Pancreatic cancer is when cancer cells form in tissues of the pancreas. Pancreatic cancer is hard to catch early, as it doesn't cause symptoms right away. Because it's often found late and spreads quickly, it can be hard to treat. Risk factors for developing pancreatic cancer include smoking and long-term diabetes. Learn more about treatment and prognosis.
Cystic adenocarcinoma in CT (tumor marked in red, pancreas marked in green)
Image by MBq Disk Bew
What Is
Pancreatic Cancer
Image by Scientific Animations, Inc.
Pancreatic Cancer
Image by Scientific Animations, Inc.
Pancreatic Cancer
The pancreas is a gland behind your stomach and in front of your spine. It produces the juices that help break down food and the hormones that help control blood sugar levels. Pancreatic cancer usually begins in the cells that produce the juices. Some risk factors for developing pancreatic cancer include
Smoking
Long-term diabetes
Chronic pancreatitis
Certain hereditary disorders
Pancreatic cancer is hard to catch early. It doesn't cause symptoms right away. When you do get symptoms, they are often vague or you may not notice them. They include yellowing of the skin and eyes, pain in the abdomen and back, weight loss and fatigue. Also, because the pancreas is hidden behind other organs, health care providers cannot see or feel the tumors during routine exams. Doctors use a physical exam, blood tests, imaging tests, and a biopsy to diagnose it.
Because it is often found late and it spreads quickly, pancreatic cancer can be hard to treat. Possible treatments include surgery, radiation, chemotherapy, and targeted therapy. Targeted therapy uses substances that attack cancer cells without harming normal cells.
Source: National Cancer Institute
Additional Materials (18)
Pancreas
Pancreas and nearby organs: Shown is a detailed drawing of the pancreas (head, body, and tail of the pancreas, and the pancreatic duct) and nearby organs and structures (duodenum, common bile duct, and small intestine).
Image by Don Blis (artist) _ National Cancer Institute
Diagram showing pancreatic cancer in the lymph nodes (N staging).
Node (N) describes whether the cancer has spread to the lymph nodes. N0 means there are no lymph nodes containing cancer. N1 means there are 1 to 3 lymph nodes that contain cancer cells. Cancer that has spread to the lymph nodes means the cancer is more likely to have spread further than the pancreas.
Image by Wikimedia/Cancer Research UK
Pancreatic Cancer - Meditoons™
Video by Meditoons/YouTube
10 Things You Didn't Know About Pancreatic Cancer | Cancer Research UK
Video by Cancer Research UK/YouTube
Pancreatic Cancer Animation
Video by LysisMedia.com/YouTube
What is Pancreatic Cancer: 10 Things You Should Know About Pancreatic Cancer | Cancer Research UK
Video by Cancer Research UK/YouTube
What is Pancreatic Cancer? (Symptoms, Causes, Treatment, Prevention)
Video by healthery/YouTube
Signs and Symptoms of Pancreatic Cancer - Mayo Clinic
Video by Mayo Clinic/YouTube
The Progress of Pancreatic Cancer Research
Video by Michigan Medicine/YouTube
Pancreatic Cancer | Patty's Story
Video by Johns Hopkins Medicine/YouTube
Pancreatic Cancer | Eric's Story
Video by Johns Hopkins Medicine/YouTube
Hereditary Pancreatic Cancer | Q&A
Video by Johns Hopkins Medicine/YouTube
Chemotherapy and Pancreatic Cancer - Mayo Clinic
Video by Mayo Clinic/YouTube
Diagnosing Pancreatic Tumors and Cysts - Mayo Clinic
Video by Mayo Clinic/YouTube
Pancreatic Cancer Statistics | Did You Know?
Video by National Cancer Institute/YouTube
Pancreatic Neuroendocrine Tumors - Santhi Vege, M.D. - Mayo Clinic
Video by Mayo Clinic/YouTube
What You Need to Know About Pancreatic Cysts
Video by Johns Hopkins Medicine/YouTube
Powered by Chemo: Patient with Pancreatic Cancer Tackles Ironman
Video by UC San Diego Health/YouTube
Pancreas
Don Blis (artist) _ National Cancer Institute
Diagram showing pancreatic cancer in the lymph nodes (N staging).
Wikimedia/Cancer Research UK
0:50
Pancreatic Cancer - Meditoons™
Meditoons/YouTube
1:57
10 Things You Didn't Know About Pancreatic Cancer | Cancer Research UK
Cancer Research UK/YouTube
0:56
Pancreatic Cancer Animation
LysisMedia.com/YouTube
1:30
What is Pancreatic Cancer: 10 Things You Should Know About Pancreatic Cancer | Cancer Research UK
Cancer Research UK/YouTube
6:40
What is Pancreatic Cancer? (Symptoms, Causes, Treatment, Prevention)
healthery/YouTube
6:32
Signs and Symptoms of Pancreatic Cancer - Mayo Clinic
Mayo Clinic/YouTube
3:56
The Progress of Pancreatic Cancer Research
Michigan Medicine/YouTube
3:21
Pancreatic Cancer | Patty's Story
Johns Hopkins Medicine/YouTube
3:27
Pancreatic Cancer | Eric's Story
Johns Hopkins Medicine/YouTube
7:00
Hereditary Pancreatic Cancer | Q&A
Johns Hopkins Medicine/YouTube
6:34
Chemotherapy and Pancreatic Cancer - Mayo Clinic
Mayo Clinic/YouTube
5:55
Diagnosing Pancreatic Tumors and Cysts - Mayo Clinic
Mayo Clinic/YouTube
2:43
Pancreatic Cancer Statistics | Did You Know?
National Cancer Institute/YouTube
4:08
Pancreatic Neuroendocrine Tumors - Santhi Vege, M.D. - Mayo Clinic
Mayo Clinic/YouTube
9:48
What You Need to Know About Pancreatic Cysts
Johns Hopkins Medicine/YouTube
4:12
Powered by Chemo: Patient with Pancreatic Cancer Tackles Ironman
UC San Diego Health/YouTube
Overview
Pancreatic Cancer
Image by StoryMD
Pancreatic Cancer
Amylase is one of several enzymes produced by the pancreas and secreted into the digestive tract to help break down nutrients (amylase is also produced by the salivary glands). The enzyme is usually present in the blood and urine only in small quantities, but when pancreatic tissue is injured, inflamed (pancreatitis) or when the pancreatic duct is blocked or a tumor is present, amylase can leak into the blood and urine. As cancerous tissue overwhelms the pancreas, its function is compromised and enzyme levels fall.
Image by StoryMD
Pancreatic Cancer - General Information
General Information About Pancreatic Cancer
KEY POINTS
Pancreatic cancer is a disease in which malignant (cancer) cells form in the tissues of the pancreas.
Smoking and health history can affect the risk of pancreatic cancer.
Signs and symptoms of pancreatic cancer include jaundice, pain, and weight loss.
Pancreatic cancer is difficult to diagnose early.
Tests that examine the pancreas are used to diagnose and stage pancreatic cancer.
Certain factors affect prognosis (chance of recovery) and treatment options.
Pancreatic cancer is a disease in which malignant (cancer) cells form in the tissues of the pancreas.
The pancreas is a gland about 6 inches long that is shaped like a thin pear lying on its side. The wider end of the pancreas is called the head, the middle section is called the body, and the narrow end is called the tail. The pancreas lies between the stomach and the spine.
Anatomy of the pancreas. The pancreas has three areas: head, body, and tail. It is found in the abdomen near the stomach, intestines, and other organs.
The pancreas has two main jobs in the body:
To make juices that help digest (break down) food.
To make hormones, such as insulin and glucagon, that help control blood sugar levels. Both of these hormones help the body use and store the energy it gets from food.
The digestive juices are made by exocrine pancreas cells and the hormones are made by endocrine pancreas cells. About 95% of pancreatic cancers begin in exocrine cells.
Source: National Cancer Institute (NIH)
Additional Materials (32)
Pancreas
Illustration of Anatomy of Human Pancreas
Image by OpenStax College
Mitochondrial Dynamics in Pancreatic Cancer
This image shows mitochondrial staining (red) and nuclear staining (blue) of abnormal pancreatic ducts from a mouse model of human pancreatic ductal carcinoma. Mitochondrial shape changes occur throughout the progression of pancreatic cancer and the machinery that regulates the dynamics of mitochondria may be a promising new therapeutic target in the fight against this disease.
This image was originally submitted as part of the 2016 NCI Cancer Close Up project and selected for exhibit. This image is part of the NCI Cancer Close Up 2016 collection.
See also https://visualsonline.cancer.gov/closeup2016.
Image by National Cancer Institute \ Univ. of Virginia Cancer Center / David Kashatus
Pancreatic Cancer
Pancreatic Cancer: In Situ : The summary staging system categorizes cancer (shown here in the pancreas) according to its spread. In situ cancer is present only in cells in which it began.
Image by TheVisualMD
Mitochondrial Shape in Pancreatic Cancer
This image shows mitochondrial staining (red) and nuclear staining (blue) of abnormal pancreatic ducts from a mouse model of human pancreatic ductal carcinoma. Mitochondrial shape changes occur throughout the progression of pancreatic cancer and the machinery that regulates the dynamics of mitochondria may be a promising new therapeutic target in the fight against this disease.
This image was originally submitted as part of the 2016 NCI Cancer Close Up project. This image is part of the NCI Cancer Close Up 2016 collection.
See also https://visualsonline.cancer.gov/closeup2016.
Image by National Cancer Institute / Univ. of Virginia Cancer Center / David Kashatus
Pancreatic Cancer
Cancer Types _ Pancreatic Cancer Cells or Tissue _ Abnormal Cells or Tissue
Image by Dr. Lance Liotta Laboratory _ NCI
Sensitive content
This media may include sensitive content
Tumor-Targeted Magnetic Iron Oxide Nanoparticles for Image-guided Pancreatic Cancer Therapy
Investigators in the Cancer Nanotechnology Platform Partnership (CNPP) at Emory University have developed tumor-targeting magnetic iron oxide nanoparticles for image-guided pancreatic cancer therapy. The nanoparticles deliver therapeutic agents into pancreatic cancer tumors and produce signals that can be tracked by magnetic resonance imaging (MRI). This microscopy image of a tumor section (obtained from a mouse tumor model) shows the blue-stained nanoparticles selectively accumulating in the peripheral tumor area and then penetrating into tumor cells. This image is part of the Nanotechnology Image Library collection.
Image by National Cancer Institute / Lily Yang, M.D., Ph.D., and Hui Mao, Ph.D.
Sensitive content
This media may include sensitive content
MIF-Induced Mesenchymal Marker in Pancreatic Cancer
Macrophage migration inhibitory factor (MIF) enhances disease aggressiveness and the metastatic potential of pancreatic cancer cells by inducing epithelial-to-mesenchymal transition (EMT). This image, obtained with confocal microscopy, shows enhanced vimentin expression (pink), a mesenchymal marker, in pancreatic cancer cells stably overexpressing MIF.
This image was originally submitted as part of the 2015 NCI Cancer Close Up project. This image is part of the NCI Cancer Close Up 2015 collection.
See also https://visualsonline.cancer.gov/closeup.
Image by NCI Center for Cancer Research / Naotake Funamizu, S. Perwez Hussain
Pancreatic tuberculosis with splenic tuberculosis mimicking advanced pancreatic cancer with splenic metastasizes
CT scans of the pancreas. CT scan of pancrease demonstrating a mass in the pancreatic tail () and metastasizes in the spleen
Image by Rong, Y., Lou, W., Jin, D.
Celiac Plexus Blockade in computertomography in a patient suffering from back-pain caused by pancreatic cancer.
Back-Pain Caused by Pancreatic Cancer: Celiac Plexus Blockade in computertomography in a patient suffering from back-pain caused by pancreatic cancer.
Image by Hellerhoff
Amylase, Pancreatic Cancer
Amylase is one of several enzymes produced by the pancreas and secreted into the digestive tract to help break down nutrients (amylase is also produced by the salivary glands). The enzyme is usually present in the blood and urine only in small quantities, but when pancreatic tissue is injured, inflamed (pancreatitis) or when the pancreatic duct is blocked or a tumor is present, amylase can leak into the blood and urine. As cancerous tissue overwhelms the pancreas, its function is compromised and enzyme levels fall.
Image by TheVisualMD
Pancreatic Cancer Survivor - Mayo Clinic
Video by Mayo Clinic/YouTube
Top 5 things you probably didn't know about Pancreatic Cancer with Dr. John A. Chabot
Video by Columbia University Department of Surgery/YouTube
Update: What is new in targeted therapy for pancreatic cancer?
Video by ImedexCME/YouTube
Blend of imaging, treatments allows removal of "inoperable" pancreatic cancer
Video by MD Anderson Cancer Center/YouTube
Screening in familial pancreatic cancer
Video by ImedexCME/YouTube
Pancreatic Auto Islet Transplantation with Total Pancreatectomy
Video by Johns Hopkins Medicine/YouTube
Pancreatic Cancer: Diana's Story
Video by NorthShore University HealthSystem/YouTube
Pancreatic Cancer Prevention | Lana's Story
Video by Johns Hopkins Medicine/YouTube
How long can I expect to live? What is my prognosis with pancreatic cancer? (Douglas Evans, MD)
Video by Froedtert & the Medical College of Wisconsin/YouTube
Pancreatic Cancer Treatment
Video by Lee Health/YouTube
Surgery Is Becoming an Option for More Pancreatic Cancer Patients, Mayo Clinic Expert Says
Video by Mayo Clinic/YouTube
Nutrition & Pancreatic Cancer Treatment Explanation Video
Video by Columbia University Department of Surgery/YouTube
Radiation Therapy and Pancreatic Cancer - Mayo Clinic
Video by Mayo Clinic/YouTube
Pancreatic cancer symptoms
Video by Michigan Medicine/YouTube
Mayo Clinic Minute: The link between diabetes and pancreatic cancer
Video by Mayo Clinic/YouTube
An Option for Pancreatic Cancer
Video by Lee Health/YouTube
Niraparib + Immunotherapy for Pancreatic Cancer
Video by Penn Medicine/YouTube
Pancreatic Cancer Symptoms and Treatment | UPMC On Topic
Video by UPMC/YouTube
Mayo Clinic Minute: Understanding pancreatic cancer
Video by Mayo Clinic/YouTube
Diet and Nutrition in Managing Pancreatic Cancer - Mayo Clinic
Video by Mayo Clinic/YouTube
Researchers Identify Best Drug Therapy for Rare, Aggressive, Pancreatic Cancer
Video by Mayo Clinic/YouTube
Pancreatic Cancer - Dr. Allyson Ocean
Video by NewYork-Presbyterian Hospital/YouTube
Pancreas
OpenStax College
Mitochondrial Dynamics in Pancreatic Cancer
National Cancer Institute \ Univ. of Virginia Cancer Center / David Kashatus
Pancreatic Cancer
TheVisualMD
Mitochondrial Shape in Pancreatic Cancer
National Cancer Institute / Univ. of Virginia Cancer Center / David Kashatus
Pancreatic Cancer
Dr. Lance Liotta Laboratory _ NCI
Sensitive content
This media may include sensitive content
Tumor-Targeted Magnetic Iron Oxide Nanoparticles for Image-guided Pancreatic Cancer Therapy
National Cancer Institute / Lily Yang, M.D., Ph.D., and Hui Mao, Ph.D.
Sensitive content
This media may include sensitive content
MIF-Induced Mesenchymal Marker in Pancreatic Cancer
NCI Center for Cancer Research / Naotake Funamizu, S. Perwez Hussain
Pancreatic tuberculosis with splenic tuberculosis mimicking advanced pancreatic cancer with splenic metastasizes
Rong, Y., Lou, W., Jin, D.
Celiac Plexus Blockade in computertomography in a patient suffering from back-pain caused by pancreatic cancer.
Hellerhoff
Amylase, Pancreatic Cancer
TheVisualMD
2:31
Pancreatic Cancer Survivor - Mayo Clinic
Mayo Clinic/YouTube
2:18
Top 5 things you probably didn't know about Pancreatic Cancer with Dr. John A. Chabot
Columbia University Department of Surgery/YouTube
22:06
Update: What is new in targeted therapy for pancreatic cancer?
ImedexCME/YouTube
3:04
Blend of imaging, treatments allows removal of "inoperable" pancreatic cancer
MD Anderson Cancer Center/YouTube
16:43
Screening in familial pancreatic cancer
ImedexCME/YouTube
1:57
Pancreatic Auto Islet Transplantation with Total Pancreatectomy
Johns Hopkins Medicine/YouTube
3:57
Pancreatic Cancer: Diana's Story
NorthShore University HealthSystem/YouTube
3:10
Pancreatic Cancer Prevention | Lana's Story
Johns Hopkins Medicine/YouTube
4:48
How long can I expect to live? What is my prognosis with pancreatic cancer? (Douglas Evans, MD)
Froedtert & the Medical College of Wisconsin/YouTube
1:44
Pancreatic Cancer Treatment
Lee Health/YouTube
3:02
Surgery Is Becoming an Option for More Pancreatic Cancer Patients, Mayo Clinic Expert Says
Mayo Clinic/YouTube
2:58
Nutrition & Pancreatic Cancer Treatment Explanation Video
Columbia University Department of Surgery/YouTube
15:59
Radiation Therapy and Pancreatic Cancer - Mayo Clinic
Mayo Clinic/YouTube
0:55
Pancreatic cancer symptoms
Michigan Medicine/YouTube
1:01
Mayo Clinic Minute: The link between diabetes and pancreatic cancer
Mayo Clinic/YouTube
1:42
An Option for Pancreatic Cancer
Lee Health/YouTube
1:25
Niraparib + Immunotherapy for Pancreatic Cancer
Penn Medicine/YouTube
4:28
Pancreatic Cancer Symptoms and Treatment | UPMC On Topic
UPMC/YouTube
1:01
Mayo Clinic Minute: Understanding pancreatic cancer
Mayo Clinic/YouTube
10:00
Diet and Nutrition in Managing Pancreatic Cancer - Mayo Clinic
Mayo Clinic/YouTube
1:42
Researchers Identify Best Drug Therapy for Rare, Aggressive, Pancreatic Cancer
Mayo Clinic/YouTube
4:14
Pancreatic Cancer - Dr. Allyson Ocean
NewYork-Presbyterian Hospital/YouTube
Endocrine Pancreas
Abdomen Showing Pancreas
Image by TheVisualMD
Abdomen Showing Pancreas
3D visualization of a frontal view of the pancreas within the abdomen. The pancreas is an organ part of the endocrine system; it secretes hormones that serve to regulate endocrine and excocrine functions of the body.
Image by TheVisualMD
Endocrine Pancreas
The pancreas is a long, slender organ, most of which is located posterior to the bottom half of the stomach (Figure 17.18). Although it is primarily an exocrine gland, secreting a variety of digestive enzymes, the pancreas has an endocrine function. Its pancreatic islets—clusters of cells formerly known as the islets of Langerhans—secrete the hormones glucagon, insulin, somatostatin, and pancreatic polypeptide (PP).
The pancreatic islets each contain four varieties of cells:
The alpha cell produces the hormone glucagon and makes up approximately 20 percent of each islet. Glucagon plays an important role in blood glucose regulation; low blood glucose levels stimulate its release.
The beta cell produces the hormone insulin and makes up approximately 75 percent of each islet. Elevated blood glucose levels stimulate the release of insulin.
The delta cell accounts for four percent of the islet cells and secretes the peptide hormone somatostatin. Recall that somatostatin is also released by the hypothalamus (as GHIH), and the stomach and intestines also secrete it. An inhibiting hormone, pancreatic somatostatin inhibits the release of both glucagon and insulin.
The PP cell accounts for about one percent of islet cells and secretes the pancreatic polypeptide hormone. It is thought to play a role in appetite, as well as in the regulation of pancreatic exocrine and endocrine secretions. Pancreatic polypeptide released following a meal may reduce further food consumption; however, it is also released in response to fasting.
Regulation of Blood Glucose Levels by Insulin and Glucagon
Glucose is required for cellular respiration and is the preferred fuel for all body cells. The body derives glucose from the breakdown of the carbohydrate-containing foods and drinks we consume. Glucose not immediately taken up by cells for fuel can be stored by the liver and muscles as glycogen, or converted to triglycerides and stored in the adipose tissue. Hormones regulate both the storage and the utilization of glucose as required. Receptors located in the pancreas sense blood glucose levels, and subsequently the pancreatic cells secrete glucagon or insulin to maintain normal levels.
Glucagon
Receptors in the pancreas can sense the decline in blood glucose levels, such as during periods of fasting or during prolonged labor or exercise (Figure 17.19). In response, the alpha cells of the pancreas secrete the hormone glucagon, which has several effects:
It stimulates the liver to convert its stores of glycogen back into glucose. This response is known as glycogenolysis. The glucose is then released into the circulation for use by body cells.
It stimulates the liver to take up amino acids from the blood and convert them into glucose. This response is known as gluconeogenesis.
It stimulates lipolysis, the breakdown of stored triglycerides into free fatty acids and glycerol. Some of the free glycerol released into the bloodstream travels to the liver, which converts it into glucose. This is also a form of gluconeogenesis.
Taken together, these actions increase blood glucose levels. The activity of glucagon is regulated through a negative feedback mechanism; rising blood glucose levels inhibit further glucagon production and secretion.
Figure 17.19 Homeostatic Regulation of Blood Glucose Levels Blood glucose concentration is tightly maintained between 70 mg/dL and 110 mg/dL. If blood glucose concentration rises above this range, insulin is released, which stimulates body cells to remove glucose from the blood. If blood glucose concentration drops below this range, glucagon is released, which stimulates body cells to release glucose into the blood.
Insulin
The primary function of insulin is to facilitate the uptake of glucose into body cells. Red blood cells, as well as cells of the brain, liver, kidneys, and the lining of the small intestine, do not have insulin receptors on their cell membranes and do not require insulin for glucose uptake. Although all other body cells do require insulin if they are to take glucose from the bloodstream, skeletal muscle cells and adipose cells are the primary targets of insulin.
The presence of food in the intestine triggers the release of gastrointestinal tract hormones such as glucose-dependent insulinotropic peptide (previously known as gastric inhibitory peptide). This is in turn the initial trigger for insulin production and secretion by the beta cells of the pancreas. Once nutrient absorption occurs, the resulting surge in blood glucose levels further stimulates insulin secretion.
