pancreatic cancer [Gk, pan + kreas + L, cancer, crab] , a malignant neoplastic disease of the pancreas characterized by anorexia, flatulence, weakness, dramatic weight loss, epigastric or back pain, jaundice, pruritus, a palpable abdominal mass, recent onset of diabetes, and clay-colored stools if the pancreatic and biliary ducts are obstructed. Symptoms depend on the location of the tumor within the pancreas or in metastatic sites. Diagnostic measures include barium radiographic studies of the stomach and duodenum, transhepatic cholangiography (endoscopic retrograde cholangiopancreatography), laboratory evaluation of liver function, celiac arteriography, computed axial tomography, and magnetic resonance imaging. Exploratory laparotomy is often required for a definitive diagnosis. About 90% of pancreatic tumors are adenocarcinomas; two thirds are in the head of the pancreas. Most tumors are not resectable at the time of diagnosis, but localized cancers in the pancreas may be treated by partial pancreatectomy with excision of the common bile duct, duodenum, and distal part of the stomach. Functioning islet cell lesions may be excised or treated with streptozocin, an antibiotic toxic to beta cells of the pancreas. Total gastrectomy is recommended for gastrin-producing islet cell tumors that are resectable and accompanied by severe peptic ulcer disease. Radiotherapy or chemotherapy with docetaxel, cisplatin, femocitabine, or mitomycin C may offer temporary palliation, but cancer of the pancreas has a poor prognosis. Few people live for more than 1 year after diagnosis. Most nursing care is of a palliative nature. Pancreatic cancer occurs three to four times more often in men than in women. Though uncommon, it is increasing in incidence in the industrialized areas of the world. People who smoke more than 10 to 20 cigarettes a day, have diabetes mellitus, or have been exposed to polychlorinated biphenyl compounds are at increased risk of development of pancreatic cancer.
