Palliative Care

Your pancreas is an organ behind your stomach. It produces chemicals that help you digest your food. Pancreatic cancer happens when cells in the pancreas grow out of control. This cancer is usually difficult to detect until it has spread, making it hard to treat.

Prevention

Providers don’t understand pancreatic cancer well enough to identify ways to prevent it. But there are a few things you can do to reduce your risk. Quitting tobacco is one of the most important things you can do. Talk to your provider about how to quit for good and call the Maine Tobacco Helpline at 1.800.207.1230 for extra support. Maintaining a healthy weight is also important. Also avoid exposure to harmful chemicals at work, especially if you work in the dry cleaning or metal-working industries.

Detection & Diagnosis

People usually have no symptoms of pancreatic cancer until it has already spread to other organs. That’s why it’s important to be aware of risk factors that may indicate you’re at a high risk for the disease. If you are at high risk, talk to your provider about how to recognize signs and symptoms of the disease. These may include loss of appetite or unintended weight loss, pain in the upper abdomen that radiates to your back, yellowing of your skin and the whites of your eyes (also known as jaundice), depression, new-onset diabetes, blood clots, and fatigue.

Treatment

Our cancer care team will discuss the treatment options that will work best for you, depending on the stage of your cancer, your overall health and personal preferences. Typical pancreatic cancer treatment options include surgery, chemotherapy, radiation therapy, or a combination of these three. In some cases these are combined to attempt to cure the cancer and/or to relieve pain or other symptoms of the disease.

Support

Central Maine Comprehensive Cancer Center offers a variety of support services to help you on your journey to better health. Our nurse navigators are dedicated to guiding you to resources that will support you and your family, including oncology social workers who can direct you to a variety of counseling services, from nutritional to financial.

Screening and Diagnosis

If you’re worried you may have pancreatic cancer, we understand you want answers quickly. At Central Maine Healthcare, we can answer all your questions and will work to provide an accurate diagnosis as quickly as possible.

Screening for Pancreatic Cancer

A screening test is used to find cancer before it produces any symptoms. Pancreatic cancer is one of many cancers for which there are no recommended tests that will detect this cancer early in those who are at average risk for the disease.

If you are at high risk for the disease your provider may recommend an endoscopic ultrasound, which uses a thin, flexible tube (called an endoscope) to insert a small ultrasound probe into your digestive tract. Providers use the ultrasound to look for any evidence of cancer. If they find a tumor, a needle can be inserted in the endoscope to take a sample which can be further examined.

Risk Factors for Pancreatic Cancer

A risk factor is anything that increases your risk for a disease. In pancreatic cancer there are a few risk factors you can control: not smoking, maintaining a healthy weight, and limiting exposure to workplace chemicals in the dry cleaning and metal-working industries.

There are more factors you can’t change, but you should be aware of them so you can tell your provider. These include:

Family history of pancreatic cancer African American descent Over the age of 45 Diagnosed with diabetes History of chronic pancreatitis

Cirrhosis (scarring) of the liver Genetic syndrome Stomach problems such as ulcers or excess stomach acid

Diagnosing Pancreatic Cancer

If your provider suspects you may have pancreatic cancer, they will start by doing a physical exam and getting your medical history. Depending on what they find, they will order one or more of the following tests:

Imaging Tests: X-rays, sound waves, radioactive substances or magnetic fields create images of the inside of your abdomen. An endoscopic ultrasound is commonly used.

Biopsy: This procedure involves removing a small bit of tissue to examine under a microscope. In some cases, your provider may use a needle inserted through the skin to the pancreas to remove the tissue. Other times, they will get a sample during an endoscopic ultrasound.

Blood Test: To diagnose your condition, your provider may draw blood to test it for tumor markers. These markers are specific proteins shed by pancreatic cancer. One of these tests is called CA19-9. It isn’t always reliable and it’s not always clear how to use the results. But it can still be helpful to providers, in addition to other tests.

Treatment

At Central Maine Healthcare, our oncologists treat patients with pancreatic cancer, so they understand the disease well and apply their depth of experience to provide the best care for each person. You can take on your treatment with peace of mind.

Personalized Treatment Plans: If you’ve been diagnosed with pancreatic cancer, your cancer care team at Central Maine Healthcare will work together to create the treatment plan that will work best for you. It will take into account the stage and location of your cancer, your overall health and personal preferences.

Surgery: An operation to remove the cancer is one option you and your providers may consider. There are two kinds of surgery for pancreatic cancer. The first is done only in situations where providers are confident they can remove all the cancer. It’s called “potentially curative,” meaning it may cure the cancer. The second – called “palliative” — is done when imaging tests show that the cancer is too widespread to be removed by surgery. Its goal is only to relieve symptoms or prevent complications, not to cure the cancer.

In rare instances, a third approach is done by surgeons who are highly experienced with operating on pancreatic tumors and only in patients whose cancer has not spread too far. It begins with chemotherapy and radiation to weaken the cancer over several months. After these treatments, a surgeon will conduct a very long surgery – as much as 14 hours – to remove the remaining cancer. It’s a difficult surgery for both provider and patient. Talk to your provider about whether this treatment may make sense for you.

Radiation Therapy: Radiation therapy is the use of x-rays and protons to kill cancer cells. It may be used in situations where surgery is too dangerous. It may also be used before or after surgery, and/or in combination with chemotherapy.

Chemotherapy: This treatment uses anti-cancer drugs injected into a vein or taken by mouth (orally). It is sometimes combined with radiation treatment (called chemoradiation) to treat cancer that has spread to organs near the pancreas, but not to more distant areas of the body.

Palliative Treatment: Your cancer care team may advise palliative treatments to help relieve pain and other symptoms. These treatments may use any of the techniques listed above. Palliative is not the same as hospice care.

Taking Care of the Whole You: Wherever your journey takes you, we’re here to support you. We offer a complete range of support services designed to pick up where medical treatments leave off. They include a nurse navigator whose job is to guide you through the entire process of cancer diagnosis and treatment. An oncology social worker can put you in touch with resources including financial counseling, nutritional support and cancer education classes. And our Arbor House hospitality facility offers residential options free of charge for you and your family.