Precisely how insulin facilitates glucose uptake is not entirely clear. However, insulin appears to activate a tyrosine kinase receptor, triggering the phosphorylation of many substrates within the cell. These multiple biochemical reactions converge to support the movement of intracellular vesicles containing facilitative glucose transporters to the cell membrane. In the absence of insulin, these transport proteins are normally recycled slowly between the cell membrane and cell interior. Insulin triggers the rapid movement of a pool of glucose transporter vesicles to the cell membrane, where they fuse and expose the glucose transporters to the extracellular fluid. The transporters then move glucose by facilitated diffusion into the cell interior.
Source: CNX OpenStax
Additional Materials (2)
Endocrine pancreas | Gastrointestinal system physiology | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
What does the pancreas do? - Emma Bryce
Video by TED-Ed/YouTube
6:50
Endocrine pancreas | Gastrointestinal system physiology | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
3:21
What does the pancreas do? - Emma Bryce
TED-Ed/YouTube
The Power of Your Pancreas: Keep Your Digestive Juices Flowing
Sensitive content
This media may include sensitive content
Female Torso Displaying Pancreas and Duodenum
Image by TheVisualMD
Sensitive content
This media may include sensitive content
Female Torso Displaying Pancreas and Duodenum
3D visualization reconstructed from scanned human data of an anterior view of female torso with window cut away to reveal the retroperitoneal positions of the pancreas and the duodenum. During embryological development, stomach rotation causes the duodenum to become characteristically c-shaped and rotate; this combined with the rapid growth of the head of the pancreas causes the duodenum and the pancreas to swing out of the median plane so that they press against the dorsal body wall. The now posterior portion of the dorsal mesentery fuses with the adjacent peritoneum; this fusion causes the previous distinct layers to disappear, and fixes all but a small portion of the duodenum and the entire pancreas in a retroperitoneal position.
Image by TheVisualMD
The Power of Your Pancreas: Keep Your Digestive Juices Flowing
How much you eat alters more than your waistline. It also affects your body’s organs, starting with your pancreas. With each bite, your pancreas must release enough digestive juices and hormones for you to benefit from the food you eat. Putting too much stress on your pancreas—by too much eating, drinking, or smoking—can cause serious health issues.
The pancreas lies behind your stomach. It’s surrounded by the intestines, liver, and gallbladder. These neighboring organs work together to help you digest your food.
“The pancreas produces a variety of enzymes to help break down the carbohydrates, proteins, and fats in your diet into smaller elements that are more easily used for energy,” says Dr. Dana Andersen, a pancreatic specialist at NIH. “It also produces specialized hormones that travel through the blood and help regulate a variety of body functions.”
The best known hormone produced by the pancreas is insulin. Insulin controls how much sugar, or glucose, is taken up by your body’s cells. If the insulin-producing cells in the pancreas are damaged, diabetes may arise. Type 2 diabetes occurs when the pancreas can’t produce enough insulin to handle the sugar in your blood. Obesity worsens type 2 diabetes.
“Obesity can make your body less sensitive to insulin, so it takes more insulin to achieve the same metabolic work. That puts more stress on the pancreas,” Andersen says. “Just losing 5 or 10 pounds can help the pancreas to work more efficiently.”
High levels of fat in the blood can also lead to inflammation of the pancreas, or pancreatitis, which can be chronic or acute. With chronic pancreatitis, the inflammation doesn’t heal and gets worse over time. Eventually, it can lead to permanent damage.
Acute pancreatitis occurs suddenly and is very painful. It usually resolves in a few days with treatment. In severe cases, bleeding and permanent tissue damage may occur. The most common causes of acute pancreatitis are gallstones and heavy alcohol use. Gallstones are small, pebble-like substances made of hardened bile (a liquid produced by the liver to digest fat). Other causes of acute pancreatitis include abdominal trauma, medications, and infections.
Genetic disorders of the pancreas and certain autoimmune disorders can also lead to pancreatitis. But in nearly half of cases, the cause is unknown—a condition known as idiopathic pancreatitis.
Tracking your family’s medical history can help you learn if you’re at risk for pancreatic problems. “It’s always a good idea to tell your doctor if there’s been a family history of pancreatic disease,” Andersen says. “That may not sound like much, but to a doctor it’s very important information.”
Knowledge of family health history is especially important for possible early detection of pancreatic cancer, which usually has no symptoms in its early stages. When caught early, pancreatic cancer may be curable with surgery. But most patients with pancreatic cancer aren’t diagnosed until more advanced stages, when the chances for survival are low.
NIH researchers are looking for new ways to detect pancreatic diseases early and predict who’s most at risk. Eating a healthy diet and limiting your exposure to harmful substances, like tobacco and alcohol, can help keep your pancreas and your entire digestive system working properly.
Pancreas Problems?
Talk to your doctor if you have any of these symptoms of pancreatitis:
abdominal pain
nausea
vomiting
fever
rapid pulse
unexplained weight loss
diarrhea
oily stools
Source: NIH News in Health
Additional Materials (27)
Obese man with visible Pancreas Eating a Cookie
An obese man in a black t-shirt is shown eating a cookie. Some of his anatomy is visible, with his pancreas highlighted. The image accompanies information on the damaging effects on the pancreas of overeating sugar. Too much sugar overloads the glucose uptake system, leading to insulin resistance and Type II diabetes.
Image by TheVisualMD
Pancreas, Kidney and Spleen
Pancreas, Kidney and Spleen
Image by TheVisualMD
Bile Duct , Pancreas and Duodenum
Bile Duct , Pancreas and Duodenum
Image by TheVisualMD
Pancreas
Pancreas and nearby organs: Shown is a detailed drawing of the pancreas (head, body, and tail of the pancreas, and the pancreatic duct) and nearby organs and structures (duodenum, common bile duct, and small intestine).
Image by Don Blis (artist) _ National Cancer Institute
Human Pancreas
The body's ability to use glucose as its main source of energy depends on the hormone insulin, produced by the pancreas. Our bodies and brains run on glucose. The carbohydrates we eat are broken down in the small intestine into glucose and circulated throughout the body.
Image by TheVisualMD
Pancreas Clinical Anatomy and Physiology
Video by Armando Hasudungan/YouTube
Illustration of the digestive organs
Illustration of the digestive organs, your liver, stomach, gallbladder, and pancreas.
Your pancreas produces digestive juices and hormones that help you benefit from the food you eat.
Photograph of torso with the pancreas and gallbladder
The pancreas is irregular in appearance and extends to the left side of the abdomen. The gallbladder is above the pancreas and is the smaller of the two structures. The bile ducts are the tubes leading to the pancreas.
Image by NIDDK Image Library
Drawing of a body torso showing the pancreas and part of the digestive system, with the pancreas labeled
Pancreas
Image by NIDDK Image Library
Drawing of the pancreas in relation to other local organs and conduits, with the liver, bile duct, gallbadder, duodenum, pancreas, and pancreatic duct labeled
Pancreatitis is an inflammation of the pancreas. The pancreas is a large gland behind the stomach and close to the duodenum.
Image by NIDDK Image Library
Pancreas and blood glucose
Drawing showing how the pancreas responds to low or high blood glucose levels. Insulin and glucagon help regulate blood glucose levels.
Image by NIDDK Image Library
Small and Isolated Iset Cells in the Peripheral Pancreas by Phase Contrast
cross section: human pancreas
magnification: 400x by phase contrast
hematoxylin eosin stain
Image by Berkshire Community College Bioscience Image Library
Pancreas
Importance of Pancreas : The pancreas is really two organs in one: a digestive organ that secretes enzymes that help break down nutrients into forms the body can readily absorb; and endocrine gland that produces the hormones that govern the digestion of sugar. The dramatic upsurge in the incidence of diabetes has put the organ in the spotlight.
Image by TheVisualMD
Drawing of a torso showing the labeled liver and pancreas
Insulin is made in the pancreas.
Image by NIDDK Image Library
Exocrine and Endocrine Pancreas
The pancreas has a head, a body, and a tail. It delivers pancreatic juice to the duodenum through the pancreatic duct.
Image by CNX Openstax
Pancreatic Tissue
Pancreas
Image by Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014
Liver, Gallbladder, Duodenum, Pancreas
The pancreas functions as two organs in one. It secretes digestive enzymes into the duodenum (the first section of the small intestine), which then combine with bile, produced in the liver and stored in the gallbladder. The majority of cells in the pancreas (some 98%) are cells arranged in grapelike clusters that produce these important enzymes. The other 2% of pancreatic cells are those that produce the hormone insulin. Our bodies (and especially our brains) run on glucose, which is produced by the digestion of carbohydrates. The body's ability to use glucose as its main source of energy depends on insulin.
Image by TheVisualMD
Pancreas and Duodenum with Pancreatic Duct and Bile Duct
The biliary system consists of the organs and ducts that produce and transport bile. When damaged or dying red blood cells are broken down, bilirubin, a yellow pigment and component of hemoglobin, is released into the bloodstream. Bilirubin is eliminated from the body by the liver as a component of bile, which is stored in the gallbladder and then released into the small intestine to aid digestion. The pancreas functions as two organs in one. It secretes digestive enzymes into the duodenum (the first section of the small intestine), which then combine with bile, produced in the liver and stored in the gallbladder. The majority of cells in the pancreas (some 98%) are cells arranged in grapelike clusters that produce these important enzymes. The other 2% of pancreatic cells are those that produce the hormone insulin. Our bodies (and especially our brains) run on glucose, which is produced by the digestion of carbohydrates. The body's ability to use glucose as its main source of energy depends on insulin.
Image by TheVisualMD
Cardiovascular System of Male Abdomen with Pancreas
Image showing the cardiovascular system of the male abdomen. Prominently shown is the pancreas and its blood supply with several of the abdominal organs in ghosted outline. The abdominal aorta is the largest artery in the abdomen and supplies oxygenated blood to all the abdominal and pelvic organs and the legs. The largest vein in the abdomen is the inferior vena cava, which receives the blood from the lower limbs and much of the blood from the back and the walls, along with the contents of the abdomen and pelvis.
Image by TheVisualMD
Pancreas
Our bodies and brains run on glucose. The carbohydrates we eat are broken down in the small intestine into glucose and circulated throughout the body. The body's ability to use glucose as its main source of energy depends on the hormone insulin, produced by the pancreas.
Image by TheVisualMD
Female Figure Eating Apple Showing Thoracic Anatomy with Pancreas Highlighted
The pancreas is about 10 in (25 cm) long and runs across the back of the abdomen, behind the stomach and close to the duodenum. It secretes both digestive juices and hormones. The digestive juices neutralize acidic gastric juices from the stomach. The hormones the pancreas secretes, insulin and glucagon, have the vital function of keeping glucose in a very narrow range. Insulin and glucagon have opposite effects on your body. When the level of glucose in the blood is high, insulin signals certain cells, including muscle, fat, and liver cells, to take glucose in. When it's low, glucagon signals the cells to release it. Without insulin, glucose can't get into the cells, so it remains in your bloodstream. When glucose levels are too low (hypoglycemia) or too high (hyperglycemia), many serious health conditions can result.
Image by TheVisualMD
An illustration of a pancreas transplant.
An illustration of a pancreas transplant.
Image by BruceBlaus
The Digestive
Image by NIDDK/NIH
Obese man with visible Pancreas Eating a Cookie
TheVisualMD
Pancreas, Kidney and Spleen
TheVisualMD
Bile Duct , Pancreas and Duodenum
TheVisualMD
Pancreas
Don Blis (artist) _ National Cancer Institute
Human Pancreas
TheVisualMD
15:51
Pancreas Clinical Anatomy and Physiology
Armando Hasudungan/YouTube
Illustration of the digestive organs
NIH News in Health
Normal Pancreas, Kidneys and Adrenal Glands
TheVisualMD
Pancreas
CNX Openstax
Pancreas, kidneys, heart and spleen
TheVisualMD
Pancreas, Gall Bladder, Bile Duct, Duodenum
TheVisualMD
Photograph of torso with the pancreas and gallbladder
NIDDK Image Library
Drawing of a body torso showing the pancreas and part of the digestive system, with the pancreas labeled
NIDDK Image Library
Drawing of the pancreas in relation to other local organs and conduits, with the liver, bile duct, gallbadder, duodenum, pancreas, and pancreatic duct labeled
NIDDK Image Library
Pancreas and blood glucose
NIDDK Image Library
Small and Isolated Iset Cells in the Peripheral Pancreas by Phase Contrast
Berkshire Community College Bioscience Image Library
Pancreas
TheVisualMD
Drawing of a torso showing the labeled liver and pancreas
NIDDK Image Library
Exocrine and Endocrine Pancreas
CNX Openstax
Pancreatic Tissue
Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014
Liver, Gallbladder, Duodenum, Pancreas
TheVisualMD
Pancreas and Duodenum with Pancreatic Duct and Bile Duct
TheVisualMD
Cardiovascular System of Male Abdomen with Pancreas
TheVisualMD
Pancreas
TheVisualMD
Female Figure Eating Apple Showing Thoracic Anatomy with Pancreas Highlighted
TheVisualMD
An illustration of a pancreas transplant.
BruceBlaus
The Digestive
NIDDK/NIH
Exocrine and Endocrine Pancreas
Pancreas
Image by TheVisualMD
Pancreas
The cells that produce insulin are housed in the pancreas, a gland about 5 to 6 inches long with a flattened shape that curls over onto itself at one end. It sits near the back of the midsection, between the stomach and spine. The pancreas also produces enzymes that aid in digestion.
Image by TheVisualMD
Exocrine and Endocrine Pancreas
The soft, oblong, glandular pancreas lies transversely in the retroperitoneum behind the stomach. Its head is nestled into the “c-shaped” curvature of the duodenum with the body extending to the left about 15.2 cm (6 in) and ending as a tapering tail in the hilum of the spleen. It is a curious mix of exocrine (secreting digestive enzymes) and endocrine (releasing hormones into the blood) functions (image).
Exocrine and Endocrine Pancreas
The pancreas has a head, a body, and a tail. It delivers pancreatic juice to the duodenum through the pancreatic duct.
The exocrine part of the pancreas arises as little grape-like cell clusters, each called an acinus (plural = acini), located at the terminal ends of pancreatic ducts. These acinar cells secrete enzyme-rich pancreatic juice into tiny merging ducts that form two dominant ducts. The larger duct fuses with the common bile duct (carrying bile from the liver and gallbladder) just before entering the duodenum via a common opening (the hepatopancreatic ampulla). The smooth muscle sphincter of the hepatopancreatic ampulla controls the release of pancreatic juice and bile into the small intestine. The second and smaller pancreatic duct, the accessory duct (duct of Santorini), runs from the pancreas directly into the duodenum, approximately 1 inch above the hepatopancreatic ampulla. When present, it is a persistent remnant of pancreatic development.
Scattered through the sea of exocrine acini are small islands of endocrine cells, the islets of Langerhans. These vital cells produce the hormones pancreatic polypeptide, insulin, glucagon, and somatostatin.
Pancreatic Juice
The pancreas produces over a liter of pancreatic juice each day. Unlike bile, it is clear and composed mostly of water along with some salts, sodium bicarbonate, and several digestive enzymes. Sodium bicarbonate is responsible for the slight alkalinity of pancreatic juice (pH 7.1 to 8.2), which serves to buffer the acidic gastric juice in chyme, inactivate pepsin from the stomach, and create an optimal environment for the activity of pH-sensitive digestive enzymes in the small intestine. Pancreatic enzymes are active in the digestion of sugars, proteins, and fats.
The pancreas produces protein-digesting enzymes in their inactive forms. These enzymes are activated in the duodenum. If produced in an active form, they would digest the pancreas (which is exactly what occurs in the disease, pancreatitis). The intestinal brush border enzyme enteropeptidase stimulates the activation of trypsin from trypsinogen of the pancreas, which in turn changes the pancreatic enzymes procarboxypeptidase and chymotrypsinogen into their active forms, carboxypeptidase and chymotrypsin.
The enzymes that digest starch (amylase), fat (lipase), and nucleic acids (nuclease) are secreted in their active forms, since they do not attack the pancreas as do the protein-digesting enzymes.
Pancreatic Secretion
Regulation of pancreatic secretion is the job of hormones and the parasympathetic nervous system. The entry of acidic chyme into the duodenum stimulates the release of secretin, which in turn causes the duct cells to release bicarbonate-rich pancreatic juice. The presence of proteins and fats in the duodenum stimulates the secretion of CCK, which then stimulates the acini to secrete enzyme-rich pancreatic juice and enhances the activity of secretin. Parasympathetic regulation occurs mainly during the cephalic and gastric phases of gastric secretion, when vagal stimulation prompts the secretion of pancreatic juice.
Usually, the pancreas secretes just enough bicarbonate to counterbalance the amount of HCl produced in the stomach. Hydrogen ions enter the blood when bicarbonate is secreted by the pancreas. Thus, the acidic blood draining from the pancreas neutralizes the alkaline blood draining from the stomach, maintaining the pH of the venous blood that flows to the liver.
Source: CNX OpenStax
Additional Materials (4)
Abdomen Revealing Pancreas and Kidney
Sugar is one of the nutrients your body uses for energy. It is the product of the body's breakdown of complex carbohydrates and is circulated in the blood to all your cells. Although blood sugar levels change depending on whether you just ate or exercised, in general, your body keeps the sugar levels within a narrow range. Not enough sugar - hypoglycemia - and you can get hungry, shaky, sweaty, tired, and even faint. Too much sugar - hyperglycemia - is a cardiovascular risk factor leading to arteriosclerosis (hardening of the arteries). To control blood sugar levels, your body depends on a hormone called insulin.
Image by TheVisualMD
What does the pancreas do? - Emma Bryce
Video by TED-Ed/YouTube
The Role and Anatomy of the Pancreas
Video by ThePancreasPatient/YouTube
Human Pancreas
The body's ability to use glucose as its main source of energy depends on the hormone insulin, produced by the pancreas. Our bodies and brains run on glucose. The carbohydrates we eat are broken down in the small intestine into glucose and circulated throughout the body.
Image by TheVisualMD
Abdomen Revealing Pancreas and Kidney
TheVisualMD
3:21
What does the pancreas do? - Emma Bryce
TED-Ed/YouTube
3:16
The Role and Anatomy of the Pancreas
ThePancreasPatient/YouTube
Human Pancreas
TheVisualMD
Risk Factors
Risk factors increase the chances someone will get cancer.
Image by TheVisualMD
Risk factors increase the chances someone will get cancer.
Risk factors increase the chances someone will get cancer. About 60-70% of cancers are caused by lifestyle factors, such as smoking and being overweight. Tobacco use is the single largest causative factor for cancer, accounting for about 30% of all cancer deaths in developed countries. Other risk factors include age over 65; overweight and obesity; inactive lifestyle; diet high in fats, particularly saturated fats, and low in fruits, vegetables and fiber; consumption of preserved meat or pickled foods; viruses, including Epstein-Barr virus, hepatitis B or C virus, and human papillomaviruses (HPV); bacteria (eg, Helicobacter pylori); parasites; environmental and industrial toxins; radiation, including UV radiation and the radioactive gas radon; drugs (eg, estrogen, progestin and anabolic steroids); and immunologic disorders.
Image by TheVisualMD
Smoking and Health History Can Affect the Risk of Pancreatic Cancer
Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk with your doctor if you think you may be at risk.
Risk factors for pancreatic cancer include the following:
Smoking.
Being very overweight.
Having a personal history of diabetes or chronic pancreatitis.
Having a family history of pancreatic cancer or pancreatitis.
Having certain hereditary conditions, such as:
Multiple endocrine neoplasia type 1 (MEN1) syndrome.
Hereditary nonpolyposis colon cancer (HNPCC; Lynch syndrome).
Pancreatic Cancer: Signs, Symptoms and Risk Factors
Video by ThePancreasPatient/YouTube
Pancreatic Cancer Statistics | Did You Know?
Video by National Cancer Institute/YouTube
Pancreatic Cancer: Risk Factors and Symptoms
Video by Winship Cancer Institute of Emory University/YouTube
1:37
Pancreatic Cancer: Risk Factors
AllHealthGo/YouTube
3:33
Pancreatic Cancer: Signs, Symptoms and Risk Factors
ThePancreasPatient/YouTube
2:43
Pancreatic Cancer Statistics | Did You Know?
National Cancer Institute/YouTube
2:05
Pancreatic Cancer: Risk Factors and Symptoms
Winship Cancer Institute of Emory University/YouTube
Signs and Symptoms
Symptoms of Cancer
Image by TheVisualMD
Symptoms of Cancer
The symptoms of cancer depend on the type of cancer, its location, the size of the tumor, and how much it affects nearby organs or tissues. If a cancer has metastasized, symptoms may appear in different parts of the body.
Image by TheVisualMD
Signs and Symptoms of Pancreatic Cancer Include Jaundice, Pain, and Weight Loss
Pancreatic cancer may not cause early signs or symptoms. Signs and symptoms may be caused by pancreatic cancer or by other conditions. Check with your doctor if you have any of the following:
Jaundice (yellowing of the skin and whites of the eyes).
Light-colored stools.
Dark urine.
Pain in the upper or middle abdomen and back.
Weight loss for no known reason.
Loss of appetite.
Feeling very tired.
Source: National Cancer Institute (NCI)
Additional Materials (9)
Depiction of a jaundice patient
This is a depiction of a man suffering from Jaundice. The typical symptoms - yellowing of the skin and eyes - have been shown.
Image by https://www.myupchar.com
6 Warning Signs of Pancreatic Cancer
Video by Cleveland Clinic/YouTube
Signs and Symptoms of Pancreatic Cancer - Mayo Clinic
Video by Mayo Clinic/YouTube
What is Pancreatic Cancer? (Symptoms, Causes, Treatment, Prevention)
Video by healthery/YouTube
Pancreatic Cancer - Meditoons™
Video by Meditoons/YouTube
Pancreatic cancer symptoms
Video by Michigan Medicine/YouTube
Pancreatic Cancer Symptoms and Treatment | UPMC On Topic
Video by UPMC/YouTube
Signs of pancreatic adenocarcinoma - Mayo Clinic
Video by Mayo Clinic/YouTube
Cancer signs and symptoms
Symptoms of Cancer : The symptoms of cancer depend on the type of cancer, its location, the size of the tumor, and how much it affects nearby organs or tissues. If a cancer has metastasized, symptoms may appear in different parts of the body. Some cancers may be asymptomatic (have no symptoms at all) or be asymptomatic until the cancer has reached an advanced stage. Pancreatic cancer, for example, may not cause symptoms until the cancerous cells have grown around nearby nerves. Symptoms that are commonly seen with different forms of cancer include chills, fever, malaise, night sweats, unexplained weight loss, pain, loss of appetite, and change in bowel habits or bladder function.
