Dr. F.W. Nugent is a medical oncologist specializing in gastrointestinal cancers with a special interest in pancreatic cancer. Dr. Nugent graduated from Middlebury College with a bachelors degree in religion before graduating from Albany Medical College. He presently serves as vice-chairman of medical oncology at the Lahey Clinic in Burlington, Massachusetts.
Dr. Keith E. Stuart is a medical oncologist specializing in the study and treatment of cancers involving the gastrointestinal tract, with a special interest in tumors involving the liver. He was educated at Harvard University (graduating magna cum laude) and Albert Einstein College of Medicine and did his medical training at the New England Deaconess Hospital.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
I was diagnosed with
pancreatic cancer on May 25 of this year. On a routine
yearly blood test, I was found to have slightly elevated blood levels of liver
enzymes (my alkaline phosphatase, ALT, and AST were mildly elevated). Since I
had no symptoms of abdominal pain or weight
loss, both my doctor and I felt
quite confident that these liver abnormalities were merely due to the statin
that I was taking to lower cholesterol. For the sake of completeness, my doctor
ordered a liver ultrasound, which showed multiple liver tumors. A subsequent CAT
scan of the abdomen done that same afternoon showed an orange-sized mass in the
tail of my pancreas with multiple metastases (spread of tumor) in the liver. A
liver biopsy confirmed that it was pancreatic cancer.
It was a shock
At the time of my diagnosis, I was a healthy, reasonably fit, 57-year-old newlywed working as a
gastroenterologist in a thriving medical practice in South Orange County. My
wife and I just bought a new home and were in the process of decorating it and
putting in the landscaping.
I have no risk factors for developing pancreatic cancer. I do not drink
alcohol, and do not smoke (smoking
cigarettes is a risk factor for pancreatic
cancer). None of my parents and relatives had pancreatic cancer. I never had
diabetes mellitus (diabetes mellitus is another known risk factor). I exercise
vigorously almost daily (four days per week of tennis, and one to two days of strength
training). I maintained a healthy weight (obesity is also a risk factor for
pancreatic cancer).
Few patients diagnosed with
pancreatic cancer have identifiable
risk factors.
Pancreatic cancer is highly
lethal.
Pancreatic cancer is difficult to diagnose, and the diagnosis is often
made late in the disease course. Symptoms include weight loss,
back pain, and
jaundice.
The only curable treatment is surgical removal of all
cancer.
Chemotherapy after surgery can lower the chances of the cancer returning.
Chemotherapy for metastatic pancreatic cancer can extend life and improve the
quality of life for people with the disease.
Patients diagnosed with
pancreatic cancer are encouraged to seek out clinical trials to improve
pancreatic cancer treatment.
Many organizations exist to help provide
information and support for patients and families fighting pancreatic cancer.
What is the pancreas, and what is the function of the pancreas?
The pancreas is an organ in the abdomen that sits in front of the spine above
the level of the belly button. It performs two main functions: first, it makes
insulin, a hormone that regulates blood sugar levels, and second: it makes
enzymes, which help break down proteins. Enzymes help digestion by chopping
proteins into smaller parts so that they can be more easily absorbed by the body
and used for energy. Enzymes leave the pancreas via a system of tubes called
"ducts" that connect the pancreas to the intestines. The pancreas sits deep in
the belly and is in close proximity to many important structures such as the
small intestine (the duodenum) and the bile ducts, as well as important blood
vessels and nerves.
Pancreas (Pancreatic Cancer)
Cancer that starts in the pancreas is called pancreatic cancer. This picture of the pancreas shows its location in the back of the abdomen, behind the stomach.
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
There are many causes of back pain. Pain in the low back can relate to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.
Muscle spasms are involuntary muscle contractions that come on suddenly and are usually quite painful. Dehydration, doing strenuous exercise in a hot environment, prolonged muscle use, and certain diseases of the nervous system may cause muscle spasms. Symptoms and signs of a muscle spasm include an acute onset of pain and a possible bulge seen or felt beneath the skin where the muscle is located. Gently stretching the muscle usually resolves a muscle spasm.
