Pancreatic cancer

Overview

Pancreatic cancer occurs when a cell in the pancreas is damaged and this malignant (cancer) cell starts to grow out of control.

Our approach

Northwell Health takes the most advanced approach to treating pancreatic cancer. 

Highlights of the state-of-the-art treatments and services include:

  • Minimally invasive and robotic surgical techniques which result in quicker recovery, less pain and less scarring
  • Cutting-edge approaches to delivering chemotherapy
  • Precision external beam radiation therapy techniques that protect healthy tissue while targeting diseased areas
  • Targeted therapies that identify and attack cancer cells
  • Biologic therapy that boosts the immune system to fight the cancer 
  • Leading-edge therapies that help reduce fatigue, alleviate pain and help the patient stay strong and independent 
  • Broad range of supportive care services

Multidisciplinary Pancreatic Cancer Treatment

Within the first several days of a visit, the multidisciplinary team will conduct comprehensive tests and develop a personalized cancer treatment program.

Each pancreatic cancer diagnosis is unique, so the team meets regularly to discuss patient treatment during weekly multidisciplinary conferences where pancreatic cancer experts at share ideas and best practices for delivering collaborative patient care. The specialists review each treatment phase to constantly improve pancreatic cancer care and ensure treatment milestones are reached. 

From diagnosis through treatment and follow-up, each patient is in the capable hands of some of the region's top pancreatic cancer experts every step of the way. 

Symptoms

Unlike breast cancer and colorectal cancer, there are no screening tests for pancreatic cancer, so patients usually see their doctors when they experience symptoms such as:

  • Abdominal pain — A dull pain that radiates from the upper abdomen to the back
  • Bloating — A sense of feeling full quickly with meals or an uncomfortable swelling in the abdomen
  • Weight loss, jaundice and itching — in more advanced stages

Be aware that these symptoms could be due to conditions other than pancreatic cancer, so it’s best to see a doctor right away.

Diagnosis

The first step to making a pancreatic cancer diagnosis is usually a physical, during which a doctor will look for symptoms of pancreatic cancer and other signs. The doctor will also consider personal and family medical history. If pancreatic cancer is suspected, the patient will be sent for further tests. 

Specialists use various procedures and tests to deliver an accurate pancreatic cancer diagnosis as well as to determine the stage, or extent, of the cancer. These, most of which are usually outpatient procedures, include:

  • Blood tests — Special blood tests check for elevated levels of substances that can indicate tumors, blockages and the presence of cancer.
  • Endoscopic ultrasound (EUS) — A thin, lighted tube called an endoscope is inserted into the body that emits ultrasound waves and creates images of internal organs and structures.
  • Endoscopic retrograde cholangiopancreatography (ERCP) — With the aid of a video endoscope, this X-ray examination detects blockages and other abnormalities in the pancreas.  
  • Biopsy — A sample of pancreatic tissue is removed by a needle or during a laparoscopic surgical procedure. It is then examined under a microscope by a pathologist to look for signs of cancer.
  • Imaging tests
    • Chest X-rays — An X-ray looks for tumors in the chest, lungs and bones.
    • CT or CAT scan (computerized axial tomography) — More detailed than an X-ray, this pancreatic cancer diagnosis procedure uses a combination of X-rays and computer technology to produce detailed images. 
    • MRI  scan (magnetic resonance imaging) — A powerful magnet, radio waves and computer imaging combine to create highly detailed pictures of areas inside the body. 
    • PET scan (positron emission tomography) — Small amounts of radioactive sugar are injected to highlight cancers and areas of infection and inflammation.

Staging

According to the National Cancer Institute, the extent that pancreatic cancer has spread is measured in several stages and sub-stages from Stage 0 to Stage IV:

  • Stage 0 — Abnormal cells are found in the lining of the pancreas. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.
  • Stage I — Cancer has formed and is found in the pancreas only. 
  • Stage II — Cancer may have spread to nearby tissue and organs, and may have spread to lymph nodes near the pancreas.
  • Stage III — Cancer has spread to the major blood vessels near the pancreas and may have spread to nearby lymph nodes.
  • Stage IV — Cancer may be of any size and has spread to distant organs, such as the liver, lung and peritoneal cavity. It may have also spread to organs and tissues near the pancreas or to lymph nodes.

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