Image by TheVisualMD
Depiction of a jaundice patient
https://www.myupchar.com
3:15
6 Warning Signs of Pancreatic Cancer
Cleveland Clinic/YouTube
6:32
Signs and Symptoms of Pancreatic Cancer - Mayo Clinic
Mayo Clinic/YouTube
6:40
What is Pancreatic Cancer? (Symptoms, Causes, Treatment, Prevention)
healthery/YouTube
0:50
Pancreatic Cancer - Meditoons™
Meditoons/YouTube
0:55
Pancreatic cancer symptoms
Michigan Medicine/YouTube
4:28
Pancreatic Cancer Symptoms and Treatment | UPMC On Topic
UPMC/YouTube
2:26
Signs of pancreatic adenocarcinoma - Mayo Clinic
Mayo Clinic/YouTube
Cancer signs and symptoms
TheVisualMD
Diagnosis
Recurrence of a pancreatic cancer
Image by James Heilman, MD/Wikimedia
Recurrence of a pancreatic cancer
Recurrence of a pancreatic cancer
Image by James Heilman, MD/Wikimedia
Tests That Examine the Pancreas Are Used to Diagnose and Stage Pancreatic Cancer
Pancreatic cancer is difficult to diagnose early.
Pancreatic cancer is difficult to detect and diagnose for the following reasons:
There aren’t any noticeable signs or symptoms in the early stages of pancreatic cancer.
The signs and symptoms of pancreatic cancer, when present, are like the signs and symptoms of many other illnesses.
The pancreas is hidden behind other organs such as the stomach, small intestine, liver, gallbladder, spleen, and bile ducts.
Tests that examine the pancreas are used to diagnose and stage pancreatic cancer.
Pancreatic cancer is usually diagnosed with tests and procedures that make pictures of the pancreas and the area around it. The process used to find out if cancer cells have spread within and around the pancreas is called staging. Tests and procedures to detect, diagnose, and stage pancreatic cancer are usually done at the same time. In order to plan treatment, it is important to know the stage of the disease and whether or not the pancreatic cancer can be removed by surgery.
The following tests and procedures may be used:
Physical exam and health history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances, such as bilirubin, released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.
Tumor marker test: A procedure in which a sample of blood, urine, or tissue is checked to measure the amounts of certain substances, such as CA 19-9, and carcinoembryonic antigen (CEA), made by organs, tissues, or tumor cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the body. These are called tumor markers.
MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. A spiral or helical CT scan makes a series of very detailed pictures of areas inside the body using an x-ray machine that scans the body in a spiral path.
PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do. A PET scan and CT scan may be done at the same time. This is called a PET-CT.
Abdominal ultrasound: An ultrasound exam used to make pictures of the inside of the abdomen. The ultrasound transducer is pressed against the skin of the abdomen and directs high-energy sound waves (ultrasound) into the abdomen. The sound waves bounce off the internal tissues and organs and make echoes. The transducer receives the echoes and sends them to a computer, which uses the echoes to make pictures called sonograms. The picture can be printed to be looked at later.
Endoscopic ultrasound (EUS): A procedure in which an endoscope is inserted into the body, usually through the mouth or rectum. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. A probe at the end of the endoscope is used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. This procedure is also called endosonography.
Endoscopic retrograde cholangiopancreatography (ERCP): A procedure used to x-ray the ducts (tubes) that carry bile from the liver to the gallbladder and from the gallbladder to the small intestine. Sometimes pancreatic cancer causes these ducts to narrow and block or slow the flow of bile, causing jaundice. An endoscope (a thin, lighted tube) is passed through the mouth, esophagus, and stomach into the first part of the small intestine. A catheter (a smaller tube) is then inserted through the endoscope into the pancreatic ducts. A dye is injected through the catheter into the ducts and an x-ray is taken. If the ducts are blocked by a tumor, a fine tube may be inserted into the duct to unblock it. This tube (or stent) may be left in place to keep the duct open. Tissue samples may also be taken.
Percutaneous transhepatic cholangiography (PTC): A procedure used to x-ray the liver and bile ducts. A thin needle is inserted through the skin below the ribs and into the liver. Dye is injected into the liver or bile ducts and an x-ray is taken. If a blockage is found, a thin, flexible tube called a stent is sometimes left in the liver to drain bile into the small intestine or a collection bag outside the body. This test is done only if ERCP cannot be done.
Laparoscopy: A surgical procedure to look at the organs inside the abdomen to check for signs of disease. Small incisions (cuts) are made in the wall of the abdomen and a laparoscope (a thin, lighted tube) is inserted into one of the incisions. The laparoscope may have an ultrasound probe at the end in order to bounce high-energy sound waves off internal organs, such as the pancreas. This is called laparoscopic ultrasound. Other instruments may be inserted through the same or other incisions to perform procedures such as taking tissue samples from the pancreas or a sample of fluid from the abdomen to check for cancer.
Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. There are several ways to do a biopsy for pancreatic cancer. A fine needle or a core needle may be inserted into the pancreas during an x-ray or ultrasound to remove cells. Tissue may also be removed during a laparoscopy or surgery to remove the tumor.
Source: National Cancer Institute (NCI)
Additional Materials (18)
Numerous small metastases of pancreatic cancer to the lungs, chest X-ray
Image by Hellerhoff/Wikimedia
Imaging characteristics of early-stage pancreatic ductal adenocarcinoma (PDAC)
Imaging characteristics of early-stage pancreatic ductal adenocarcinoma (PDAC)
Image by Kanno, A.; Masamune, A.; Hanada, K.; Kikuyama, M.; Kitano, M./Wikimedia
CT scan showing an adenocarcinoma tumour at the head of the pancreas.
CT scanner section, after intravenous injection of a contrast medium, showing an adenocarcinoma tumour at the head of the pancreas.
Image by MBq at German Wikipedia
MRE-of Kidney Prostate and Pancreas
MR elastography of (a) the kidney, (b) the prostate,
and (c) the pancreas. The T2 weighted magnitude images from tomoelastography are
shown in the left column while the corresponding elastograms are shown on the right.
In (b), images from a healthy volunteer (top row) and a patient with prostate cancer in
transition zone (bottom row, lesion indicated by arrow) are shown. Similarly, (c)
shows images from a healthy volunteer (top row) and a patient with pancreatic ductal
adenocarcinoma (PDAC) (bottom row, PDAC and pancreatic parenchyma are
indicated by filled and empty arrows, respectively).
Image by MRelasto/Wikimedia
CA19.9
Cancer antigen 19.9 (CA 19.0) is a protein that is shed by pancreatic cancer cells. Existing research indicates that a high percentage of patients with pancreatic cancer - about 70% - will have elevated levels of the protein detectable in their bloodstream. While studies suggest CA19.9 may be a useful marker for pancreatic tumors, the test is not considered diagnostically reliable.
Image by TheVisualMD
IPMN T2w ax-07 a
Intraduktale papilläre muzinöse Neoplasie des Pankreas; Seitengangtyp. Gleichzeitig besteht ein Pankreas divisum. T2w axial.
Image by Hellerhoff/Wikimedia
Adenocarcinoma of Pancreas, FNA (5558060087)
This is one of the better differentiated areas, showing a flat sheet with prominent honeycombing. The disorganization, nuclear overlapping, and lack of uniform nuclear spacing provides a clue that is this adenocarcinoma (as opposed to non-neoplastic duct epithelium). However, if all I had was a paucicellular specimen consisting of a few such sheets, I would likely back off and call it nothing higher than "suspicious" for adenocarcinoma. Fortunately from a diagnostic standpoint, all of the other clinical, radiographic, and cytological findings pointed overwhelmingly at a diagnosis of malignancy, which made this case more straighforward than it could have been with a meager specimen and inadequate clinical and radiographic information.
Pancreatic adenocarcinomas can be very well differentiated, a fact that raises the risk of both false-positive and false-negative diagnoses. It is important to secure a good specimen (which requires immediate assessment by a pathologist or cytotechnologist during the procedure), as well as accurate and complete clinical info. In most freestanding imaging centers, with no on-site pathology coverage, these aspects are often ignored. I strongly recommend that patients have radiographically-directed biopsies performed only in facilities with pathology coverage on site.
Pathological and histological images courtesy of Ed Uthman at flickr.
Image by Ed Uthman from Houston, TX, USA/Wikimedia
Recurrence of a pancreatic cancer
Recurrence of a pancreatic cancer
Image by James Heilman, MD/Wikimedia
CT scanner section, after intravenous injection of a contrast medium, showing an adenocarcinoma cancer tumour at the head of the pancreas.
CT scanner section, after intravenous injection of a contrast medium, showing an adenocarcinoma cancer tumour at the head of the pancreas.
Image by MBq at German Wikipedia
Celiac Plexus Blockade in computertomography in a patient suffering from back-pain caused by pancreatic cancer.
Back-Pain Caused by Pancreatic Cancer: Celiac Plexus Blockade in computertomography in a patient suffering from back-pain caused by pancreatic cancer.
Image by Hellerhoff
Sensitive content
This media may include sensitive content
Pancreatic Desmoplasia
As shown here, pancreatic cancer is associated with a vast desmoplastic reaction in which the connective tissue around the tumor thickens and scars. Tests similar to the one depicted here help distinguish between "good" and "bad" stromal reactions. Researchers hope this could allow the design of therapies that will reprogram tumor-stromal interaction. Cancerous cells are in red; nuclei are in blue; stroma/desmoplasia is in cyan; and stroma-specific markers are in yellow and green while marker overlays appear white.
This image was originally submitted as part of the 2016 NCI Cancer Close Up project and selected for exhibit. This image is part of the NCI Cancer Close Up 2016 collection.
See also https://visualsonline.cancer.gov/closeup2016.
Image by National Cancer Institute \ Fox Chase Cancer Center / Neelima Shah and Edna Cukierman
Micrograph of loose, moderate and dense desmoplastic stroma in pancreatic ductal adenocarcinoma
Immunohistochemical staining of desmoplastic stroma in patients with pancreatic ductal adenocarcinoma. - Top row shows representative examples of loose, moderate and dense stroma based on H & E staining pattern, as indicated. - Middle row shows corresponding Masson’s trichrome staining (blue colour) is shown (same cases as in top row). -Bottom row shows representative examples of tumors with weak, moderate and strong expression of alpha smooth muscle actin (αSMA), as indicated. Magnification, x200.
Image by Lai Mun Wang, Michael A. Silva, Zenobia D’Costa, Robin Bockelmann, Zahir Soonawalla, Stanley Liu, Eric O’Neill, Somnath Mukherjee, W. Gillies McKenna, Ruth Muschel, Emmanouil Fokas/Wikimedia
Diagnosing Pancreatic Tumors and Cysts - Mayo Clinic
Video by Mayo Clinic/YouTube
Pancreatic Cancer: Pathophysiology, Diagnosis and Staging
Video by ThePancreasPatient/YouTube
How is pancreatic cancer diagnosed?
Video by ThePancreasPatient/YouTube
What You Need to Know About Pancreatic Cysts
Video by Johns Hopkins Medicine/YouTube
Pancreatic Cancer: Diagnosis
Video by Cancer Treatment Centers of America - CTCA/YouTube
Doctor discusses pancreatic cancer symptoms, diagnosis and treatment
Video by 9NEWS/YouTube
Numerous small metastases of pancreatic cancer to the lungs, chest X-ray
Hellerhoff/Wikimedia
Imaging characteristics of early-stage pancreatic ductal adenocarcinoma (PDAC)
Kanno, A.; Masamune, A.; Hanada, K.; Kikuyama, M.; Kitano, M./Wikimedia
CT scan showing an adenocarcinoma tumour at the head of the pancreas.
MBq at German Wikipedia
MRE-of Kidney Prostate and Pancreas
MRelasto/Wikimedia
CA19.9
TheVisualMD
IPMN T2w ax-07 a
Hellerhoff/Wikimedia
Adenocarcinoma of Pancreas, FNA (5558060087)
Ed Uthman from Houston, TX, USA/Wikimedia
Recurrence of a pancreatic cancer
James Heilman, MD/Wikimedia
CT scanner section, after intravenous injection of a contrast medium, showing an adenocarcinoma cancer tumour at the head of the pancreas.
MBq at German Wikipedia
Celiac Plexus Blockade in computertomography in a patient suffering from back-pain caused by pancreatic cancer.
Hellerhoff
Sensitive content
This media may include sensitive content
Pancreatic Desmoplasia
National Cancer Institute \ Fox Chase Cancer Center / Neelima Shah and Edna Cukierman
Micrograph of loose, moderate and dense desmoplastic stroma in pancreatic ductal adenocarcinoma
Lai Mun Wang, Michael A. Silva, Zenobia D’Costa, Robin Bockelmann, Zahir Soonawalla, Stanley Liu, Eric O’Neill, Somnath Mukherjee, W. Gillies McKenna, Ruth Muschel, Emmanouil Fokas/Wikimedia
5:55
Diagnosing Pancreatic Tumors and Cysts - Mayo Clinic
Mayo Clinic/YouTube
3:52
Pancreatic Cancer: Pathophysiology, Diagnosis and Staging
ThePancreasPatient/YouTube
2:13
How is pancreatic cancer diagnosed?
ThePancreasPatient/YouTube
9:48
What You Need to Know About Pancreatic Cysts
Johns Hopkins Medicine/YouTube
1:59
Pancreatic Cancer: Diagnosis
Cancer Treatment Centers of America - CTCA/YouTube
3:09
Doctor discusses pancreatic cancer symptoms, diagnosis and treatment
9NEWS/YouTube
CA 19-9 Blood Test
CA 19-9 Blood Test
Also called: CA 19-9 Tumor Marker, Carbohydrate Antigen 19-9, Pancreatic Cancer Antigen, CA 19-9
CA 19-9 testing is mostly used to monitor the effectiveness of treatment in individuals who have been diagnosed with pancreatic cancer. However, this antigen can also be elevated in other conditions, diseases, or types of cancer.
CA 19-9 Blood Test
Also called: CA 19-9 Tumor Marker, Carbohydrate Antigen 19-9, Pancreatic Cancer Antigen, CA 19-9
CA 19-9 testing is mostly used to monitor the effectiveness of treatment in individuals who have been diagnosed with pancreatic cancer. However, this antigen can also be elevated in other conditions, diseases, or types of cancer.
{"label":"CA 19-9 reference range","description":"This test measures the amount of a protein called CA 19-9 in the blood. It is mostly used to monitor the effectiveness of treatment in individuals with pancreatic, gallbladder, bile duct, and gastric cancers.","scale":"lin","step":0.1,"items":[{"flag":"normal","label":{"short":"Low","long":"Low","orientation":"horizontal"},"values":{"min":0,"max":35},"text":"Low amounts of CA 19.9 may be detected in healthy people. Low or stable counts may also indicate positive response to treatment or stabilized tumor growth.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":35,"max":75},"text":"You may have cancer of the pancreas, liver, gallbladder, lung, colon, or stomach.","conditions":["Pancreatic cancer","Colorectal cancer","Lung cancer","Gallbladder cancer","Pancreatitis","Gallstones","Biliary infection (cholangitis)","Bile duct blockage","Liver disease","Cystic fibrosis"]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":75,"max":130},"text":"You may have an infection of your pancreas, an infection of your gallbladder, liver disease, gallstones, or a disease called cystic fibrosis.","conditions":["Pancreatic cancer","Colorectal cancer","Lung cancer","Gallbladder cancer","Pancreatitis","Gallstones","Biliary infection (cholangitis)","Bile duct blockage","Liver disease","Cystic fibrosis"]}],"units":[{"printSymbol":"U\/mL","code":"U\/mL","name":"enzyme unit per milliliter"}],"hideunits":false,"value":17.5}[{"normal":0},{"abnormal":0},{"abnormal":1}]
Use the slider below to see how your results affect your
health.
U/mL
35
75
Your result is Low.
Low amounts of CA 19.9 may be detected in healthy people. Low or stable counts may also indicate positive response to treatment or stabilized tumor growth.
Related conditions
A CA 19-9 test measures the amount of a protein called CA 19-9 (cancer antigen 19-9) in a sample of your blood. CA 19-9 is a type of tumor marker. Tumor markers are substances made by cancer cells or by normal cells in response to cancer in your body.
Healthy people can have small amounts of CA 19-9 in their blood. High levels of CA 19-9 are often a sign of pancreatic cancer. But high levels can also be a sign of other types of cancer or certain conditions that aren't cancer. For example, gallstones and cirrhosis of the liver can cause high CA 19-9 levels.
Because high levels of CA 19-9 can mean different things, the test is not used by itself to screen for or diagnose cancer or other diseases. But it can help monitor your cancer and check how well your treatment is working.
Other names: cancer antigen 19-9, carbohydrate antigen 19-9, CA 199 measurement, CA 19-9 radioimmunoassay (RIA)
CA 19-9 blood tests may be used to:
Monitor certain types of cancer and cancer treatment. CA 19-9 levels often go up as cancer grows and go down as tumors shrink.
Help predict how cancer may behave over time.
Check whether cancer has returned after treatment.
Help diagnose certain cancers and other diseases when used with other tests.
Some people do not make CA 19-9 even when they have a cancer that usually produces high levels of CA 19-9. For these people, a CA 19-9 tumor marker test is not useful.
You may need a CA 19-9 blood test if you've been diagnosed with pancreatic cancer or another type of cancer that causes high CA 19-9. These include cancers of the:
Bile duct
Colon and rectum
Stomach
Ovaries
Bladder
During cancer treatment, your health care provider may test you on a regular basis to see if your treatment is working.
After your treatment is complete, you may need to have CA 19-9 tests to check whether the cancer has come back. High levels of CA 19-9 may be one of the first signs that cancer cells are growing again.
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
Usually, you don't need any special preparations for a CA 19-9 blood test. But ask your provider to be sure. If you take certain vitamins, you may need to stop them before the test.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
If you're being treated for cancer, you may be tested several times during your treatment. Your provider will look at all your test results to see how your CA 19-9 levels have changed. Your results may show:
Your levels of CA 19-9 are increasing. This may mean your tumor is growing, and/or your treatment is not working. More tests are usually needed to find out for sure.
Your levels of CA 19-9 are decreasing. This may mean your tumor is shrinking and your treatment is working.
Your levels of CA 19-9 have stayed the same. This may mean your disease is stable and hasn't gotten better or worse.
Your CA 19-9 levels decreased after treatment, but increased later. This may mean your cancer has come back or grown. You'll need more tests to check whether cancer is really causing the higher level of CA 19-9.
If you don't have cancer but your test results show a high level of CA 19-9, you may not a health problem that needs treatment. Healthy people can have high CA 19-9 levels. But high levels may be a sign of a condition, such as:
Pancreatitis, inflammation of the pancreas
Gallstones
Bile duct disease, including a blockage or infection
Liver disease
Cystic fibrosis
Talk with your provider about what your results may mean.
If your provider thinks you may have one of these conditions, you will probably need other tests to find out for sure.
Labs use different methods to measure the amount of CA 19-9 in your blood sample. The test method can affect your results. If you're having regular tests to monitor cancer, it's important to have your tests done the same way, and usually in the same lab. This allows your provider to compare your results over time. Your test report usually says what method was used to measure your CA 19-9 levels. If you have any questions about how your tests are done, talk with your provider.
CA 19-9 Blood Test (Pancreatic Cancer): MedlinePlus Lab Test Information [accessed on Nov 05, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (7)
Pancreatic Cancer
Pancreatic Cancer: In Situ : The summary staging system categorizes cancer (shown here in the pancreas) according to its spread. In situ cancer is present only in cells in which it began.
Image by TheVisualMD
Amylase, Pancreatic Cancer
Amylase is one of several enzymes produced by the pancreas and secreted into the digestive tract to help break down nutrients (amylase is also produced by the salivary glands). The enzyme is usually present in the blood and urine only in small quantities, but when pancreatic tissue is injured, inflamed (pancreatitis) or when the pancreatic duct is blocked or a tumor is present, amylase can leak into the blood and urine. As cancerous tissue overwhelms the pancreas, its function is compromised and enzyme levels fall.
Image by TheVisualMD
Sensitive content
This media may include sensitive content
Pancreas joined to the small bowel after pylorus preserving surgery for pancreatic cancer
Diagram showing the pancreas joined to the small bowel after pylorus preserving surgery for pancreatic cancer
Image by Cancer Research UK / Wikimedia Commons
Pancreatic Cancer
Cancer Types _ Pancreatic Cancer Cells or Tissue _ Abnormal Cells or Tissue
Image by Dr. Lance Liotta Laboratory _ NCI
Doctor explains Ca 19-9 blood test used in PANCREATIC CANCER | LAB TESTS explained
Video by Doctor O'Donovan/YouTube
Diagnosing Pancreatic Tumors and Cysts - Mayo Clinic
Video by Mayo Clinic/YouTube
T1 stage - the tumor is inside the pancreas and is 2cm or less in any direction.
T2 stage - the cancer is more than 2cm but no more than 4cm in size in any direction.
T3 stage - the cancer is more than 4cm in size.
T4 stage - the cancer has grown outside the pancreas, into the nearby large blood vessels.
Node (N) describes whether the cancer has spread to the lymph nodes. It is further divided into N0 and N1 stages.
Metastasis (M) describes whether the cancer has spread to a different part of the body. It is further divided into M0 and M1 stages.
1
2
3
4
5
6
TNM Staging for Pancreatic Cancer
TNM stands for Tumour, Node, Metastasis. This system describes the size of a primary tumour (T), whether there are lymph nodes with cancer cells in them (N) and whether the cancer has spread to a different part of the body (M).
