Your pancreas is located in your upper abdomen, behind your stomach and on top of your spine. It is divided into 3 parts: the head, which is located next to the small intestine, the body, and the tail, which is close to your spleen.
The pancreas has 2 main functions :
- Production of juices to help digest food.
- Production of hormones, like insulin.
PROBLEMS WITH YOUR PANCREAS
Diseases of the pancreas can present with a variety of symptoms including abdominal pain, diarrhea, diabetes, or jaundice (yellowing of the eyes and skin).
Pancreatitis
Pancreatitis occurs when the pancreas becomes inflamed, which can be due to a variety of sources including alcohol use, gallstones, or medications.
About Pancreatitis
What is pancreatitis?
Pancreatitis is inflammation of your pancreas which can cause leakage of pancreatic fluid into other parts of the pancreas or surrounding areas.
What are the signs and symptoms of pancreatitis?
Pancreatitis often presents with sudden severe pain in your upper belly. You may also experience nausea, vomiting, fevers, chills and upper back pain.
Why do I get pancreatitis?
The most common causes of pancreatitis are gallstones and alcohol. Other, less common reasons are certain medications and diseases that run in your family. If you have one sudden attack, you have acute pancreatitis. Multiple attacks are called chronic pancreatitis, and lead to permanent damage of your pancreas and its function.
Diagnosis of Pancreatitis
How is pancreatitis diagnosed?
If you have symptoms of pancreatitis, your doctor may order blood tests or scans of your abdomen. Sometimes you may also need a procedure.
Blood tests
- Your doctor may check blood tests to look for an infection and check he function of your liver and pancreas.
Imaging
- Abdominal Ultrasound to look for gallstones in your gallbladder.
- CT or MRI scan of your belly (or of the abdomen and pelvis) to look for gallstones and inflammation of the pancreas.
Procedures
- An Endoscopic Retrograde Cholangiopancreatography (ERCP) can remove gallstones that cause pancreatitis. Your doctor can perform and ultrasound at the same time called EUS, which can look at your pancreas.
Treatment of Pancreatitis
How is pancreatitis treated?
- Hospital admission and supportive care
- Surgery for Pancreatitis
Hospital Admission
Some patients with pancreatitis have to be admitted to the hospital. You will receive intravenous fluids and pain medications until your pain has gone away.
Some patients have more severe episodes of pancreatitis and might spend some time in the intensive care unit. Sometimes the treatment involves not eating which may require a feeding tube through your nose into your intestines until you get better.
Surgery for Pancreatitis
If you have gallstones, your gallbladder will be removed with an operation called a laparoscopic cholecystectomy after you have recovered from pancreatitis.
If your pancreas has been severely damaged, you can develop a pocket of fluid or infection which may require an endoscopy procedure or a surgery to drain it.
Pancreatic Cysts
Pancreatic cysts are usually benign, but can sometimes lead to problems which require treatment. Some cysts can have the potential to turn into cancer.
Pancreatic Cysts
What are pancreatic cysts?
Pancreatic cysts are fluid filled masses within the pancreas. They can appear after an attack of pancreatitis, or found on A CT scan. Since some cysts are pre- cancers, accurate diagnosis is very important.
What are the signs and symptoms of pancreatic cysts?
Most pancreatic cysts are silent, but patients may experience:
- Upper belly or back pain
- Nausea/Vomiting
- Acute onset of Diabetes
What is my risk for getting pancreatic cysts?
Pancreatic Pseudocysts can develop after an attack of pancreatitis. Mucinous Neoplasms of the pancreas have been linked to diabetes and chronic pancreatitis. They are sometimes more common in patients with a family history of pancreatic cancer.
Cysts We Treat
- Psuedocysts
- Serous cystadenomas
- Mucinous Cystic neoplasms (MCN)
- Intraductal Mucinous Neoplasms (IPMN)
- Cystic Islet cell tumors
Diagnosis of Pancreatic Cysts
How are pancreatic cysts diagnosed?
If you have any symptoms of a pancreatic cyst, your doctor will order blood tests and pictures (imaging) of your belly. You will also need a biopsy to confirm the diagnosis.