Jaundice is a yellowish staining of the skin and whites of the eyes (sclerae) with bilirubin, the pigment found in bile. Jaundice can be an indicator of liver or gallbladder disease, or it may result from the rupture of red blood cells (hemolysis).
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
Itching can be a common problem. Itches can be localized or generalized. There are many causes of itching to include: infection (jock itch, vaginal itch), disease (hyperthyroidism, liver or kidney), reactions to drugs, and skin infestations (pubic or body lice). Treatment for itching varies depending on the cause of the itch.
Stool color is generally brown. When stool color changes, often, an individual becomes concerned. The presence of the bilirubin in bile is generally responsible for stool color. Bilirubin concentration can vary bile color from light yellow to almost black in color. Changes in bilirubin can cause stool to turn green, gray, or clay-like in color. Intestinal bleeding may turn stool black, tarry, red, maroon, or smelly stool. Medication and food may also affect stool color.
Helicobacter pylori (H. pylori) is a bacterium that causes chronic inflammation (gastritis) of the inner lining of the stomach in humans. This bacteria also is the most common cause of ulcers worldwide.
Ascites, the accumulation of fluid in the abdominal cavity is most commonly caused by cirrhosis of the liver. Some of the other causes of ascites include portal hypertension, congestive heart failure, blood clots, and pancreatitis. The most common symptoms include increased abdominal girth and size, abdominal bloating, and abdominal pain. Treatment depends on the cause of ascites.
The hepatitis B virus is a unique, coated DNA virus belonging to the Hepadnaviridae family of viruses. The course of the virus is determined primarily by the age at which the infection is acquired and the interaction between the virus and the body's immune system. Successful treatment is associated with a reduction in liver injury and fibrosis (scarring), a decreased likelihood of developing cirrhosis and its complications, including liver cancer, and a prolonged survival.
Cancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
Obesity is the state of being well above one's normal weight. A person has traditionally been
considered to be obese if they are more than 20 percent over their ideal weight.
That ideal weight must take into account the person's height, age, sex, and
build.
Pancreatic cysts are collections of fluid within the pancreas. Some are benign, malignant, or pseudocysts. There are two major types of pancreatic cysts, inflammatory cysts and non-inflammatory cysts. Non-inflammatory cysts include: serous cyst adenomas, mucinous cyst adenomas, intraductal papillary mucinous neoplasm (IPMN), and solid pseudopapillary tumor of the pancreas. Symptoms of pancreatic cysts include abdominal pain, jaundice, fever, chills, and sepsis. Treatment depends on the type of cyst, and patient health.
Smoking is an addiction. More than 430,000 deaths occur each year in the U.S. from smoking related illnesses. Secondhand smoke or "passive smoke" also harm family members, coworkers, and others around smokers. There are a number of techniques available to assist people who want to quit smoking.
Though it's difficult to say why some people develop cancer while others don't, research shows that certain risk factors increase a person's odds of developing cancer. These risk factors include growing older, family history of cancer, diet, alcohol and tobacco use, and exposure to sunlight, ionizing radiation, certain chemicals, and some viruses and bacteria.
Digestion is the complex process of turning food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food.
Smokeless tobacco can have negative health effects such as cancers, poor oral health (gum disease and tooth decay), infertility, pregnancy complications, and nicotine addiction.
Ascites is the accumulation of fluid (usually serous
fluid which is a pale yellow and clear fluid) in the abdominal (peritoneal) cavity. The
abdominal cavity is located below the chest cavity, separated from it by the
diaphragm.
Ascitic fluid can have many sources such as liver disease,
cancers, congestive heart failure, or kidney failure.
What causes ascites?
The most common cause of ascites is advanced liver
disease or cirrhosis. Approximately 80% of the ascites cases are thought to be
due to cirrhosis. Although the exact mechanism of ascites development is not
completely understood, most theories suggest
portal hypertension (increased
pressure in the liver blood flow) as the main contributor. The basic principle
is similar to the formation of edema elsewhere in the body due to an imbalance
of pressure between inside the circulation (high pressure system) and outside, in this case, the
abdominal...