Interactive by Cancer Research UK
Pancreatic Cancer
TheVisualMD
Amylase, Pancreatic Cancer
TheVisualMD
Sensitive content
This media may include sensitive content
Pancreas joined to the small bowel after pylorus preserving surgery for pancreatic cancer
Cancer Research UK / Wikimedia Commons
Pancreatic Cancer
Dr. Lance Liotta Laboratory _ NCI
5:17
Doctor explains Ca 19-9 blood test used in PANCREATIC CANCER | LAB TESTS explained
Doctor O'Donovan/YouTube
5:55
Diagnosing Pancreatic Tumors and Cysts - Mayo Clinic
Mayo Clinic/YouTube
TNM Staging for Pancreatic Cancer
Cancer Research UK
Amylase Test
Amylase Test
Also called: Amy, Amylase, Amylase (Total), Amylase (Pancreatic), Amylase (Urine)
An amylase test is used to measure levels of amylase in the blood or urine. Amylase is an enzyme, found mainly in saliva and pancreatic fluid, that helps you digest food. Abnormal levels in blood or urine may indicate a disorder of the pancreas.
Amylase Test
Also called: Amy, Amylase, Amylase (Total), Amylase (Pancreatic), Amylase (Urine)
An amylase test is used to measure levels of amylase in the blood or urine. Amylase is an enzyme, found mainly in saliva and pancreatic fluid, that helps you digest food. Abnormal levels in blood or urine may indicate a disorder of the pancreas.
{"label":"Amylase (Blood) reference range","description":"The test measures levels of amylase in a sample of blood. Amylase is an enzyme, found mainly in saliva and pancreatic fluid, that helps you digest food. Abnormal levels in blood may indicate a disorder of the pancreas.","scale":"lin","step":0.1,"items":[{"flag":"abnormal","label":{"short":"Low","long":"Low","orientation":"horizontal"},"values":{"min":0,"max":31},"text":"A low blood amylase level in a person with pancreatitis symptoms may indicate permanent damage to the amylase-producing cells in the pancreas. Decreased levels can also be due to kidney disease and toxemia of pregnancy.","conditions":["Chronic pancreatitis","Liver disease","Kidney disease","Cystic fibrosis","Pancreatic cancer","Toxemia of pregnancy"]},{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":31,"max":110},"text":"Most of your amylase is made in the pancreas and salivary glands. A small amount of amylase in your blood is normal.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":110,"max":200},"text":"A high blood amylase level may indicate the presence of a condition affecting the pancreas.","conditions":["Acute pancreatitis","A blockage in the pancreas","Pancreatic cancer","Cholecystitis","Gastroenteritis","Perforated ulcer","Tubal pregnancy"]}],"units":[{"printSymbol":"U\/L","code":"U\/L","name":"enzyme unit per liter"}],"hideunits":false,"value":70.5}[{"abnormal":0},{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
U/L
31
110
Your result is Normal.
Most of your amylase is made in the pancreas and salivary glands. A small amount of amylase in your blood is normal.
Related conditions
{"label":"Amylase (Pancreatic) reference range","description":"The test measures levels of pancreatic amylase in a sample of blood. Pancreatic amylase is secreted by the pancreas into the small intestine. This enzyme is involved in the starch digestion process. This test is used to help diagnose and monitor diseases of the pancreas, or to determine whether the intestines have been damaged.","scale":"lin","step":0.1,"items":[{"flag":"abnormal","label":{"short":"Low","long":"Low","orientation":"horizontal"},"values":{"min":0,"max":14},"text":"A low blood amylase level in a person with pancreatitis symptoms may indicate permanent damage to the amylase-producing cells in the pancreas. Decreased levels can also be due to kidney disease and toxemia of pregnancy.","conditions":["Chronic pancreatitis","Liver disease","Kidney disease","Cystic fibrosis","Pancreatic cancer","Toxemia of pregnancy"]},{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":14,"max":55},"text":"Most of your amylase is made in the pancreas and salivary glands. A small amount of amylase in your blood is normal.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":55,"max":200},"text":"A high blood amylase level may indicate the presence of a condition affecting the pancreas.","conditions":["Acute pancreatitis","A blockage in the pancreas","Pancreatic cancer","Cholecystitis","Gastroenteritis","Perforated ulcer","Tubal pregnancy"]}],"units":[{"printSymbol":"U\/L","code":"U\/L","name":"enzyme unit per liter"}],"hideunits":false,"value":34.5}[{"abnormal":0},{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
U/L
14
55
Your result is Normal.
Most of your amylase is made in the pancreas and salivary glands. A small amount of amylase in your blood is normal.
Related conditions
{"label":"Amylase (Urine) reference range","description":"This test measures the amount of amylase in the urine. Amylase is one of several enzymes produced by the pancreas, that helps you digest carbohydrates. The test is used to diagnose and monitor problems with your pancreas, including pancreatitis.","scale":"lin","step":0.1,"items":[{"flag":"abnormal","label":{"short":"Low","long":"Low","orientation":"horizontal"},"values":{"min":0,"max":2.6},"text":"Decreased amylase levels can be caused by a wide variety of conditions. Talk to your doctor to know what your results mean in your specific case.","conditions":["Damage to the pancreas","Kidney disease","Pancreatic cancer","Toxemia of pregnancy"]},{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":2.6,"max":21.2},"text":"Most of your amylase is made in the pancreas and salivary glands. A small amount of amylase in your urine is normal. ","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":21.2,"max":40},"text":"An increased amount of amylase in the urine is called amylasuria. If your amylase levels are higher than normal, you may have one of many conditions. ","conditions":["Pancreatitis (acute or chronic)","Pancreatic cancer","Macroamylasemia","Alcohol consumption","Cholecystitis","Ectopic or ruptured tubal pregnancy","Gallbladder disease","Intestinal obstruction","Pelvic inflammatory disease","Perforated ulcer"]}],"units":[{"printSymbol":"(i.U.)\/h","code":"[IU]\/h","name":"international unit per hour"}],"hideunits":false,"value":11.9}[{"abnormal":0},{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
(i.U.)/h
2.6
21.2
Your result is Normal.
Most of your amylase is made in the pancreas and salivary glands. A small amount of amylase in your urine is normal.
Related conditions
An amylase test measures the amount of amylase in your blood or urine (pee). Amylase is an enzyme, or special protein, that helps you digest carbohydrates. Most of the amylase in your body is made by your pancreas and salivary glands.
A small amount of amylase in your blood and urine is normal. But having too much or too little may be a sign of a disorder of the pancreas or salivary glands, or another medical condition.
Other names: Amy test, serum amylase, urine amylase
Tests for amylase in blood or urine are mainly used to diagnose problems with your pancreas, including pancreatitis, which is an inflammation of the pancreas. It is also used to monitor chronic (long-term) pancreatitis.
Increases and decreases in amylase levels show up in blood before urine, so an amylase urine test may be done with or after an amylase blood test.
One or both types of amylase test may also be used to help diagnose or monitor treatment for other disorders that may affect amylase levels, such as salivary gland disorders and certain digestive conditions.
Your health care provider may order an amylase blood and/or urine test if you have symptoms of a pancreatic disorder. Symptoms may begin suddenly or slowly and include:
Pain in your upper abdomen (belly) that may spread to your back or get worse after eating
Loss of appetite
Nausea and vomiting
Fever
Fast heartbeat
Jaundice
Greasy, foul-smelling stool (poop)
Your provider may also order an amylase test to monitor an existing condition that affects the pancreas, including:
Chronic pancreatitis
Pancreatic cancer
Eating disorders
Cystic fibrosis
Alcohol use disorder
Recovery from having gallstones removed after a gallbladder attack
For an amylase blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
For an amylase urine test, you will need to give a urine sample for the test. A health care professional may give you a cleansing wipe, a small container, and instructions for how to use the "clean catch" method to collect your urine sample. It's important to follow these instructions so that germs from your skin don't get into the sample:
Wash your hands with soap and water and dry them.
Open the container without touching the inside.
Clean your genital area with the cleansing wipe:
For a penis, wipe the entire head (end) of the penis. If you have a foreskin, pull it back first.
For a vagina, separate the labia (the folds of skin around the vagina) and wipe the inner sides from front to back.
Urinate into the toilet for a few seconds and then stop the flow. Start urinating again, this time into the container. Don't let the container touch your body.
Collect at least an ounce or two of urine into the container. The container should have markings to show how much urine is needed.
Finish urinating into the toilet.
Put the cap on the container and return it as instructed.
If you have hemorrhoids that bleed or are having your menstrual period, tell your provider before your test.
Your provider may request that you collect all your urine during a 24-hour period. That's because the amount of amylase in urine can vary throughout the day. So, collecting several samples in a day may give a more accurate picture of your amylase levels. For this test, you will be given a container and specific instructions on how to collect your sample at home. Be sure to follow all instructions carefully.
In certain cases, your provider may order a test for amylase in peritoneal fluid. This is fluid between the layers of the tissue that line the inside of your abdomen (belly) and cover most of your organs. To get a sample, a health care professional will numb your skin and use a needle and tubing to draw some fluid into a container.
You should not drink alcohol for 24 hours before having an amylase blood or urine test. If you are having a blood test, your provider may also tell you to fast (not eat or drink) for two hours before the test. Your provider will let you know if there are any special instructions to follow.
There is very little risk to having a blood test. During a blood test, you may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
There is no known risk to having a urine test.
If you have a peritoneal fluid test, you may feel a little dizzy or lightheaded after the procedure. There is a small risk of the needle damaging your bowel or bladder, which may lead to bleeding or infection.
High levels of amylase in blood or urine may be a sign of:
Acute (sudden) pancreatitis
A blockage in a duct (small tube) in the pancreas
Pancreatic cancer or benign (not cancer) tumor
High levels of amylase in peritoneal fluid may be a sign of:
Acute pancreatitis
A blocked intestine
Lack of blood flow to the intestines
Low levels of amylase in blood or urine are uncommon, but may be a sign of:
Chronic pancreatitis causing permanent damage to the cells that make amylase
Kidney disease
Cystic fibrosis
Liver disease
Pre-eclampsia (a type of high blood pressure in pregnancy)
Be sure to tell your provider about any prescription or over-the-counter medicines you are taking because they may affect your test results. To learn more about your results, talk with your provider.
If your provider suspects you have pancreatitis, he or she may order a lipase blood test, along with an amylase blood test. Lipase is another enzyme produced by the pancreas. Lipase tests are considered to be more accurate for diagnosing pancreatitis, especially when pancreatitis is caused by alcohol use disorder.
Amylase Test: MedlinePlus Medical Test [accessed on Mar 08, 2024]
Amylase - blood: MedlinePlus Medical Encyclopedia [accessed on Mar 08, 2024]
Amylase (Blood) - Health Encyclopedia - University of Rochester Medical Center [accessed on Mar 08, 2024]
Amylase Test - Testing.com. Dec 14, 2022 [accessed on Mar 08, 2024]
Amylase Test | HealthLink BC [accessed on Mar 08, 2024]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (8)
Amylase
Image Caption - NIH Image Gallery
Image by Credit: Image acquired by S. Pradhan-Bhatt, PhD; Authors: S. Pradhan-Bhatt & R.L. Witt - University of Delaware/ Helen F. Graham Cancer Center & Research Institute M.C. Farach-Carson & D.A. Harrington - Rice University X. Jia
Amylase, Pancreatic Cancer
Amylase is one of several enzymes produced by the pancreas and secreted into the digestive tract to help break down nutrients (amylase is also produced by the salivary glands). The enzyme is usually present in the blood and urine only in small quantities, but when pancreatic tissue is injured, inflamed (pancreatitis) or when the pancreatic duct is blocked or a tumor is present, amylase can leak into the blood and urine. As cancerous tissue overwhelms the pancreas, its function is compromised and enzyme levels fall.
Image by TheVisualMD
What are Enzymes?
Video by FreeMedEducation/YouTube
Face, skull and Salivary Glands
3D visualization reconstructed from scanned human data of a lateral view of the face displaying salivary glands. Saliva produced in the three salivary glands (sublingual, submandibular, and parotid) is delivered to the oral cavity via salivary ducts. Saliva serves multiple functions: lubricating and cleansing the mouth, dissolving food so that it can be detected by taste buds, and secreting enzymes that begin the chemical breakdown of starches.
Image by TheVisualMD
Adult Female Eating Apple with Visible Heart and Digestive System
This image features an adult female eating an apple. Her heart and digestive system are revealed, and there is a cross-sectioned portion of her small intestine allowing a look inside. Simple sugars such as fructose, sucrose, and glucose are naturally abundant in whole foods such as fruit (like the apple in this image), vegetables, and milk. The body needs food molecules to be broken down before they can be absorbed. Due to their "simple" construction, simple sugars can be absorbed easily and put to use rapidly. Foods with simple sugars are the quickest dietary energy sources. However, like twigs on a hot fire, simple carbs burn up quickly. That's why candy bars and soda are good only for short bursts of energy. And because they are used up rapidly, these foods very soon leave you feeling hungry again.
Image by TheVisualMD
Catabolism of Lipids and Proteins
Catabolic Reactions
Image by OpenStax College
Amylase, Carbohydrate Digestion
Amylase is one of several enzymes produced by the pancreas and secreted into the digestive tract to help break down nutrients (amylase is also produced by the salivary glands). The pancreas further aids in the digestion of carbohydrates by producing the hormone insulin, which governs the metabolism of glucose, a simple sugar produced by the break down of carbohydrates.
Image by TheVisualMD
Amylase, Pancreatic Cell
The pancreas functions as two organs in one: 98% of pancreatic cells are arranged in grapelike clusters that produce digestive enzymes, such as amylase and lipase, which are released into the small intestine; the other 2% of pancreatic cells, located in regions called islets of Langerhans, function as an endocrine organ and produce hormones such as insulin.
Image by TheVisualMD
Amylase
Credit: Image acquired by S. Pradhan-Bhatt, PhD; Authors: S. Pradhan-Bhatt & R.L. Witt - University of Delaware/ Helen F. Graham Cancer Center & Research Institute M.C. Farach-Carson & D.A. Harrington - Rice University X. Jia
Amylase, Pancreatic Cancer
TheVisualMD
5:34
What are Enzymes?
FreeMedEducation/YouTube
Face, skull and Salivary Glands
TheVisualMD
Adult Female Eating Apple with Visible Heart and Digestive System
TheVisualMD
Catabolism of Lipids and Proteins
OpenStax College
Amylase, Carbohydrate Digestion
TheVisualMD
Amylase, Pancreatic Cell
TheVisualMD
Aldolase Test
Aldolase Test
Also called: ALS, Aldolase
Aldolase is a protein that can be mostly found in muscle tissue. An aldolase test is sometimes ordered along with other tests to help diagnose and monitor muscle and liver damage.
Aldolase Test
Also called: ALS, Aldolase
Aldolase is a protein that can be mostly found in muscle tissue. An aldolase test is sometimes ordered along with other tests to help diagnose and monitor muscle and liver damage.
{"label":"Aldolase reference range","description":"Aldolase is a protein that can be mostly found in muscle tissue. The test measures the level of this protein in a sample of your blood. An aldolase test is sometimes ordered along with other tests to help diagnose and monitor muscle and liver damage.","scale":"lin","step":0.1,"items":[{"flag":"abnormal","label":{"short":"Low","long":"Low","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"Decreased levels of aldolase can be related to a low muscle mass.","conditions":["Fructose intolerance","Muscle-wasting disease","Late-stage muscular dystrophy"]},{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":1,"max":7.5},"text":"Normal results may slightly vary based on the laboratory and the method used.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":7.5,"max":20},"text":"Increased aldolase levels usually indicate muscle or liver damage. ","conditions":["Muscle damage","Muscle diseases","Muscular dystrophy","Dermatomyositis","Heart attack","Liver diseases","Hepatitis","Mononucleosis","Prostate cancer","Pancreatic cancer","Liver cancer","Gangrene"]}],"units":[{"printSymbol":"U\/L","code":"U\/L","name":"enzyme unit per liter"}],"hideunits":false,"value":4.2}[{"abnormal":0},{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
U/L
1
7.5
Your result is Normal.
Normal results may slightly vary based on the laboratory and the method used.
Related conditions
Aldolase is a protein that can be found in muscle tissue. Its principal function is to help break down certain sugars to produce energy.
An aldolase test measures the amount of this protein in a sample of your blood.
Your doctor may want to order this test to help diagnose or monitor damage to your muscles or liver.
Even though this test has been replaced by other methods that can be more accurate to evaluate muscle damage, such as CK (creatine kinase), a minority of people can present high aldolase levels with normal CK levels. Hence, these two tests may sometimes be requested together.
A small amount of blood will be drawn from a vein in your arm by using a needle.
You may be required to fast for at least 6 hours before the test is done. You should also inform your healthcare practitioner if you are taking any over-the-counter or prescription medications.
Only the risks related to blood extraction, which are temporary discomfort, bruising, little bleeding, and risk of infection in the place where the needle was inserted.
Normal aldolase values can range from 1.0 to 7.5 units per liter (0.02 to 0.13 microkat/L). However, normal reference ranges may vary slightly among different laboratories.
Low aldolase levels can be related to a low muscular mass.
High aldolase levels may be due to:
Muscle damage
Muscle diseases, such as muscular dystrophy or dermatomyositis, among others.
Heart attack
Liver diseases
Hepatitis (liver inflammation)
Mononucleosis (which is an infection caused by a virus)
Prostate, pancreatic, or liver cancer
Gangrene (tissue death)
The less muscle mass you have, the lower your aldolase levels might be.
Aldolase blood test: MedlinePlus Medical Encyclopedia [accessed on Sep 29, 2018]
ALS - Clinical: Aldolase, Serum [accessed on Sep 29, 2018]
Aldolase [accessed on Sep 29, 2018]
002030: Aldolase | LabCorp [accessed on Sep 29, 2018]
Aldolase Test: Purpose, Procedure, and Results [accessed on Sep 29, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (2)
3D visualization reconstructed from scanned human data of an oblique lateral view of digestive organs
3D visualization reconstructed from scanned human data of an oblique lateral view of digestive organs. The sphincters of the stomach are highlighted. The digestive system is comprised of an alimentary canal and accessory organs; together they break down complex food stuffs into the simple structures the body can use, absorb the nutrients into the blood stream, and eliminate the leftover waste. Food passes from the esophagus to the stomach through the cardiac sphincter, which prevents chyme from returning back to the esophagus. After chemical and mechanical digestion in the stomach, the chyme moves on to the first part of the small intestine (the duodenum) through the pyloric sphincter, which controls the rate of stomach emptying.
Image by TheVisualMD
Male Abdomen with Visible Digestive Organ
3D visualiztion reconstructed from scanned human data of an oblique lateral view of digestive organs. The sphincters of the stomach are highlighted. The digestive system is comprised of an alimentary canal and accessory organs; together they break down complex food stuffs into the simple structures the body can use, absorb the nutrients into the blood stream, and eliminate the leftover waste. Food passes from the esophagus to the stomach through the cardiac sphincter, which prevents chyme from returning back to the esophagus. After chemical and mechanical digestion in the stomach, the chyme moves on to the first part of the small intestine (the duodenum) through the pyloric sphincter, which controls the rate of stomach emptying.
Image by TheVisualMD
3D visualization reconstructed from scanned human data of an oblique lateral view of digestive organs
TheVisualMD
Male Abdomen with Visible Digestive Organ
TheVisualMD
CEA Test
CEA Test
Also called: Carcinoembryonic Antigen, CEA Assay, CEA Tumor Marker, CEA
A CEA (carcinoembryonic antigen) test measures CEA in a sample of blood or other body fluid. It helps check if treatment for certain cancers is working. The test is most commonly used in colorectal cancer.
CEA Test
Also called: Carcinoembryonic Antigen, CEA Assay, CEA Tumor Marker, CEA
A CEA (carcinoembryonic antigen) test measures CEA in a sample of blood or other body fluid. It helps check if treatment for certain cancers is working. The test is most commonly used in colorectal cancer.
{"label":"CEA reference range","description":"The test measures carcinoembryonic antigen (CEA) levels in a sample of blood. It helps check if treatment for certain cancers is working. The test is most commonly used in colorectal cancer. ","scale":"lin","step":0.1,"items":[{"flag":"normal","label":{"short":"N","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":3},"text":"CEA is normally found in small amounts in the blood. Most healthy non-smoking people (97%) have values < or =3.0 ng\/mL. Some smokers may have elevated CEA, usually <5.0 ng\/mL.","conditions":[]},{"flag":"borderline","label":{"short":"E","long":"Elevated","orientation":"horizontal"},"values":{"min":3,"max":5},"text":"Most healthy non-smoking people (97%) have values < or =3.0 ng\/mL. Some smokers may have elevated CEA, usually <5.0 ng\/mL.","conditions":[]},{"flag":"abnormal","label":{"short":"H","long":"High","orientation":"horizontal"},"values":{"min":5,"max":20},"text":"A high CEA level in a person recently treated for certain cancers may mean the cancer has returned.","conditions":["Colorectal cancer"]},{"flag":"abnormal","label":{"short":"VH","long":"Very high","orientation":"horizontal"},"values":{"min":20,"max":40},"text":"Highly elevated CEA concentrations (>20 ng\/mL) in a patient with compatible symptoms are strongly suggestive of the presence of cancer and also suggest metastasis.","conditions":["Colorectal cancer"]}],"units":[{"printSymbol":"ng\/mL","code":"ng\/mL","name":"nanogram per millliiter"}],"hideunits":false,"value":1.5}[{"normal":0},{"borderline":0},{"abnormal":0},{"abnormal":1}]
Use the slider below to see how your results affect your
health.
ng/mL
3
5
20
Your result is Normal.
Related conditions
CEA stands for carcinoembryonic antigen. CEA is a protein that is a type of "tumor marker." Tumor markers are substances that are often made by cancer cells or by normal cells in response to cancer.
High levels of CEA are normal in healthy, unborn babies. After birth, CEA levels become very low or disappear completely. So, healthy adults should have little or no CEA in their bodies.
Cancers that may cause high levels of CEA include cancers of the:
Colon and rectum (colorectal or bowel cancer)
Prostate
Ovary
Lung
Thyroid
Liver
Pancreas
Breast
If you've been diagnosed with a cancer that can cause high CEA levels, CEA testing may help your health care provider learn more about your cancer and chance of recovery. The test is often used with other tests to check if cancer treatment is working.
CEA tests are not used to screen for or diagnose cancer. That's because:
Cancers that often cause high CEA levels don't always cause high levels. You can have normal CEA test results even though you have one of these cancers.
Many other health problems that aren't cancer can make CEA levels rise, including certain conditions that affect your liver, digestion, or breathing.