Blood tests
- Blood counts and liver function tests
- Ca19-9 and CEA levels. These blood tests are called “tumor markers,” and are often ordered, when patients have a “mass” in the pancreas.
Imaging
- CT or MRI scan of your belly (or of the abdomen and pelvis) to look at the cyst in the pancreas. Often cysts are discovered on a CT scan, which was done for a different reason. This test will allow your doctor to evaluate, if your cyst needs to be removed with surgery.
Procedures
- Endoscopic Ultrasound (EUS): Your doctor inserts a camera into your intestines through your mouth, so your pancreas can be seen. Usually a needle biopsy and some fluid is taken for analysis.
Treatment of Pancreatic Cysts
How are pancreatic cysts treated?
TIf you have a cysts which is concerning for cancer, you will be presented in our Multidisciplinary Tumor Board , where your doctors will discuss your case. You might need to have your cyst removed with surgery. If surgery is not recommended, your doctor may repeat evaluation every 3-6 months to follow the cyst.
How are pancreatic cysts from pancreatitis treated?
If you have a pancreatic cyst due to pancreatitis, you might not need any treatment, unless you have symtoms. If you cannot eat and your cyst does not get smaller, your doctor might recommend a procedure or surgery called cystgastrostomy .
Pancreas Tumors
Tumors in the pancreas can be either benign or cancerous.
Pancreas Tumor and Pancreatic Cancer
What is pancreatic cancer?
Pancreatic Cancer occurs when the cells of the pancreas grow out of control. The pancreas has cells that form ducts and cells that produce hormones like insulin. Both types of cells can turn into cancer cells.
What are the signs and symptoms of pancreatic cancer?
Pancreatic Cancer is often silent in early stages. Patients may present with:
- Abdominal and back pain
- Poor appetite, nausea, vomiting, weight loss
- Jaundice (yellow skin and eyes)
- Bowel blockage
- High blood sugars and Diabetes
What is my risk for getting pancreatic cancer?
Smoking, diabetes, obesity and pancreatitis increase your risk of getting pancreatic cancer. There are diseases that run in families, which increase the risk of pancreatic cancer.
Tumors We Treat
Cancers
- Pancreatic Adenocarcinoma
- Pancreatic Neuroendocrine tumors including:
Pre-Cancers
- Cystic Neoplasms
- Solid Pseudopapillary Tumors
Diagnosis of Pancreatic Cancer
How is pancreatic cancer diagnosed?
If you have any symptoms of pancreatic cancer, your doctor may order blood tests and pictures (imaging) of your belly. You will also need a biopsy to confirm the diagnosis.
Blood tests
- Complete blood count (CBC) to check your blood count.
- Comprehensive Metabolic Panel (CMP) to check your electrolytes and liver function.
- Ca19-9 and CEA levels. These blood tests are called “tumor markers,” and will give your doctor a chance to follow your response to treatment.
Imaging
- CT or MRI scan of your belly (or of the abdomen and pelvis) to look for a mass in the pancreas. This test will allow your doctor to evaluate, if your tumor can be removed with surgery.
Procedures
- Endoscopic Ultrasound (EUS): Your doctor inserts a camera into your intestines through your mouth, so your pancreas can be seen. Usually a small needle biopsy is taken at that time for diagnosis.
- An Endoscopic Retrograde Cholangiopancreatography (ERCP) is another form of endoscopy that allows your doctor to place a stent into the bile duct for patients with jaundice. This can be done at the same time as the EUS.
Treatment of Pancreatic Tumors and Cancer
How is pancreatic cancer treated?
The treatment of pancreatic cancer depends on the stage of the tumor, and involves a multidisciplinary team of doctors, nurses and medical support staff:
- Medical Oncology
- Gastroenterology
- Surgery
- Radiation
- Dietary and Social work, Palliative care.
Every patient seen here will be presented in our multidisciplinary tumor board , where we will devise your individual treatment plan. This plan may include:
We strongly encourage and support all of our patients to participate in clinical trials. We are happy to talk to you about clinical trials during your clinic visit.
