient lies on a bed that passes through a hole, and the machine moves along the patient’s body, simultaneously taking multiple x-rays. The computer then pieces the x-rays together to produce detailed pictures.
ERCP (Endoscopic retrograde cholangiopancretography)
A method for taking x-rays of the common bile duct and the pancreatic ducts. The doctor passes a long, flexible tube called an endoscope down the throat, through the stomach, and into the small intestine. The doctor then injects dye into the ducts and takes x-rays.
EUS (Endoscopic Ultrasound)
This is a test that combines ultrasound(sound waves) with an endoscope. The doctor places the tube (endoscope) into the stomach and the ultrasound machine (which is on the endoscope) is used to direct sound waves to the pancreas. This test is especially useful for detecting small tumors of the pancreas.
MRI (Magnetic Resonance Imaging)
This method of testing involves the use of an x-ray machine which is linked to a computer. The patient lies on a bed that passes through a hole, and the machine moves along the patient’s body, simultaneously taking multiple x-rays. The computer then pieces the x-rays together to produce detailed pictures.
PTC (Cholangiogram, Percutaneous Transhepatic)
A thin needle is put into the liver through the skin on the right side of the abdomen. Dye is injected in to the bile ducts in the liver so that blockages in the ducts can be seen on x-rays.

There are several ways to control pain. In most cases, the doctor prescribes medication to control the pain. However, in some cases pain medication is not enough. The doctor may use other treatments that effect the nerves in the abdomen. The doctor may inject alcohol in to the area around certain nerves to block the feeling of pain. This procedure rarely causes problems and usually provides pain relief. Sometimes, the doctor cuts nerves in the abdomen during surgery to block the feeling of pain. In addition, radiation therapy can help relieve pain by shrinking the tumor.

In patients who have cancer that is unresectible (unable to operate on), other options are pursued to relieve the symptoms of the cancer. If the bile duct is obstructed by the cancer, jaundice will develop. The jaundice and obstruction may lead to intense itching, poor appetite, diarrhea, weight loss and fever. It is important to alleviate this jaundice. ERCP with stent placement is the most common method. This involves the use of a flexible tube (endoscope) inserted into the intestine. The doctor then places a stent into the bile duct to allow the flow of bile into the intestine. This stent may be made of plastic or stainless steel. Jaundice may also be relieved by puncturing the liver via an incision within the skin on the right side of the abdomen. A tube (stent) can then be inserted. Surgery may be used to bypass the obstruction of the bile duct in some instances.