Most CEA tests use a sample of your blood to measure your CEA level. Sometimes the test uses a sample of fluid from your spine, chest, or abdomen (belly), but this is less common.
A CEA test is mostly used in people who have been diagnosed with cancers that often increase CEA levels. It's most commonly used in colorectal cancer. A provider may order a CEA test along with other tests to:
Learn more about a cancer soon after it has been diagnosed. CEA levels can help predict the likelihood of recovery and/or the chance that cancer will come back after treatment.
Check how well cancer treatment is working.
See if cancer has returned after treatment.
If you've been diagnosed with a type of cancer that can cause high CEA levels, you may need CEA testing:
Before treatment to:
Help understand how serious your cancer is.
Help guide treatment decisions.
Get a measurement of your CEA level before treatment to compare with CEA levels after treatment.
During cancer treatment to see if the treatment working.
After treatment to check whether cancer has come back. You may need to have tests on a regular schedule.
CEA is usually measured with a blood sample. During a CEA blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
Sometimes, CEA is tested in other body fluids. For these tests, your provider will remove a small sample of fluid using a thin needle.
For a CEA blood test, you usually don't need to prepare. If you smoke, you may need to stop for a while before your test. That's because smoking increases CEA levels.
A CEA blood test has very little risk. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
To understand your CEA test results, your provider will consider the results of other tests and exams. Ask your provider to explain what your test results mean for your health and treatment.
If you had a test before starting cancer treatment, in general:
A low level of CEAmay mean your tumor is small and the cancer has not spread to other parts of your body. But some cancers don't make much CEA, so your provider may use other tests to learn more about how much cancer you have and if it's spread.
A high level of CEAmay mean you have a larger tumor and/or your cancer has spread. You'll need other tests to confirm how serious your cancer is.
If you had a test to monitor your cancer during or after treatment, your provider will compare your current CEA test results with your past test results. In general:
Decreases in CEA over time often mean that treatment is working.
Increases in CEA or high levels that stay highmay mean that treatment isn't working. For example, if you had surgery for colorectal cancer, these levels may mean that the entire tumor wasn't removed or the cancer is growing back.
Decreases in CEA after treatment followed by increasesmay mean cancer has come back.
CEA levels that remain high or increase after treatment don't always mean that treatment isn't working, or cancer is growing. So, if your CEA levels don't come down, your provider will likely order other tests to find out why.
If you have questions about your results, talk with your provider.
Labs use different methods to measure CEA. The test method can affect your results. So, its best to have your tests done the same way, and usually in the same lab. This allows your provider to compare your results over time. If you have questions about how your tests are done, ask your provider.
CEA Test: MedlinePlus Medical Test [accessed on Mar 09, 2023]
https://www.cancer.gov/about-cancer/diagnosis-staging/diagnosis/tumor-markers-fact-sheet [accessed on Mar 13, 2019]
https://www.labcorp.com/test-menu/21906/carcinoembryonic-antigen-cea [accessed on Oct 03, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (20)
Carcinoembryonic Antigen (CEA): CEA in Colorectal Cancer Staging and Treatment
CEA tests are not used to screen for colorectal cancer, but they're frequently performed after the cancer has been diagnosed. CEA is useful in staging--performing tests to determine if the cancer has spread within the intestine or to distant parts of the body. CEA may also be used for treatment planning, as elevated levels may indicate a poorer prognosis. After surgery, CEA levels may be measured periodically to see if the cancer has spread. It is important to note that CEA is not a perfect predictor of how a patient will respond to treatment, nor is it conclusive in determining if cancer has spread. The American Society of Clinical Oncologists (ASCO) states that CEA should not be used as the sole basis for decision-making in colorectal cancer.
Image by TheVisualMD
Carcinoembryonic Antigen (CEA): CEA Testing During Chemotherapy
Whether CEA is tested during systemic treatment for colorectal cancer depends on the stage of the cancer. After surgery, the American Society of Clinical Oncologists (ASCO) recommends that patients with stage II or stage III cancer have a CEA test every 3 months, for a minimum of 3 years. However, if the patient is receiving chemotherapy, CEA testing should be delayed until after chemotherapy is completed. On the other hand, CEA is the marker of choice for monitoring stage IV (metastatic) colorectal cancer during systemic treatment. Patients with metastatic cancer, in which the cancer has spread to distant parts of the body, should have a CEA test every 1-3 months during chemotherapy to see if the treatment is working and whether the cancer is still spreading. ASCO recommends other tests be done in conjunction with the CEA tests.
Image by TheVisualMD
The Importance of Good Bowel Preparation During Colonoscopy
Video by Johns Hopkins Medicine/YouTube
Colon cancer: Essential facts
Video by Institute for Cancer Genetics and Informatics/YouTube
The Colon and Colon Cancer
Video by Armando Hasudungan/YouTube
Colon Cancer: Don't Ignore Your Symptoms
Video by American Cancer Society/YouTube
Colorectal Cancer Screening
Video by Mechanisms in Medicine/YouTube
This browser does not support the video element.
Treating Colon Cancer
This animation explains how colon cancer forms and how it can be treated through chemotherapy and surgery.
Video by TheVisualMD
This browser does not support the video element.
Colorectal Cancer Screening
Colorectal cancer is one of the few preventable forms of cancer thanks to effective screening. For many people, screening for colorectal cancer is an unpleasant thought, but knowing your options and taking a pro-active approach especially if you're over 50 can save your life. In this video, you can learn the "ins and outs" of colonoscopy, as well as learn about a new technique called virtual colonoscopy, which uses high-tech CT scans to screen the colon.
Video by TheVisualMD
This browser does not support the video element.
Colorectal Cancer Clip 6
Colorectal Cancer Clip 6
Video by TheVisualMD
This browser does not support the video element.
Dr. O'Kieffe and patient on preparing for a colonoscopy
A recent colonoscopy patient and gastroenterologist Dr. Donald O'Kieffe of Metro Gastroenterology, Chevy Chase, MD, explain what's involved in the preparation for your screening.
Video by TheVisualMD
This browser does not support the video element.
Dr. Klein on who should be screened
Dr. Mark Klein, a radiologist and colorectal cancer screening specialist at Washington Radiology Associates in Washington, DC, discusses who should be screened for colorectal cancer, and when.
Video by TheVisualMD
Colon cancer staging
Colon cancer staging : After colon cancer has been diagnosed, the next step is to perform tests to determine if the cancer has spread within the intestine or to distant parts of the body. This is called staging. Staging helps the doctor to decide the most appropriate treatment for the cancer at its current stage.
Image by TheVisualMD
Colorectal Cancer Types of Surgery
Surgery is the main treatment for colorectal cancer. Polyps and very early stage cancers (Stage 0 and some early Stage I tumors) can be removed during a colonoscopy, using a variety of techniques. In late Stage I and in Stage II and III cancer, the cancerous part of the colon is removed surgically. The surgeon may perform a resection, consisting of a partial colectomy (removing the cancer and a small amount of healthy tissue around it) and an anastomosis (sewing the parts of the colon back together). Nearby lymph nodes may also be removed and biopsied. If it isn't possible to perform a resection (for instance, if the cancer is at the outlet of the rectum), a colostomy may be performed. In a colostomy, a portion of the large intestine is brought through the abdominal wall to carry stool out of the body, where it empties into a special bag. The colostomy may be temporary in order to allow the colon or rectum time to heal after surgery, or it may be permanent.
Image by TheVisualMD
Colon Anatomy & Function
Image by TheVisualMD
Colostomy
Colostomy Illustration
Image by Blausen.com staff. \"Blausen gallery 2014\". Wikiversity Journal of Medicine. DOI:10.15347/wjm/2014.010. ISSN 20018762
Colorectal Cancer
Colorectal cancer refers to cancer of the colon and cancer of the rectum. The colon is the longest part of the large intestine, and the rectum is the last several inches of the large intestine, closest to the anus.
Image by TheVisualMD
What Is Colorectal Cancer?
The process of cell growth in the body is normally an orderly one. Cells grow and divide as necessary to produce more cells as they are needed. Cells that are old or damaged die, and are replaced with new cells.
Image by TheVisualMD
Treating Colorectal Cancer
There are three main treatment options for colorectal cancer:
Image by TheVisualMD
Colorectal Cancer Spread to Body Stage 4
Cancer spreads in three ways: by invading surrounding tissue, by invading the lymph system and traveling through lymph vessels to other places in the body, and by invading veins and capillaries and traveling through the bloodstream to other places in the body. Stage IV: Cancer may have spread to nearby lymph nodes and has spread to other parts of the body, such as the liver or lungs. Stage IV colorectal cancer is not considered curable. Image 5 of 5.
Image by TheVisualMD
Carcinoembryonic Antigen (CEA): CEA in Colorectal Cancer Staging and Treatment
TheVisualMD
Carcinoembryonic Antigen (CEA): CEA Testing During Chemotherapy
TheVisualMD
1:23
The Importance of Good Bowel Preparation During Colonoscopy
Johns Hopkins Medicine/YouTube
2:49
Colon cancer: Essential facts
Institute for Cancer Genetics and Informatics/YouTube
10:05
The Colon and Colon Cancer
Armando Hasudungan/YouTube
6:06
Colon Cancer: Don't Ignore Your Symptoms
American Cancer Society/YouTube
2:42
Colorectal Cancer Screening
Mechanisms in Medicine/YouTube
3:45
Treating Colon Cancer
TheVisualMD
4:13
Colorectal Cancer Screening
TheVisualMD
0:05
Colorectal Cancer Clip 6
TheVisualMD
0:48
Dr. O'Kieffe and patient on preparing for a colonoscopy
Also called: Ultrasound - abdomen, Abdominal sonogram, Abdominal sonography, Right upper quadrant sonogram, Ultrasound of the Abdomen, Ultrasound Imaging of the Abdomen, Abdominal Ultrasound
An abdominal ultrasound uses sound waves to look at organs in the abdomen, including the liver, gallbladder, spleen, pancreas, and kidneys. It may also be used to assess blood flow to abdominal organs. An abdominal ultrasound can help find the cause of stomach pain or bloating, check for kidney stones, liver disease, tumors and many other conditions.
Abdominal Ultrasound
Also called: Ultrasound - abdomen, Abdominal sonogram, Abdominal sonography, Right upper quadrant sonogram, Ultrasound of the Abdomen, Ultrasound Imaging of the Abdomen, Abdominal Ultrasound
An abdominal ultrasound uses sound waves to look at organs in the abdomen, including the liver, gallbladder, spleen, pancreas, and kidneys. It may also be used to assess blood flow to abdominal organs. An abdominal ultrasound can help find the cause of stomach pain or bloating, check for kidney stones, liver disease, tumors and many other conditions.
{"label":"Abdominal ultrasound reference range","description":"An abdominal ultrasound uses sound waves to look at organs in the abdomen, including the liver, gallbladder, spleen, pancreas, and kidneys. It may also be used to assess blood flow to abdominal organs. An abdominal ultrasound can help find the cause of stomach pain or bloating, check for kidney stones, liver disease, tumors and many other conditions.","scale":"lin","step":0.25,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"A normal result indicates that the organs examined appear normal.","conditions":[]},{"flag":"abnormal","label":{"short":"Abnormal","long":"Abnormal","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"The meaning of abnormal results depends on the organ being examined and the type of problem. Talk to your doctor if you have any questions or concerns.","conditions":["Abdominal aortic aneurysm","Abscess","Appendicitis","Cholecystitis","Gallstones","Hydronephrosis","Kidney cysts","Kidney stones","Pancreatitis (inflammation in pancreas)","Spleen enlargement (splenomegaly)","Portal hypertension","Liver tumors","Obstruction of bile ducts","Cirrhosis"]}],"hideunits":true,"value":0.5}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal result indicates that the organs examined appear normal.
Related conditions
https://www.niddk.nih.gov/health-information/diagnostic-tests/prostate#additional [accessed on Sep 16, 2019]
https://www.niddk.nih.gov/health-information/digestive-diseases/appendicitis/diagnosis [accessed on Sep 19, 2019]
https://www.niddk.nih.gov/health-information/diagnostic-tests/urinary-tract-imaging [accessed on Sep 16, 2019]
https://www.niddk.nih.gov/health-information/urologic-diseases/urine-blockage-newborns/vesicoureteral-reflux [accessed on Sep 16, 2019]
https://medlineplus.gov/ency/article/003777.htm [accessed on Oct 09, 2021]
https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/abdominal-ultrasound [accessed on Oct 09, 2021]
https://www.radiologyinfo.org/en/info/abdominus [accessed on Oct 09, 2021]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
PET Scan
PET Scan
Also called: PET Imaging, Positron Emission Tomography, Positron Emission Testing, PET Scan
A PET scan is an imaging test that uses a radioactive substance (tracer) to check for changes in chemical activity in the body. This activity may be a sign of cancer, heart disease, or a brain disorder.
PET Scan
Also called: PET Imaging, Positron Emission Tomography, Positron Emission Testing, PET Scan
A PET scan is an imaging test that uses a radioactive substance (tracer) to check for changes in chemical activity in the body. This activity may be a sign of cancer, heart disease, or a brain disorder.
{"label":"PET scan reference range","description":"A PET scan is an imaging test that uses a radioactive substance (tracer) to check for changes in chemical activity in the body. This activity may be a sign of cancer, heart disease, or a brain disorder.","scale":"lin","step":0.25,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"There are no problems detected in the size, shape, or function of the organ being scanned. There are no areas in which the tracer has abnormally collected.","conditions":[]},{"flag":"abnormal","label":{"short":"Abnormal","long":"Abnormal","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"A PET scan can find abnormal activity and it can be more sensitive than other imaging tests. It may also show changes to your body sooner.","conditions":["Cancer","Heart disease","Brain disorder"]}],"hideunits":true,"value":0.5}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
Your result is Normal.
There are no problems detected in the size, shape, or function of the organ being scanned. There are no areas in which the tracer has abnormally collected.
Related conditions
A PET (positron emission tomography) scan is a nuclear imaging test that looks at how well your tissues and organs are working. It also checks for signs of cancer. For the scan, you will get an injection of a small amount of a tracer, which is a safe radioactive substance.
The tracer settles in areas of your body that have high levels of chemical activity. This activity can be a sign of cancer or other diseases. The tracer can also help measure blood flow, oxygen use, and changes in the metabolism of a particular tissue or organ. Metabolism is the process your body uses to make energy from the food you eat.
Chemical changes in your body can show up before you even have symptoms of a disease. Since a PET scan can see how your organs are working in real-time, it can find signs of disease at an early stage, often before the disease can be seen on other imaging tests.
Other names: positron emission tomography
A PET scan is most often used to:
Diagnose or monitor certain cancers, including breast, thyroid, and lung cancers
Find out how well your heart muscle is working
Check blood flow to your heart
Check for signs of certain brain disorders, such as Parkinson's disease, Huntington's disease, Alzheimer's disease, and other types of dementia
A PET scan is often done along with a CT scan, a type of x-ray that takes a series of pictures as it rotates around you.
You may need a PET scan to find out if you have cancer. If you've already been diagnosed with cancer, you may need this test to see if your cancer treatment is working.
A PET scan also helps diagnose and monitor heart and brain diseases. So you may need this test if you:
Have a family history of heart disease.
Are being treated for heart disease. This test can show if the treatment is working.
Have symptoms of a brain disease, such as tremors, memory problems, and/or seizures.
Before the scan, you will change into a hospital gown. You may be asked to empty your bladder. During the scan:
A health care provider will inject the radioactive tracer into your vein through an intravenous (IV) line. The tracer sends out a form of energy called gamma rays. The scanner picks up the rays to create images of the inside of your body.
You will need to wait for your body to absorb the tracer, which takes 45 to 60 minutes.
You will then lie on a narrow, padded table, which will slide into a large, donut-shaped scanner.
The scanner will move slowly across your body to capture images. As this happens, you will need to be very still for about 30 minutes.
You will hear clicking or buzzing noises as the images are taken.
The scanner will send images to a computer monitor for your provider to review.
Your provider will then remove the IV line.
The test takes about two hours to complete, including the time you wait for the tracer to be absorbed by your body.
Talk to your provider about how to prepare for the test.
You may be asked to fast (not eat or drink) for four to six hours before the test.
You may be asked to avoid tobacco products and food or drinks with caffeine or alcohol for 24 hours before the test.
If you have diabetes and use insulin, you may need to change the timing of your regular dose. Your provider will give you specific instructions about adjusting your insulin since people with diabetes may not absorb the sugar in the tracer. This may affect the results of your scan.
You may need to stop taking other medicines or supplements before the test, so tell your provider about everything you take. But don't stop taking any medicines unless your provider tells you to.
Also, tell your provider if you have claustrophobia (fear of enclosed spaces). Your provider may decide to give you a medicine to help you relax during the test.
There is very little exposure to radiation in a PET scan. Only a small amount of radioactive substance is used, and it will leave your body through your urine and stool (poop) within 2 to 10 hours. Drink more water after the test to help remove the remaining tracer from your body.
While radiation exposure in a PET scan is safe for most adults, it can be harmful to a developing baby. So be sure to tell your provider if you are pregnant or think you may be pregnant. Also, tell your provider if you are breastfeeding, since the tracer may contaminate your breast milk.
Allergic reactions to the tracer are rare and usually mild.
Depending on which part of the body was being scanned, your results may show signs of:
Cancer. Cancer cells show up as bright spots on a PET scan.
Heart disease. The scan can show decreased blood flow to the heart.
A brain disorder. The scan may show changes in certain brain chemicals that can be a sign of a disease.
Some cancers don’t show up on a PET scan, so your provider may order additional tests based on your symptoms and medical history. If you also had a CT scan, your provider will review the results of the two scans to help make a diagnosis.
If you have questions about your results, talk to your provider.
Your PET scan results will be looked at by a radiologist, a doctor who specializes in diagnosing and treating medical conditions using imaging technologies. They will share the results with your provider.
https://my.clevelandclinic.org/health/diagnostics/10123-pet-scan [accessed on Jul 27, 2021]
https://medlineplus.gov/ency/article/007341.htm [accessed on Jul 27, 2021]
https://medlineplus.gov/ency/article/007342.htm [accessed on Jul 27, 2021]
https://medlineplus.gov/ency/article/007343.htm [accessed on Jul 27, 2021]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (23)
What is it Like to Have a PET Scan? | Cancer Research UK
Video by Cancer Research UK/YouTube
PET Scan in 3 views
PET Scan in 3 views
PET Scan in 3 views
1
2
3
PET Scan in 3 views
PET Scan in 3 views
Interactive by TheVisualMD
PET/CT
CT
PET
1
2
3
PET/CT Scans of Colorectal Cancer 1) Pet/CT scan 2) CT Scan 3) Pet Scan
PET scans can often detect a tumor that can't be seen on CT scans or regular X-rays. Cancer tumors grow rapidly and so actively metabolize glucose. In a PET scan, the patient is injected with glucose containing a radioactive tracer. The PET scan image shows areas of the body that utilize the glucose. The brain, heart, and bladder all metabolize glucose and appear black in the image, along with any cancer tumors that are present.
Interactive by TheVisualMD
How Does a PET Scan Work?
Video by NIBIB gov/YouTube
UCSF Radiology: How does a PET scan help with cancer imaging?
Video by UCSF Imaging/YouTube
Your PET/CT scan at University College Hospital
Video by University College London Hospitals NHS Foundation Trust/YouTube
How X-rays see through your skin - Ge Wang
Video by TED-Ed/YouTube
PET Scans and CAT Scans
Video by Lee Health/YouTube
Having a PET-CT scan
Video by Design Science/YouTube
How does a PET scan work?
Video by Imperial College London/YouTube
Patient exercises
EKG monitoring
Inject radiotracer
Scanning with stress
Patient rests
Inject radiotracer again
1
2
3
4
5
6
Myocardial perfusion scan
Myocardial perfusion imaging is a test that uses a low dose of a radioactive agent to evaluate the blood flow and function of the heart. This scan is done in conjunction with a cardiac stress test a diagnostic test in which a person walks on a treadmill or pedals (a stationary bicycle) while hooked up to equipment that monitors the heart. The test monitors heart rate breathing blood pressure electrical activity (on an electrocardiogram) and the person's level of tiredness. It shows if the heart's blood supply is sufficient and if the heart rhythm is normal. A stress test can detect the following problems:
- Abnormal changes in heart rate or blood pressure
- Symptoms such as shortness of breath or chest pain
- Abnormal changes in the heart's rhythm or electrical activity
Interactive by TheVisualMD
Testing for bowel cancer
Video by Cancer Research UK/YouTube
MRI Animation
Video by Blausen Medical Corporate/YouTube
Carcinogenesis head and neck short version only animation
Video by Amsterdam UMC/YouTube
Head and Neck Cancer
Video by Robert Miller/YouTube
What are the Risk Factors and Symptoms of Head and Neck Cancers? | Dana-Farber Cancer Institute
Video by Dana-Farber Cancer Institute/YouTube
Introduction to Head and Neck Cancer | Memorial Sloan Kettering
Video by Memorial Sloan Kettering/YouTube
Throat Cancer
Video by Michigan Medicine/YouTube
Rush Radiosurgery: Head and Neck Cancer Radiation
Video by Rush Radiosurgery/YouTube
Treating the head and neck - Radiotherapy and its physics (3/15)
Video by OpenLearn from The Open University/YouTube
Nutrition Video for Head & Neck Cancer
Video by Stanford Health Care/YouTube
Throat Cancer Largely Due to Smoking And Drinking, Studies Show
Video by VOA News/YouTube
What is nuclear medicine? An illustrated introduction
Video by navalorama/YouTube
3:13
What is it Like to Have a PET Scan? | Cancer Research UK
Cancer Research UK/YouTube
PET Scan in 3 views
TheVisualMD
PET/CT Scans of Colorectal Cancer 1) Pet/CT scan 2) CT Scan 3) Pet Scan
TheVisualMD
1:33
How Does a PET Scan Work?
NIBIB gov/YouTube
1:30
UCSF Radiology: How does a PET scan help with cancer imaging?
UCSF Imaging/YouTube
3:31
Your PET/CT scan at University College Hospital
University College London Hospitals NHS Foundation Trust/YouTube
4:42
How X-rays see through your skin - Ge Wang
TED-Ed/YouTube
1:37
PET Scans and CAT Scans
Lee Health/YouTube
5:17
Having a PET-CT scan
Design Science/YouTube
4:25
How does a PET scan work?
Imperial College London/YouTube
Myocardial perfusion scan
TheVisualMD
1:37
Testing for bowel cancer
Cancer Research UK/YouTube
0:36
MRI Animation
Blausen Medical Corporate/YouTube
4:03
Carcinogenesis head and neck short version only animation
Amsterdam UMC/YouTube
7:27
Head and Neck Cancer
Robert Miller/YouTube
2:35
What are the Risk Factors and Symptoms of Head and Neck Cancers? | Dana-Farber Cancer Institute
Dana-Farber Cancer Institute/YouTube
18:04
Introduction to Head and Neck Cancer | Memorial Sloan Kettering
Memorial Sloan Kettering/YouTube
6:01
Throat Cancer
Michigan Medicine/YouTube
1:13
Rush Radiosurgery: Head and Neck Cancer Radiation
Rush Radiosurgery/YouTube
1:57
Treating the head and neck - Radiotherapy and its physics (3/15)
OpenLearn from The Open University/YouTube
4:25
Nutrition Video for Head & Neck Cancer
Stanford Health Care/YouTube
2:39
Throat Cancer Largely Due to Smoking And Drinking, Studies Show
VOA News/YouTube
3:02
What is nuclear medicine? An illustrated introduction
navalorama/YouTube
Laparoscopy
Laparoscopy
Also called: Diagnostic Laparoscopy, Exploratory Laparoscopy, Laparoscopy, Laparoscopy and Dye
A laparoscopy is surgery that lets a surgeon see your organs without making a large cut in your body. It is used to diagnose and treat conditions that develop in your belly or pelvis.
Laparoscopy
Also called: Diagnostic Laparoscopy, Exploratory Laparoscopy, Laparoscopy, Laparoscopy and Dye
A laparoscopy is surgery that lets a surgeon see your organs without making a large cut in your body. It is used to diagnose and treat conditions that develop in your belly or pelvis.
{"label":"Laparoscopy reference range","description":"A laparoscopy looks inside the body in real time, to check the organs in the belly (abdomen) and pelvis. It is used to diagnose and treat conditions of the abdomen or pelvis. Laparoscopy may also be used to take a small tissue sample for testing (a biopsy).","scale":"lin","step":0.25,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"A normal result means that the examined site was found to have a normal shape and size, without any abnormal masses or tissues.","conditions":[]},{"flag":"abnormal","label":{"short":"Abnormal","long":"Abnormal","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"An abnormal result indicates that a problem was detected in the examined area.","conditions":["Endometriosis","Fibroids","Ovarian cysts","Ectopic pregnancy","Congenital organ anomalies","Adhesions","Noncancerous tumors","Cancer","Inflammation","Infections","Fluid in the abdominal or pelvic cavities"]}],"hideunits":true,"value":0.5}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal result means that the examined site was found to have a normal shape and size, without any abnormal masses or tissues.
Related conditions
{"label":"Laparoscopy and dye reference range","description":"The dye test can show if the fallopian tubes are blocked, whilst the laparoscopy examines the abdominal cavity and the uterus, tubes, ovaries and neighboring organs. The test is used to assess pelvic health and to check the patency of the fallopian tubes.","scale":"lin","step":0.25,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"In the normal pelvis, the uterus, tubes and ovaries are gleaming with health. Neither the tubes nor the ovaries should be stuck down by adhesions or any other abnormalities.","conditions":[]},{"flag":"abnormal","label":{"short":"Abnormal","long":"Abnormal","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"The presence of any abnormality such as endometriosis, fibroids or adhesions is noted. If the dye does not enter either tube where it joins the uterus on each side, this could indicate a tubal obstruction. ","conditions":["Endometriosis","Fibroids","Fallopian tube obstruction","Ovarian cysts","Ectopic pregnancy","Congenital organ anomalies","Adhesions","Noncancerous tumors","Cancer","Inflammation","Infections","Fluid in the abdominal or pelvic cavities"]}],"hideunits":true,"value":0.5}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
Your result is Normal.
In the normal pelvis, the uterus, tubes and ovaries are gleaming with health. Neither the tubes nor the ovaries should be stuck down by adhesions or any other abnormalities.
Related conditions
A laparoscopy is a type of surgery that lets a surgeon look inside your body without making a large incision (cut). It's used to help diagnose and sometimes treat conditions that develop in your belly or pelvis.
To do a laparoscopy, a surgeon makes a small cut near your belly button that's usually a half-inch long or less. The surgeon inserts a long, thin tube with a camera through the cut and into your body. This tube is called a laparoscope. The camera sends images from inside your body to a video monitor. This allows the surgeon to see inside your body.
The surgeon may make one or two other small cuts in your belly for inserting special surgical tools into your body. Using these tools, the surgeon can remove samples of tissue to check for signs of disease (a biopsy).
Sometimes during a laparoscopy, the surgeon will use these tools to do procedures to treat certain problems. For example, if a laparoscopy finds a tumor, the surgeon may remove it completely during the same surgery. Many common surgical treatments can be done with laparoscopic surgery.
Laparoscopy is sometimes called "minimally invasive surgery" or "keyhole surgery," because it requires smaller cuts than traditional, "open" surgery. The use of smaller cuts has several benefits, including:
Shorter hospital stays
Less pain
Faster recovery and smaller scars
Laparoscopy is used to help diagnose the cause of symptoms in the belly or pelvis. It's usually done if imaging tests, such as x-rays, ultrasounds, and MRI scans, haven't provided enough information to confirm a diagnosis.
The test is often used to help diagnose:
Digestive diseases
Urinary disorders
Disorders in the female reproductive system, which includes the uterus, ovaries, and fallopian tubes
A surgeon uses laparoscopy to:
Examine organs and glands to look for:
Abnormal growths, such as cysts and tumors (cancerous and not cancerous)
Scar tissue and adhesions
Bleeding
Infections
Collect tissue samples to check for disease
Find out if a known cancer has spread in the body
There are many reasons why you may need a laparoscopy, including if:
You have pain or other symptoms in your belly or pelvis and imaging tests haven't been able to find the cause.
You've been in a serious accident or have been wounded and may have organ injuries.
You have cancer and your health care provider needs to know if it has spread to other parts of your body. This information helps choose your treatment.
You've had abnormal liver tests and your provider doesn't know why.
If you're female, you may need a laparoscopy to:
Find out what's causing problems getting pregnant
Diagnose symptoms that may involve your reproductive organs, including:
Pelvic inflammatory disease (PID)
Endometriosis
Ectopic pregnancy
Uterine fibroids
Ovarian cysts
Laparoscopy is usually done in a hospital or an outpatient clinic. In general, it includes these steps:
You'll wear a hospital gown and lay on an operating table.
Usually, you will have general anesthesia, which is medicine to make you sleep during the surgery. The medicine is injected into your bloodstream through an intravenous (IV) line that's inserted into a vein. You may also inhale a gas from a mask to make you sleep.
To do the laparoscopy, the surgeon will:
Make a small cut near your belly button
Put carbon dioxide gas into your belly to open up space between your organs so it's easier to see them
Insert the laparoscope and small camera into your belly
Move the laparoscope to look at your organs and glands on a computer screen
If you need to have a biopsy or another procedure, the surgeon may need to make more small cuts to insert surgical tools.
When the surgeon is done, the tools and most of the gas will be removed from your body, and the small incisions will be closed and bandaged.
After surgery, you will be moved to a recovery room. In most cases, you'll be able to go home after a few hours, but that depends on what procedures were done during the laparoscopy. Before you leave, you'll get information about what to expect over the next few days at home.
Your provider will let you know how to prepare. Be sure to follow all the instructions. You will need to fast (not eat or drink) for a period of time before a laparoscopy. Ask your provider whether you should take your usual medicines and/or supplements. But don't stop taking any medicine without talking with your provider first.
Plan to wear loose-fitting clothes because after the surgery, your belly may be bloated from the gas and a little sore. You're also likely to feel groggy, so you'll need to plan to have someone take you home.
You may have mild abdominal pain or discomfort for a few days after a laparoscopy. You may also have neck or shoulder pain. That's because the gas used in the surgery may irritate nerves in your belly that run through your shoulder.
After a laparoscopy, serious problems are very uncommon. But they can include bleeding, infection, blood clots, damage to an organ or blood vessel, and problems from the medicine that made you sleep during the procedure.
The results of a laparoscopy depend on the reason for doing the procedure. Your provider can explain what was found and what that information means for your health. In general, your provider will be able to make a very accurate diagnosis of your condition based on the information from a laparoscopy.
Laparoscopy: MedlinePlus Medical Test [accessed on Mar 09, 2023]
Diagnostic laparoscopy: MedlinePlus Medical Encyclopedia [accessed on Dec 21, 2018]
Pelvic Laparoscopy: Purpose, Procedure, and Recovery [accessed on Dec 20, 2018]
Female Pelvic Laparoscopy Procedure | Cleveland Clinic [accessed on Dec 20, 2018]
Gynecologic Laparoscopy: Purpose, Procedure, and Risks [accessed on Dec 20, 2018]
Laparoscopy: Purpose, Preparation, Procedure, and Recovery [accessed on Dec 20, 2018]
Laparoscopic Surgery: Purpose, Procedure, and Benefits [accessed on Dec 20, 2018]
https://www.acog.org/~/media/For%20Patients/faq136.pdf [accessed on Dec 20, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (13)
Diagnostic Pelvic Laparoscopy
Video by Covenant Health/YouTube
Anti-Reflux Laparoscopy Heartburn Surgery Medical PreOp® Patient Education
Video by PreOp.com Patient Engagement - Patient Education/YouTube
Sleeve Gastrectomy at Duke Center for Metabolic and Weight Loss Surgery
Video by Duke Health/YouTube
Gallstones and Surgical Removal of Gallbladder (Cholecystectomy) Animation.
Video by Alila Medical Media/YouTube
Surgeon Performing Laparoscopic Kidney Transplant
This photograph shows the posterior view of two surgeons performing laparoscopic kidney transplant surgery with a view of the patient's abdomen on the monitor. Laparoscopy is a a minimally invasive procedure which requires only small incisions and has replaced conventional operations for kidney removal that used to require a larger opening and therefore longer recovery time. The procedure for living donors involves inserting a special needle into the abdominal cavity to fill it up with gas and create space. A metal tube with a camera, called a laparoscope, is inserted through a two-inch incision in the skin. Surgical instruments can be inserted through the laparoscope, and the surgeon can watch his progress in removing the kidney on a video monitor above the patient. With laparoscopic surgery, donors feel less pain after the transplant, and are able to return to their daily routine sooner.
Image by TheVisualMD
Laparoscopic stomach surgery
Doctors Ronald Post (left) and John Smear (center) and Physician's Assistant Debra Blackshire perform laparoscopic stomach surgery at Langley Air Force Base, Va., on Jan. 31, 2005. The surgery will involve the removal of the gall bladder to help alleviate acid reflux disease.
Image by Samuel Bendet, US Air Force
Illustration of Laparoscopy
Laparoscopy (from Ancient Greek λαπάρα (lapara), meaning 'flank, side', and σκοπέω (skopeo), meaning 'to see') is an operation performed in the abdomen or pelvis using small incisions (usually 0.5–1.5 cm) with the aid of a camera. The laparoscope aids diagnosis or therapeutic interventions with a few small cuts in the abdomen.
Image by Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436.
Laparoscopic Cholecystectomy
X-ray of organs during a laprasopic cholecystectomy. The picture shows the liver on top, the biliary tree within the liver, and the cystic duct going from the gall bladder to the common bile duct, which then goes down to duodenum.
Sleeve Gastrectomy at Duke Center for Metabolic and Weight Loss Surgery
Duke Health/YouTube
3:06
Gallstones and Surgical Removal of Gallbladder (Cholecystectomy) Animation.
Alila Medical Media/YouTube
Surgeon Performing Laparoscopic Kidney Transplant
TheVisualMD
Laparoscopic stomach surgery
Samuel Bendet, US Air Force
Illustration of Laparoscopy
Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436.
Laparoscopic Cholecystectomy
HenrikP
Sensitive content
This media may include sensitive content
Uterus
Hic et nunc
Sleeve Gastrectomy
Stevenfruitsmaak at en.wikipedia derivative work: Jan Friberg (talk)
Laparoscopic Surgery (Keyhole Surgery)
U.S. Navy photo by Mass Communication Specialist Seaman Paul Polach
Abdominal Quadrant Regions
OpenStax College
Ultrasound of Pelvis and Abdomen
TheVisualMD
About ERCP
ERCP
Image by Drus1a/Wikimedia
ERCP
Diagram of the process of ERCP
Image by Drus1a/Wikimedia
About ERCP
What is ERCP?
Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure that combines upper gastrointestinal (GI) endoscopy and x-rays to find and treat problems of the bile and pancreatic ducts.
What are the bile and pancreatic ducts?
Your bile ducts are tubes that carry bile from your liver to your gallbladder and duodenum. Your pancreatic ducts are tubes that carry pancreatic juice from your pancreas to your duodenum. Small pancreatic ducts empty into the main pancreatic duct. Your common bile duct and main pancreatic duct join before emptying into your duodenum.
Your common bile duct and main pancreatic duct join before emptying into your duodenum.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (8)
ERCP Procedure
Video by eMedTV/YouTube
The Role of Endoscopic Retrograde Cholangiopancreatography (ERCP)
Video by Memorial Sloan Kettering/YouTube
Cholangitis
Fluoroscopic image of en:common bile duct stone seen at the time of ERCP. The stone is impacted in the distal common bile duct.
Image by Samir
Pancreas and Duodenum with Pancreatic Duct and Bile Duct
The biliary system consists of the organs and ducts that produce and transport bile. When damaged or dying red blood cells are broken down, bilirubin, a yellow pigment and component of hemoglobin, is released into the bloodstream. Bilirubin is eliminated from the body by the liver as a component of bile, which is stored in the gallbladder and then released into the small intestine to aid digestion. The pancreas functions as two organs in one. It secretes digestive enzymes into the duodenum (the first section of the small intestine), which then combine with bile, produced in the liver and stored in the gallbladder. The majority of cells in the pancreas (some 98%) are cells arranged in grapelike clusters that produce these important enzymes. The other 2% of pancreatic cells are those that produce the hormone insulin. Our bodies (and especially our brains) run on glucose, which is produced by the digestion of carbohydrates. The body's ability to use glucose as its main source of energy depends on insulin.
Image by TheVisualMD
The gallbladder and bile ducts | Cancer Research UK
Video by Cancer Research UK/YouTube
Drawing of the biliary system with the liver, biliary tree (bile ducts), common bile duct, gallbladder, pancreas, duodenal papilla, main pancreatic duct, and duodenum labeled. Inset of an enlarged biliary system with the duodenal papilla and papillary orifice labeled
The common bile duct and the main pancreatic duct join before emptying their contents into the duodenum through the papillary orifice at the end of the duodenal papilla—a small, nipplelike structure that extends into the duodenum.
Image by NIDDK Image Library
The biliary tract
Drawing of the biliary system, with the liver, gallbladder, duodenum, pancreatic duct, common bile duct, pancreas, cystic duct, and hepatic ducts labeled.
Image by NIDDK Image Library
Biliary Tract
Drawing of the biliary system with the liver, gallbladder, pancreas, duodenum, bile ducts, cystic duct, common bile duct, and pancreatic duct labeled.
Image by NIDDK Image Library
3:37
ERCP Procedure
eMedTV/YouTube
2:18
The Role of Endoscopic Retrograde Cholangiopancreatography (ERCP)
Memorial Sloan Kettering/YouTube
Cholangitis
Samir
Pancreas and Duodenum with Pancreatic Duct and Bile Duct
TheVisualMD
1:27
The gallbladder and bile ducts | Cancer Research UK
Cancer Research UK/YouTube
Drawing of the biliary system with the liver, biliary tree (bile ducts), common bile duct, gallbladder, pancreas, duodenal papilla, main pancreatic duct, and duodenum labeled. Inset of an enlarged biliary system with the duodenal papilla and papillary orifice labeled
NIDDK Image Library
The biliary tract
NIDDK Image Library
Biliary Tract
NIDDK Image Library
Blood Test Accurately Detects Early-Stage Pancreatic Cancer
MiRNA
Image by Kelvinsong/Wikimedia
MiRNA
Diagram of microRNA. Based on [1], [2], [3], the wikipedia article, and various other sources.
The editable text is in this file, off beyond the page boundaries.
Image by Kelvinsong/Wikimedia
Blood Test Accurately Detects Early-Stage Pancreatic Cancer
Scientists have developed a blood test that can accurately detect early-stage pancreatic cancer, according to results from a large study. The test is a liquid biopsy, a type of test that uses blood or other bodily fluids to detect or monitor cancer.
Exosomes from each organ are stamped with a unique mark, like a ZIP code, allowing researchers to zero in on exosomes made by the pancreas. Then by looking at microRNA inside those exosomes, researchers can tell if there's cancer in the pancreas.
Credit: Created by Nadia Jaber with Biorender.com
For the vast majority of people with pancreatic cancer, their cancer is found when it has already crept into other organs and can’t be removed with surgery. That’s because early-stage disease doesn’t cause obvious symptoms, and there aren’t any reliable tests to check for it.
If pancreatic cancer is caught earlier, however, chances of living for 5 years after diagnosis are much higher: 44% for early-stage disease versus 3% for late-stage disease.
The blood test, developed by Ajay Goel, Ph.D., of City of Hope Duarte Cancer Center in California and his colleagues, analyzes small bits of RNA released by tumors. The new study, which included nearly 1,000 people from several countries, showed that the test accurately detected early- and late-stage pancreatic cancer in a large and diverse group of people.
And when the researchers combined their blood test with one that detects a protein called CA19-9, the combination accurately identified 97% of people with early-stage pancreatic cancer. High accuracy means that a test is not only good at flagging those with cancer, but is also good at not flagging those who don’t have cancer.
Dr. Goel presented the findings at the American Association for Cancer Research annual meeting on April 8. However, the results haven’t yet been peer-reviewed—that is, evaluated for scientific quality and accuracy by other experts in the field.
“Pancreatic cancer is devastating,” said Matthew Young, Ph.D., co–lead program director of NCI’s Pancreatic Cancer Detection Consortium, which funded the study. “Once you're diagnosed [with late-stage disease], you usually have 3 to 6 months to live. So, anything we can do to change that is important.”
But in the general population, where the risk of pancreatic cancer is low, even a test with near perfect accuracy would lead to a lot of false-positive test results, Dr. Young explained. If a test indicates that someone may have pancreatic cancer, they have to get abdominal surgery to see if they truly have the disease, he said.
But for people at higher risk of developing pancreatic cancer, the benefits are more likely to outweigh the harms of a screening test, he added.
“The most effective and practical use of [this] blood test would be in high-risk individuals,” Dr. Goel agreed. That includes people with an inherited genetic mutation that puts them at high risk for pancreatic cancer, people with family members who’ve had pancreatic cancer, and people with chronic pancreatitis or new-onset diabetes.
But the test needs to be studied in more detail before it can be used to screen people for pancreatic cancer, said Howard Crawford, Ph. D., scientific director of the Henry Ford Pancreatic Cancer Center in Michigan, who wasn’t involved in the study.
MicroRNAs for detecting cancer
For more than a decade, researchers have been studying whether microRNAs—a type of RNA—can be used to detect cancer.
MicroRNAs are ideal molecules for cancer detection, Dr. Goel said, because they are abundant and stable in the blood, and tumors release loads of them. Some of those microRNAs are floating freely, while others are packaged in tiny sacs called exosomes.
It’s easy to measure levels of free-floating microRNAs in people with cancer, Dr. Young explained, but it’s hard to tell where in the body those microRNAs—and therefore, the cancer—came from.
Exosome-packaged microRNAs, on the other hand, offer something free-floating ones don’t: a kind of ZIP code. Each organ in the body releases exosomes stamped a unique mark, Dr. Goel explained.
By looking at those markings, the team can tell if exosomes in the blood came from the pancreas, he said.
In an initial study, Dr. Goel and his team found that analyzing both free-floating and exosome-packaged microRNAs proved to be the key for detecting early-stage pancreatic cancer. Among more than 100 people already diagnosed with the disease, the test accurately detected early- and late-stage pancreatic cancer.
“First, the [free-floating microRNAs] are saying, ‘yes, we can detect a cancer.’ Second, the exosomes are saying ‘the cancer is in the pancreas,’” Dr. Young explained.
With promising results from the initial study, the researchers were ready to test their idea on a larger and more diverse group of people.
Validating a liquid biopsy for detecting pancreatic cancer
For the current study, the team collected blood samples from people in Japan, the United States, South Korea, and China. About 500 of the participants had confirmed pancreatic cancer (including early- and late-stage disease); the other participants were considered healthy controls.
Could a Diabetes Diagnosis Help Detect Pancreatic Cancer Early?
Studies are trying to identify this deadly cancer earlier in people with a new diabetes diagnosis.
In the Japanese group, or cohort, the microRNA analysis could distinguish between people with and without pancreatic cancer. The test was then validated in the other three cohorts, resulting in an accuracy of 93% in the US cohort, 91% in the Korean cohort, and 88% in the Chinese cohort.
For detecting early-stage pancreatic cancer in the US cohort, the microRNA analysis had an accuracy of 91% on its own and 97% when combined with a test for CA19-9. In the researchers’ initial study, the accuracy of CA19-9 alone was 86% for early-stage pancreatic cancer.
Follow-up studies to answer important questions
The researchers are now applying their microRNA test to blood samples collected via NCI’s Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial.
Because those samples were collected years before some participants received a cancer diagnosis, the analysis will determine whether their test can find pancreatic cancer before traditional diagnostic tests like CT scans can pick it up , Dr. Goel said.
The accuracy of the test also needs to be checked in people with certain diseases, Dr. Crawford said.
“Pancreatic cancer and chronic pancreatitis have many cellular and molecular features in common, so it is essential that chronic pancreatitis patients are included in follow-up studies,” he explained.
“Many promising early detection techniques have fallen down when trying to distinguish pancreatic cancer from non-cancerous pancreatic disease, more specifically chronic pancreatitis,” he added.
People with cancers “that share common mutations with pancreatic cancer, such as lung and colorectal cancers” should also be included in future studies, Dr. Crawford noted. That would ensure the test is picking up signals specifically from pancreatic cancer and not another type of cancer, he explained.
And, ultimately, the only way to know if a cancer screening test truly benefits patients is if it reduces deaths from cancer in a randomized clinical trial.
Source: Nadia Jaber - National Cancer Institute (NCI)
Additional Materials (3)
MicroRNAs and Argonaute RNA binding
Crystallographic structures of a microRNA (light blue) together with the bound target mRNA molecule (dark blue), and the Argonaute protein (PDB: 6MDZ).
Image by J.J.Froehlich/Wikimedia
Roles of microRNAs on immune checkpoints
Figure 3. Roles of microRNAs on immune checkpoints. AML = acute myeloid leukemia, CRC = colorectal cancer, DLBCL= diffuse large B-cell lymphoma, HCC = hepatocellular carcinoma, HNSCC = head and neck squamous cell carcinoma, MPM = malignant pleural mesothelioma, NSCLC = nonsmall cell lung cancer, RCC = renal cell carcinoma, BTLA = B and T lymphocyte attenuator, CEACAM-1 = carcinoembryonic antigen-related cell adhesion molecule 1, LAG-3 = lymphocyte activation gene 3 protein and TIM-3 = T cell immunoglobulin mucin receptor 3.
Image by Alexandre Perrier, Audrey Didelot, Pierre Laurent-Puig, Hélène Blons and Simon Garinet/Wikimedia
Workflow and elements of miRNA biosensors
Figure illustrating the workflow of miRNA detection. miRNAs can be detected through conventional methods such as microarrays, q-PCR, and NGS miRNAs. Complex biosensors such as electrochemical biosensors, optical biosensors, and microfluidics utilize nanomaterials, recognition elements, and amplification elements for sensitive and specific detection of miRNAs.
Image by Molecfood505/Wikimedia
MicroRNAs and Argonaute RNA binding
J.J.Froehlich/Wikimedia
Roles of microRNAs on immune checkpoints
Alexandre Perrier, Audrey Didelot, Pierre Laurent-Puig, Hélène Blons and Simon Garinet/Wikimedia
Tests and procedures to stage pancreatic cancer are usually done at the same time as diagnosis.
There are three ways that cancer spreads in the body.
Cancer may spread from where it began to other parts of the body.
The following stages are used for pancreatic cancer:
Stage 0 (Carcinoma in Situ)
Stage I
Stage II
Stage III
Stage IV
The following groups are used to plan treatment:
Resectable pancreatic cancer
Borderline resectable pancreatic cancer
Locally advanced pancreatic cancer
Metastatic pancreatic cancer
Recurrent pancreatic cancer
Tests and procedures to stage pancreatic cancer are usually done at the same time as diagnosis.
The process used to find out if cancer has spread within the pancreas or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage of the disease in order to plan treatment. The results of some of the tests used to diagnose pancreatic cancer are often also used to stage the disease.
There are three ways that cancer spreads in the body.
Cancer can spread through tissue, the lymph system, and the blood:
Tissue. The cancer spreads from where it began by growing into nearby areas.
Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
Cancer may spread from where it began to other parts of the body.
When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.
Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.
Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if pancreatic cancer spreads to the liver, the cancer cells in the liver are actually pancreatic cancer cells. The disease is metastatic pancreatic cancer, not liver cancer.
The following stages are used for pancreatic cancer:
Stage 0 (Carcinoma in Situ)
Stage 0 pancreatic cancer. Abnormal cells are found in the lining of the pancreas. These abnormal cells may become cancer and spread into nearby normal tissue.
In 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
Stage I pancreatic cancer. Cancer is found in the pancreas only. In stage IA, the tumor is 2 centimeters or smaller. In stage IB, the tumor is larger than 2 centimeters but not larger than 4 centimeters.
In stage I, cancer has formed and is found in the pancreas only. Stage I is divided into stages IA and IB, depending on the size of the tumor.
Stage IA: The tumor is 2 centimeters or smaller.
Stage IB: The tumor is larger than 2 centimeters but not larger than 4 centimeters.
Stage II
Stage II is divided into stages IIA and IIB, depending on the size of the tumor and where the cancer has spread.
Stage IIA: The tumor is larger than 4 centimeters.Stage IIA pancreatic cancer. The tumor is larger than 4 centimeters.
Stage IIB: The tumor is any size and cancer has spread to 1 to 3 nearby lymph nodes.Stage IIB pancreatic cancer. The tumor is any size and cancer has spread to 1 to 3 nearby lymph nodes.
Stage III
Stage III pancreatic cancer. The tumor is any size and cancer has spread to (a) 4 or more nearby lymph nodes; or (b) the major blood vessels near the pancreas. These include the portal vein, common hepatic artery, celiac axis (trunk), and superior mesenteric artery.
In stage III, the tumor is any size and cancer has spread to:
four or more nearby lymph nodes; or
the major blood vessels near the pancreas.
Stage IV
Stage IV pancreatic cancer. The tumor is any size and cancer has spread to other parts of the body, such as the lung, liver, or peritoneal cavity (the body cavity that contains most of the organs in the abdomen).
In stage IV, the tumor is any size and cancer has spread to other parts of the body, such as the liver, lung, or peritoneal cavity (the body cavity that contains most of the organs in the abdomen).
The following groups are used to plan treatment:
Resectable pancreatic cancer
Resectable pancreatic cancer can be removed by surgery because it has not grown into important blood vessels near the tumor.
Borderline resectable pancreatic cancer
Borderline resectable pancreatic cancer has grown into a major blood vessel or nearby tissue or organs. It may be possible to remove the tumor, but there is a high risk that all of the cancer cells will not be removed with surgery.
Locally advanced pancreatic cancer
Locally advanced pancreatic cancer has grown into or close to nearby lymph nodes or blood vessels, so surgery cannot completely remove the cancer.
Metastatic pancreatic cancer
Metastatic pancreatic cancer has spread to other organs, so surgery cannot completely remove the cancer.
Recurrent pancreatic cancer
Recurrent pancreatic cancer has recurred (come back) after it has been treated. The cancer may come back in the pancreas or in other parts of the body.
T1 stage - the tumor is inside the pancreas and is 2cm or less in any direction.
T2 stage - the cancer is more than 2cm but no more than 4cm in size in any direction.
T3 stage - the cancer is more than 4cm in size.
T4 stage - the cancer has grown outside the pancreas, into the nearby large blood vessels.
Node (N) describes whether the cancer has spread to the lymph nodes. It is further divided into N0 and N1 stages.
Metastasis (M) describes whether the cancer has spread to a different part of the body. It is further divided into M0 and M1 stages.
1
2
3
4
5
6
TNM Staging for Pancreatic Cancer
TNM stands for Tumour, Node, Metastasis. This system describes the size of a primary tumour (T), whether there are lymph nodes with cancer cells in them (N) and whether the cancer has spread to a different part of the body (M).
Interactive by Cancer Research UK
Sensitive content
This media may include sensitive content
Diagram showing pancreatic cancer that has spread (M staging).
Metastasis (M) describes whether the cancer has spread to a different part of the body. M0 means the cancer has not spread into distant organs such as the liver or lungs. M1 means the cancer has spread to other organs.
Image by Cancer Research UK / Wikimedia Commons
Progression of pancreatic intraepithelial neoplasia
Progression of pancreatic intraepithelial neoplasia
Image by Source article: Hackeng WM, Hruban RH, Offerhaus GJ, Brosens LA
Title and optimization: Mikael Häggström, M.D. Author info - Reusing images- Conflicts of interest: NoneMikael Häggström, M.D./Wikimedia
Stages of Pancreatic Cancer
Video by AllHealthGo/YouTube
Stage IV Pancreatic Cancer
Video by AllHealthGo/YouTube
Pancreatic Cancer -- Staging
Video by Cancer GPS/YouTube
What are the different stages of pancreatic cancer?
Diagram showing pancreatic cancer that has spread (M staging).
Cancer Research UK / Wikimedia Commons
Progression of pancreatic intraepithelial neoplasia
Source article: Hackeng WM, Hruban RH, Offerhaus GJ, Brosens LA
Title and optimization: Mikael Häggström, M.D. Author info - Reusing images- Conflicts of interest: NoneMikael Häggström, M.D./Wikimedia
2:32
Stages of Pancreatic Cancer
AllHealthGo/YouTube
1:32
Stage IV Pancreatic Cancer
AllHealthGo/YouTube
1:26
Pancreatic Cancer -- Staging
Cancer GPS/YouTube
3:58
What are the different stages of pancreatic cancer?
ThePancreasPatient/YouTube
Plan Treatment
Area removed for surgery to remove all of the pancreas (total pancreatectomy) / How the bowel is joined back together after a total pancreatectomy
Total Pancreatectomy
Interactive by Cancer Research UK
Area removed for surgery to remove all of the pancreas (total pancreatectomy) / How the bowel is joined back together after a total pancreatectomy
Total Pancreatectomy
Diagram showing area removed for surgery to remove all of the pancreas (total pancreatectomy) and how the bowel is joined back together after a total pancreatectomy.
Interactive by Cancer Research UK
The Following Groups Are Used to Plan Pancreatic Cancer Treatment:
Resectable pancreatic cancer
Resectable pancreatic cancer can be removed by surgery because it has not grown into important blood vessels near the tumor.
Borderline resectable pancreatic cancer
Borderline resectable pancreatic cancer has grown into a major blood vessel or nearby tissue or organs. It may be possible to remove the tumor, but there is a high risk that all of the cancer cells will not be removed with surgery.
Locally advanced pancreatic cancer
Locally advanced pancreatic cancer has grown into or close to nearby lymph nodes or blood vessels, so surgery cannot completely remove the cancer.
Metastatic pancreatic cancer
Metastatic pancreatic cancer has spread to other organs, so surgery cannot completely remove the cancer.
Recurrent pancreatic cancer
Recurrent pancreatic cancer has recurred (come back) after it has been treated. The cancer may come back in the pancreas or in other parts of the body.
Source: National Cancer Institute (NCI)
Additional Materials (15)
Pancreas
Illustration of anatomy of Human Pancreas
Image by Blausen.com staff. \"Blausen gallery 2014\"
Sensitive content
This media may include sensitive content
Pancreatectomy
Diagram showing the area removed for a total pancreatectomy
Image by Cancer Research UK / Wikimedia Commons
Sensitive content
This media may include sensitive content
Pancreatectomy
Diagram showing how the bowel is joined back together after a total pancreatectomy.
Image by Cancer Research UK / Wikimedia Commons
Whipple Surgery (Close Up)
A medical illustration depicting the Whipple procedure.
Image by BruceBlaus/Wikimedia
Whipple Procedure
Whipple Surgery
Image by BruceBlaus
Mitochondrial Dynamics in Pancreatic Cancer
This image shows mitochondrial staining (red) and nuclear staining (blue) of abnormal pancreatic ducts from a mouse model of human pancreatic ductal carcinoma. Mitochondrial shape changes occur throughout the progression of pancreatic cancer and the machinery that regulates the dynamics of mitochondria may be a promising new therapeutic target in the fight against this disease.
This image was originally submitted as part of the 2016 NCI Cancer Close Up project and selected for exhibit. This image is part of the NCI Cancer Close Up 2016 collection.
See also https://visualsonline.cancer.gov/closeup2016.
Image by National Cancer Institute \ Univ. of Virginia Cancer Center / David Kashatus
Mitochondrial Shape in Pancreatic Cancer
This image shows mitochondrial staining (red) and nuclear staining (blue) of abnormal pancreatic ducts from a mouse model of human pancreatic ductal carcinoma. Mitochondrial shape changes occur throughout the progression of pancreatic cancer and the machinery that regulates the dynamics of mitochondria may be a promising new therapeutic target in the fight against this disease.
This image was originally submitted as part of the 2016 NCI Cancer Close Up project. This image is part of the NCI Cancer Close Up 2016 collection.
See also https://visualsonline.cancer.gov/closeup2016.
Image by National Cancer Institute / Univ. of Virginia Cancer Center / David Kashatus
Imaging characteristics of early-stage pancreatic ductal adenocarcinoma (PDAC)
Imaging characteristics of early-stage pancreatic ductal adenocarcinoma (PDAC)
Image by Kanno, A.; Masamune, A.; Hanada, K.; Kikuyama, M.; Kitano, M./Wikimedia
Pancreatic Cancer
Pancreatic Cancer: In Situ : The summary staging system categorizes cancer (shown here in the pancreas) according to its spread. In situ cancer is present only in cells in which it began.
Image by TheVisualMD
This browser does not support the video element.
10 Things You Didn't Know About Pancreatic Cancer
10 Things You Didn't Know About Pancreatic Cancer, short animation by Cancer Research UK
Video by Cancer Research UK / Wikimedia Commons
Seeking early detection for pancreatic cancer | Kaiser Permanente
Video by Kaiser Permanente Thrive/YouTube
Pancreatic Cancer: Advances in treatment and detection
Video by Dana-Farber Cancer Institute/YouTube
Top 5 things you probably didn't know about Pancreatic Cancer with Dr. John A. Chabot
Video by Columbia University Department of Surgery/YouTube
Diagnosing Pancreatic Tumors and Cysts - Mayo Clinic
Video by Mayo Clinic/YouTube
Early detection of pancreatic cancer
Video by KochInstituteMIT/YouTube
Pancreas
Blausen.com staff. \"Blausen gallery 2014\"
Sensitive content
This media may include sensitive content
Pancreatectomy
Cancer Research UK / Wikimedia Commons
Sensitive content
This media may include sensitive content
Pancreatectomy
Cancer Research UK / Wikimedia Commons
Whipple Surgery (Close Up)
BruceBlaus/Wikimedia
Whipple Procedure
BruceBlaus
Mitochondrial Dynamics in Pancreatic Cancer
National Cancer Institute \ Univ. of Virginia Cancer Center / David Kashatus
Mitochondrial Shape in Pancreatic Cancer
National Cancer Institute / Univ. of Virginia Cancer Center / David Kashatus
Imaging characteristics of early-stage pancreatic ductal adenocarcinoma (PDAC)
Kanno, A.; Masamune, A.; Hanada, K.; Kikuyama, M.; Kitano, M./Wikimedia
Pancreatic Cancer
TheVisualMD
1:56
10 Things You Didn't Know About Pancreatic Cancer
Cancer Research UK / Wikimedia Commons
1:58
Seeking early detection for pancreatic cancer | Kaiser Permanente
Kaiser Permanente Thrive/YouTube
2:29
Pancreatic Cancer: Advances in treatment and detection
Dana-Farber Cancer Institute/YouTube
2:18
Top 5 things you probably didn't know about Pancreatic Cancer with Dr. John A. Chabot
Columbia University Department of Surgery/YouTube
5:55
Diagnosing Pancreatic Tumors and Cysts - Mayo Clinic
Mayo Clinic/YouTube
20:48
Early detection of pancreatic cancer
KochInstituteMIT/YouTube
An MRNA Vaccine to Treat Pancreatic Cancer
MRNA Vaccine for pancreatic cancer
Image by Sverdrup at English Wikipedia
MRNA Vaccine for pancreatic cancer
Messenger RNA and pancreas
Image by Sverdrup at English Wikipedia
An MRNA Vaccine to Treat Pancreatic Cancer
At a Glance
A personalized mRNA vaccine against pancreatic cancer created a strong anti-tumor immune response in half the participants in a small study.
The vaccine will soon be tested in a larger clinical trial. The approach may also have potential for treating other deadly cancer types.
An experimental vaccine for pancreatic cancer showed progress against the disease. MattL_Images / Shutterstock
Pancreatic ductal adenocarcinoma (PDAC), the most common type of pancreatic cancer, is one of the deadliest cancer types. Despite modern therapies, only about 12% of people diagnosed with this cancer will be alive five years after treatment.
Immunotherapies—drugs that help the body’s immune system attack tumors—have revolutionized the treatment of many tumor types. But to date, they have proven ineffective in PDAC. Whether pancreatic cancer cells produce neoantigens—proteins that can be effectively targeted by the immune system—hasn’t been clear.
An NIH-funded research team led by Dr. Vinod Balachandran from Memorial Sloan Kettering Cancer Center (MSKCC) have been developing a personalized mRNA cancer-treatment vaccine approach. It is designed to help immune cells recognize specific neoantigens on patients’ pancreatic cancer cells. Results from a small clinical trial of their experimental treatment were published on May 10, 2023, in Nature.
After surgery to remove PDAC, the team sent tumor samples from 19 people to partners at BioNTech, the company that produced one of the COVID-19 mRNA vaccines. BioNTech performed gene sequencing on the tumors to find proteins that might trigger an immune response. They then used that information to create a personalized mRNA vaccine for each patient. Each vaccine targeted up to 20 neoantigens.
Customized vaccines were successfully created for 18 of the 19 study participants. The process, from surgery to delivery of the first dose of the vaccine, took an average of about nine weeks.
All patients received a drug called atezolizumab before vaccination. This drug, called an immune checkpoint inhibitor, prevents cancer cells from suppressing the immune system. The vaccine was then given in nine doses over several months. After the first eight doses, study participants also started standard chemotherapy drugs for PDAC, followed by a ninth booster dose.
Sixteen volunteers stayed healthy enough to receive at least some of the vaccine doses. In half these patients, the vaccines activated powerful immune cells, called T cells, that could recognize the pancreatic cancer specific to the patient. To track the T cells made after vaccination, the research team developed a novel computational strategy with the lab of Dr. Benjamin Greenbaum at MSKCC. Their analysis showed that T cells that recognized the neoantigens were not found in the blood before vaccination. Among the eight patients with strong immune responses, half had T cells target more than one vaccine neoantigen.
By a year and a half after treatment, the cancer had not returned in any of the people who had a strong T cell response to the vaccine. In contrast, among those whose immune systems didn’t respond to the vaccine, the cancer recurred within an average of just over a year. In one patient with a strong response, T cells produced by the vaccine even appeared to eliminate a small tumor that had spread to the liver. These results suggest that the T cells activated by the vaccines kept the pancreatic cancers in check.
“It’s exciting to see that a personalized vaccine could enlist the immune system to fight pancreatic cancer—which urgently needs better treatments,” Balachandran says. “It’s also motivating as we may be able to use such personalized vaccines to treat other deadly cancers.”
More work is needed to understand why half the people did not have a strong immune response to their personalized vaccines. The researchers are currently planning to launch a larger clinical trial of the vaccine.
—by Sharon Reynolds
Source: nih.gov
Additional Materials (6)
pancreas Pre-mRNA
Image by Vossman/Wikimedia
Vaccine
Image by Artem Podrez/Pexels
MRNA therapeutics
Currently, mRNA is mainly delivered to different human tissues through liposomes, lipid nanoparticles(LNPs), polymerase complexes, and cationic peptides, and also has great potential in vaccine development and iPSC cell culture.
Image by Mmc9719/Wikimedia
Pancreatic Cancer
Image by medlineplus.gov
Messenger RNA
The interaction of mRNA in a cell.
Image by Sverdrup at English Wikipedia
Pre-mRNA-1ysv-tubes
A hairpin loop from a pre-mRNA. Notice its bases (light green) and backbone (sky blue). NMR structure of the central region of the human GluR-B R/G pre-mRNA, from the protein data bank ID 1ysv. Taken from w:PDB ids 1ysv model 1 imaged using w:UCSF Chimera.
Image by Vossman/Wikimedia
pancreas Pre-mRNA
Vossman/Wikimedia
Vaccine
Artem Podrez/Pexels
MRNA therapeutics
Mmc9719/Wikimedia
Pancreatic Cancer
medlineplus.gov
Messenger RNA
Sverdrup at English Wikipedia
Pre-mRNA-1ysv-tubes
Vossman/Wikimedia
Treatment
Diagram showing the parts removed with a Whipple's operation
Diagram showing how the pancreas and bowel is joined back together after a Whipple's operation
1
2
Whipple's operation
Interactive by Cancer Research UK / Wikimedia Commons
Diagram showing the parts removed with a Whipple's operation
Diagram showing how the pancreas and bowel is joined back together after a Whipple's operation
1
2
Whipple's operation
Interactive by Cancer Research UK / Wikimedia Commons
Treatment of Pancreatic Cancer
Treatment Option Overview
KEY POINTS
There are different types of treatment for patients with pancreatic cancer.
Five types of standard treatment are used:
Surgery
Radiation therapy
Chemotherapy
Chemoradiation therapy
Targeted therapy
There are treatments for pain caused by pancreatic cancer.
Patients with pancreatic cancer have special nutritional needs.
New types of treatment are being tested in clinical trials.
Treatment for pancreatic cancer may cause side effects.
Patients may want to think about taking part in a clinical trial.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Follow-up tests may be needed.
There are different types of treatment for patients with pancreatic cancer.
Different types of treatment are available for patients with pancreatic cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Five types of standard treatment are used:
Surgery
One of the following types of surgery may be used to take out the tumor:
Whipple procedure: A surgical procedure in which the head of the pancreas, the gallbladder, part of the stomach, part of the small intestine, and the bile duct are removed. Enough of the pancreas is left to produce digestive juices and insulin.
Total pancreatectomy: This operation removes the whole pancreas, part of the stomach, part of the small intestine, the common bile duct, the gallbladder, the spleen, and nearby lymph nodes.
Distal pancreatectomy: Surgery to remove the body and the tail of the pancreas. The spleen may also be removed if cancer has spread to the spleen.
If the cancer has spread and cannot be removed, the following types of palliative surgery may be done to relieve symptoms and improve quality of life:
Biliary bypass: If cancer is blocking the bile duct and bile is building up in the gallbladder, a biliary bypass may be done. During this operation, the doctor will cut the gallbladder or bile duct in the area before the blockage and sew it to the small intestine to create a new pathway around the blocked area.
Endoscopic stent placement: If the tumor is blocking the bile duct, surgery may be done to put in a stent (a thin tube) to drain bile that has built up in the area. The doctor may place the stent through a catheter that drains the bile into a bag on the outside of the body or the stent may go around the blocked area and drain the bile into the small intestine.
Gastric bypass: If the tumor is blocking the flow of food from the stomach, the stomach may be sewn directly to the small intestine so the patient can continue to eat normally.
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. External radiation therapy uses a machine outside the body to send radiation toward the area of the body with cancer.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). Combination chemotherapy is treatment using more than one anticancer drug.
Chemoradiation therapy
Chemoradiation therapy combines chemotherapy and radiation therapy to increase the effects of both.
Targeted therapy
Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells. Targeted therapies usually cause less harm to normal cells than chemotherapy or radiation therapy do. Tyrosine kinase inhibitors (TKIs) are targeted therapy drugs that block signals needed for tumors to grow. Erlotinib is a type of TKI used to treat pancreatic cancer.
There are treatments for pain caused by pancreatic cancer.
Pain can occur when the tumor presses on nerves or other organs near the pancreas. When pain medicine is not enough, there are treatments that act on nerves in the abdomen to relieve the pain. The doctor may inject medicine into the area around affected nerves or may cut the nerves to block the feeling of pain. Radiation therapy with or without chemotherapy can also help relieve pain by shrinking the tumor.
Patients with pancreatic cancer have special nutritional needs.
Surgery to remove the pancreas may affect its ability to make pancreatic enzymes that help to digest food. As a result, patients may have problems digesting food and absorbing nutrients into the body. To prevent malnutrition, the doctor may prescribe medicines that replace these enzymes.
New types of treatment are being tested in clinical trials.
This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI website.
Treatment for pancreatic cancer may cause side effects.
Follow-up tests may be needed
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.
Follow-up tests may be needed.
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
Source: National Cancer Institute (NCI)
Additional Materials (16)
T1 stage - the tumor is inside the pancreas and is 2cm or less in any direction.
T2 stage - the cancer is more than 2cm but no more than 4cm in size in any direction.
T3 stage - the cancer is more than 4cm in size.
T4 stage - the cancer has grown outside the pancreas, into the nearby large blood vessels.
Node (N) describes whether the cancer has spread to the lymph nodes. It is further divided into N0 and N1 stages.
Metastasis (M) describes whether the cancer has spread to a different part of the body. It is further divided into M0 and M1 stages.
1
2
3
4
5
6
TNM Staging for Pancreatic Cancer
TNM stands for Tumour, Node, Metastasis. This system describes the size of a primary tumour (T), whether there are lymph nodes with cancer cells in them (N) and whether the cancer has spread to a different part of the body (M).
Interactive by Cancer Research UK
Sensitive content
This media may include sensitive content
Tumor-Targeted Magnetic Iron Oxide Nanoparticles for Image-guided Pancreatic Cancer Therapy
Investigators in the Cancer Nanotechnology Platform Partnership (CNPP) at Emory University have developed tumor-targeting magnetic iron oxide nanoparticles for image-guided pancreatic cancer therapy. The nanoparticles deliver therapeutic agents into pancreatic cancer tumors and produce signals that can be tracked by magnetic resonance imaging (MRI). This microscopy image of a tumor section (obtained from a mouse tumor model) shows the blue-stained nanoparticles selectively accumulating in the peripheral tumor area and then penetrating into tumor cells. This image is part of the Nanotechnology Image Library collection.
Image by National Cancer Institute / Lily Yang, M.D., Ph.D., and Hui Mao, Ph.D.
Area removed for surgery to remove all of the pancreas (total pancreatectomy) / How the bowel is joined back together after a total pancreatectomy
Total Pancreatectomy
Diagram showing area removed for surgery to remove all of the pancreas (total pancreatectomy) and how the bowel is joined back together after a total pancreatectomy.
Interactive by Cancer Research UK
Sensitive content
This media may include sensitive content
Pancreas joined to the small bowel after pylorus preserving surgery for pancreatic cancer
Diagram showing the pancreas joined to the small bowel after pylorus preserving surgery for pancreatic cancer
Image by Cancer Research UK / Wikimedia Commons
Diagram showing how the pancreas and bowel is joined back together after a Whipple's operation
Diagram showing how the pancreas and bowel is joined back together after a Whipple's operation.
Image by Cancer Research UK/Wikimedia
Treating Cancer
Because cancers differ from one another in many ways, and because each patient is unique, there isn`t just one approach to treatment. Cancer treatment aims to eliminate the primary tumor, prevent the recurrence or spread of the cancer, and relieve symptoms. Types of cancer treatment include surgery; radiation therapy, which targets specific cancer cells; chemotherapy, which targets cancer cells throughout the body; and biological therapy, which works with the body`s own immune system. If you have cancer, it`s important to educate yourself about the type of cancer you have and the options for its treatment so that you can make informed decisions.
Image by TheVisualMD
X-ray of port-a-cath in azygos vein - anteroposterior
Chest X-ray of a 66 year old man who received a port for chemotherapy for a pancreatic cancer. It shows that the tip of the port is placed in the azygos vein. As of upload date, it has remained functional for therapy for 9 months, although there have been occasional problems aspirating from it.
Image by Mikael Häggström, M.D. Author info - Reusing images- Conflicts of interest: NoneMikael Häggström, M.D.Consent note: Written informed consent was obtained from the individual, including online publication./Wikimedia
CT scan of a 66 year old man who received a port for chemotherapy for a pancreatic cancer
CT scan in the median plane (with a 3 cm thick maximum intensity projection) of a 66 year old man who received a port for chemotherapy for a pancreatic cancer. It shows that the tip of the port is placed in the azygos vein. As of upload date, it has remained functional for therapy for 9 months, although there have been occasional problems aspirating from it.
Image by Mikael Häggström, M.D. Author info - Reusing images- Conflicts of interest: NoneMikael Häggström, M.D.Consent note: Written informed consent was obtained from the individual, including online publication./Wikimedia
Targeted Therapy for Pancreatic Cancer - A tumor (brown) in the head of the pancreas.
Food and Drug Administration approved olaparib (Lynparza) to treat some people with metastatic pancreatic cancer who have inherited mutations in the BRCA1 or BRCA2 genes. Under the approval, patients are eligible to receive olaparib if they have completed at least 16 weeks of initial platinum-based chemotherapy without their cancer progressing. Testing for BRCA mutations must be done using an FDA-approved test. The approval was based on results from the POLO clinical trial, which are described in the article below.
Image by J Adv Pract Oncol. September-October 2014. CC BY 2.0.
Pancreas and Digestive System
The pancreas functions as two organs in one: 98% of pancreatic cells are arranged in grapelike clusters that produce digestive enzymes, such as amylase and lipase, which are released into the small intestine; the other 2% of pancreatic cells, located in regions called islets of Langerhans, function as an endocrine organ and produce hormones such as insulin.
Image by TheVisualMD
Pancreatic Cancer: Advances in treatment and detection
Video by Dana-Farber Cancer Institute/YouTube
Pancreatic Cancer Treatment
Video by Lee Health/YouTube
Radiation Therapy and Pancreatic Cancer - Mayo Clinic
Video by Mayo Clinic/YouTube
Little-known approach to pancreatic cancer treatment offers hope to patients
Video by WGN News/YouTube
Pancreatic cancer treatment: Mayo Clinic Radio
Video by Mayo Clinic/YouTube
Surgery for Advanced Pancreas Cancer - Mayo Clinic
Video by Mayo Clinic/YouTube
TNM Staging for Pancreatic Cancer
Cancer Research UK
Sensitive content
This media may include sensitive content
Tumor-Targeted Magnetic Iron Oxide Nanoparticles for Image-guided Pancreatic Cancer Therapy
National Cancer Institute / Lily Yang, M.D., Ph.D., and Hui Mao, Ph.D.
Total Pancreatectomy
Cancer Research UK
Sensitive content
This media may include sensitive content
Pancreas joined to the small bowel after pylorus preserving surgery for pancreatic cancer
Cancer Research UK / Wikimedia Commons
Diagram showing how the pancreas and bowel is joined back together after a Whipple's operation
Cancer Research UK/Wikimedia
Treating Cancer
TheVisualMD
X-ray of port-a-cath in azygos vein - anteroposterior
Mikael Häggström, M.D. Author info - Reusing images- Conflicts of interest: NoneMikael Häggström, M.D.Consent note: Written informed consent was obtained from the individual, including online publication./Wikimedia
CT scan of a 66 year old man who received a port for chemotherapy for a pancreatic cancer
Mikael Häggström, M.D. Author info - Reusing images- Conflicts of interest: NoneMikael Häggström, M.D.Consent note: Written informed consent was obtained from the individual, including online publication./Wikimedia
Targeted Therapy for Pancreatic Cancer - A tumor (brown) in the head of the pancreas.
J Adv Pract Oncol. September-October 2014. CC BY 2.0.
Pancreas and Digestive System
TheVisualMD
2:29
Pancreatic Cancer: Advances in treatment and detection
Dana-Farber Cancer Institute/YouTube
1:44
Pancreatic Cancer Treatment
Lee Health/YouTube
15:59
Radiation Therapy and Pancreatic Cancer - Mayo Clinic
Mayo Clinic/YouTube
2:59
Little-known approach to pancreatic cancer treatment offers hope to patients
WGN News/YouTube
8:41
Pancreatic cancer treatment: Mayo Clinic Radio
Mayo Clinic/YouTube
6:38
Surgery for Advanced Pancreas Cancer - Mayo Clinic
Mayo Clinic/YouTube
Treatment Options by Stage
Amylase, Pancreatic Cancer
Image by TheVisualMD
Amylase, Pancreatic Cancer
Amylase is one of several enzymes produced by the pancreas and secreted into the digestive tract to help break down nutrients (amylase is also produced by the salivary glands). The enzyme is usually present in the blood and urine only in small quantities, but when pancreatic tissue is injured, inflamed (pancreatitis) or when the pancreatic duct is blocked or a tumor is present, amylase can leak into the blood and urine. As cancerous tissue overwhelms the pancreas, its function is compromised and enzyme levels fall.
Image by TheVisualMD
Pancreatic Cancer - Treatment Options by Stage
Treatment of Resectable or Borderline Resectable Pancreatic Cancer
Treatment of resectable or borderline resectable pancreatic cancer may include the following:
Chemotherapy with or without radiation therapy followed by surgery.
Surgery.
Surgery followed by chemotherapy.
Surgery followed by chemoradiation.
A clinical trial of chemotherapy and/or radiation therapy before surgery.
A clinical trial of different ways of giving radiation therapy.
Surgery to remove the tumor may include Whipple procedure, total pancreatectomy, or distal pancreatectomy.
Palliative therapy can be started at any stage of disease.
Treatment of Locally Advanced Pancreatic Cancer
Treatment of pancreatic cancer that is locally advanced may include the following:
Chemotherapy with or without targeted therapy.
Chemotherapy and chemoradiation.
Surgery (Whipple procedure, total pancreatectomy, or distal pancreatectomy).
Palliative surgery or stent placement to bypass blocked areas in ducts or the small intestine. Some patients may also receive chemotherapy and chemoradiation to shrink the tumor to allow for surgery.
A clinical trial of new anticancer therapies together with chemotherapy or chemoradiation.
A clinical trial of radiation therapy given during surgery or internal radiation therapy.
Palliative therapy can be started at any stage of disease.
Treatment of Metastatic or Recurrent Pancreatic Cancer
Treatment of pancreatic cancer that has metastasized or recurred may include the following:
Chemotherapy with or without targeted therapy.
Clinical trials of new anticancer agents with or without chemotherapy.
Palliative therapy can be started at any stage of disease.
Source: NIH: National Cancer Institute
Additional Materials (5)
CT scan of a patient with a non-functioning pancreatic NET before and 6 months after treatment with four cycles of 177Lu-DOTATATE.
CT scan of a patient with a non-functioning pancreatic NET before and 6 months after treatment with four cycles of 177Lu-DOTATATE. The size of the liver is reduced and almost all metastases have disappeared.
Image by Kjaer, A; Knigge, U/Wikimedia
What is the Treatment for Pancreatic Cancer?
Video by Roswell Park Comprehensive Cancer Center/YouTube
Chemotherapy and Pancreatic Cancer - Mayo Clinic
Video by Mayo Clinic/YouTube
Pancreatic Cancer: new treatment and research opportunities
Video by Dana-Farber Cancer Institute/YouTube
Pancreatic cancer treatment options
Video by Piedmont Healthcare/YouTube
CT scan of a patient with a non-functioning pancreatic NET before and 6 months after treatment with four cycles of 177Lu-DOTATATE.
Kjaer, A; Knigge, U/Wikimedia
2:51
What is the Treatment for Pancreatic Cancer?
Roswell Park Comprehensive Cancer Center/YouTube
6:34
Chemotherapy and Pancreatic Cancer - Mayo Clinic
Mayo Clinic/YouTube
2:21
Pancreatic Cancer: new treatment and research opportunities
Dana-Farber Cancer Institute/YouTube
1:28
Pancreatic cancer treatment options
Piedmont Healthcare/YouTube
Drugs Approved for Pancreatic Cancer
Development and Elimination of Cancer Cells as Chemotherapy is Applied
Image by IdkItsKatieB
Development and Elimination of Cancer Cells as Chemotherapy is Applied
The cells shown either reproduce and grow into other healthy cells, or develop a tumor through the quick replication of damaged cells. A chemotherapy drug is applied to inhibit the growth and replication only of the damaged cells.
Image by IdkItsKatieB
Drugs Approved for Pancreatic Cancer
This page lists cancer drugs approved by the Food and Drug Administration (FDA) for pancreatic cancer. The list includes generic names and brand names.This page also lists common drug combinations used in pancreatic cancer. The individual drugs in the combinations are FDA-approved. However, the drug combinations themselves usually are not approved, although they are widely used.
There may be drugs used in pancreatic cancer that are not listed here.
Drugs Approved for Gastroenteropancreatic Neuroendocrine Tumors
Afinitor Disperz (Everolimus) Lanreotide Acetate
Lutathera (Lutetium Lu 177-Dotatate)
Lutetium Lu 177-Dotatate
Somatuline Depot (Lanreotide Acetate)
Drugs Approved for Pancreatic Neuroendocrine Tumors
Belzutifan Welireg (Belzutifan)
Source: National Cancer Institute (NCI)
Additional Materials (1)
Chemotherapy Vials
Variety of chemotherapy drugs in vials.
Image by Bill Branson (Photographer) / National Cancer Institute
Chemotherapy Vials
Bill Branson (Photographer) / National Cancer Institute
Palliative Care
Whipple Surgery (Close Up)
Image by BruceBlaus/Wikimedia
Whipple Surgery (Close Up)
A medical illustration depicting the Whipple procedure.
Image by BruceBlaus/Wikimedia
Palliative Therapy
Palliative therapy can improve the patient's quality of life by controlling the symptoms and complications of pancreatic cancer.
Palliative therapy for pancreatic cancer includes the following:
Palliative surgery or stent placement to bypass blocked areas in ducts or the small intestine.
Palliative radiation therapy to help relieve pain by shrinking the tumor.
An injection of medicine to help relieve pain by blocking nerves in the abdomen.
Other palliative medical care alone.
Source: NIH: National Cancer Institute
Additional Materials (10)
Celiac Plexus Blockade in computertomography in a patient suffering from back-pain caused by pancreatic cancer.
Back-Pain Caused by Pancreatic Cancer: Celiac Plexus Blockade in computertomography in a patient suffering from back-pain caused by pancreatic cancer.
Image by Hellerhoff
Surgery and stents to relieve symptoms of pancreatic cancer
Your doctor puts a flexible tube called an endoscope into your mouth and they pass it down your throat to your stomach. The endoscope has a light and camera on the end. This means your doctor can see pictures of inside your body on a screen.
They pass the tube through your stomach to the first part of your small bowel (duodenum). Your bile duct opens into the duodenum.
Your doctor then injects dye into the bile duct and uses an x-ray to watch the flow of the dye to see where the blockage is. They then put the stent in position to open up the bile duct so that the bile can flow again.
Image by Cancer Research UK
Pancreas
Illustration of anatomy of Human Pancreas, Exocrine and Endocrine Pancreas
Image by OpenStax College
Hospice
Image by AndrzejRembowski/Pixabay
Drainage of the cyst into the stomach using a gastroscopically inserted stent
Pancreatic pseudocyst: The large pancreatic pseudocyst (see pancreatic pseudocyst 01 THWZ.jpg and pancreatic pseudocyst 02 THWZ.jpg) was derived gastroscopically under endosonographic control using a stent (arrow) into the stomach.
Image by Thomas Zimmermann (THWZ)/Wikimedia
What is "palliative treatment" for pancreatic cancer?
Video by ThePancreasPatient/YouTube
Pancreatic Cancer: Treatment and Outcomes
Video by ThePancreasPatient/YouTube
Treatment innovations for pancreatic adenocarcinoma - Mayo Clinic
Video by Mayo Clinic/YouTube
New study targets Achilles’ heel of pancreatic cancer, with promising results
Video by Salk Institute/YouTube
Pancreatic Cancer and Immunotherapy with Dr. Elizabeth M. Jaffee
Video by Cancer Research Institute/YouTube
Celiac Plexus Blockade in computertomography in a patient suffering from back-pain caused by pancreatic cancer.
Hellerhoff
Surgery and stents to relieve symptoms of pancreatic cancer
Cancer Research UK
Pancreas
OpenStax College
Hospice
AndrzejRembowski/Pixabay
Drainage of the cyst into the stomach using a gastroscopically inserted stent
Thomas Zimmermann (THWZ)/Wikimedia
4:21
What is "palliative treatment" for pancreatic cancer?
ThePancreasPatient/YouTube
4:25
Pancreatic Cancer: Treatment and Outcomes
ThePancreasPatient/YouTube
3:57
Treatment innovations for pancreatic adenocarcinoma - Mayo Clinic
Mayo Clinic/YouTube
2:38
New study targets Achilles’ heel of pancreatic cancer, with promising results
Salk Institute/YouTube
31:30
Pancreatic Cancer and Immunotherapy with Dr. Elizabeth M. Jaffee
Cancer Research Institute/YouTube
Prognosis
Relative incidence of pancreatic neoplasms
Image by Mikael Häggström, M.D. Author info - Reusing images- Conflicts of interest: NoneMikael Häggström, M.D./Wikimedia
Relative incidence of pancreatic neoplasms
Relative incidence of pancreatic neoplasms
Image by Mikael Häggström, M.D. Author info - Reusing images- Conflicts of interest: NoneMikael Häggström, M.D./Wikimedia
Certain Factors Affect Prognosis (Chance of Recovery) and Treatment Options
The prognosis and treatment options depend on the following:
Whether or not the tumor can be removed by surgery.
The stage of the cancer (the size of the tumor and whether the cancer has spread outside the pancreas to nearby tissues or lymph nodes or to other places in the body).
The patient’s general health.
Whether the cancer has just been diagnosed or has recurred (come back).
Pancreatic cancer can be controlled only if it is found before it has spread, when it can be completely removed by surgery. If the cancer has spread, palliative treatment can improve the patient's quality of life by controlling the symptoms and complications of this disease.
Source: National Cancer Institute (NCI)
Additional Materials (9)
Fewer than 3,000 people diagnosed with pancreatic cancer will be alive in five years.
Pancreatic cancer doesn’t discriminate. It doesn’t respect age, gender, race, wealth, or social status. It is an equal opportunity disease. Even Steve Jobs, with his vast fortune, fame, and access to new experimental treatments, could not forestall the inevitable. However, pancreatic cancer research has made some strides over recent years that may give patients a fighting chance. Pancreatic cancer is an especially deadly type of cancer. Fewer than 3,000 people diagnosed will be alive in five years.
Image by StoryMD
Based on data from SEER 22 (Excluding IL/MA) 2013–2019. Gray figures represent those who have died from pancreatic cancer. Green figures represent those who have survived 5 years or more.
Relative survival is an estimate of the percentage of patients who would be expected to survive the effects of their cancer. It excludes the risk of dying from other causes. Because survival statistics are based on large groups of people, they cannot be used to predict exactly what will happen to an individual patient. No two patients are entirely alike, and treatment and responses to treatment can vary greatly.
Image by National Cancer Institute
Pancreatic Cancer Statistics | Did You Know?
Video by National Cancer Institute/YouTube
Pancreatic Cancer | Eric's Story
Video by Johns Hopkins Medicine/YouTube
How long can I expect to live? What is my prognosis with pancreatic cancer? (Douglas Evans, MD)
Video by Froedtert & the Medical College of Wisconsin/YouTube
Pancreatic Cancer Survivor - Mayo Clinic
Video by Mayo Clinic/YouTube
Inoperable: Ken’s Pancreas Cancer
Video by Henry Ford Health/YouTube
Living with Pancreatic Cancer
Video by Get Palliative Care/YouTube
Mitochondrial Shape in Pancreatic Cancer
This image shows mitochondrial staining (red) and nuclear staining (blue) of abnormal pancreatic ducts from a mouse model of human pancreatic ductal carcinoma. Mitochondrial shape changes occur throughout the progression of pancreatic cancer and the machinery that regulates the dynamics of mitochondria may be a promising new therapeutic target in the fight against this disease.
This image was originally submitted as part of the 2016 NCI Cancer Close Up project. This image is part of the NCI Cancer Close Up 2016 collection.
See also https://visualsonline.cancer.gov/closeup2016.
Image by National Cancer Institute / Univ. of Virginia Cancer Center / David Kashatus
Fewer than 3,000 people diagnosed with pancreatic cancer will be alive in five years.
StoryMD
Based on data from SEER 22 (Excluding IL/MA) 2013–2019. Gray figures represent those who have died from pancreatic cancer. Green figures represent those who have survived 5 years or more.
National Cancer Institute
2:43
Pancreatic Cancer Statistics | Did You Know?
National Cancer Institute/YouTube
3:27
Pancreatic Cancer | Eric's Story
Johns Hopkins Medicine/YouTube
4:48
How long can I expect to live? What is my prognosis with pancreatic cancer? (Douglas Evans, MD)
Froedtert & the Medical College of Wisconsin/YouTube
2:31
Pancreatic Cancer Survivor - Mayo Clinic
Mayo Clinic/YouTube
12:33
Inoperable: Ken’s Pancreas Cancer
Henry Ford Health/YouTube
0:38
Living with Pancreatic Cancer
Get Palliative Care/YouTube
Mitochondrial Shape in Pancreatic Cancer
National Cancer Institute / Univ. of Virginia Cancer Center / David Kashatus
Send this HealthJournal to your friends or across your social medias.
Pancreatic Cancer
Pancreatic cancer is when cancer cells form in tissues of the pancreas. Pancreatic cancer is hard to catch early, as it doesn't cause symptoms right away. Because it's often found late and spreads quickly, it can be hard to treat. Risk factors for developing pancreatic cancer include smoking and long-term diabetes. Learn more about treatment and prognosis.