Pancreatic cancer and the elderly

by Rose Broyles

With the recent tragic death of actor Patrick Swayze, I started thinking about how devastating this disease truly is. It does not discriminate between rich and poor nor young nor old. Besides Swayze’s high profile case, Apple mogul Steve Jobs was diagnosed with pancreatic cancer in 2004 and recently came back to the controls of Apple after going on a leave of absence for medical treatments. Jobs has a less aggressive form, where he has been able to respond well to treatments. Closer to home, my sister’s best friend succumbed to this horrible disease 13 years ago about two years after we lost my beloved brother-in-law.

I can’t imagine the despair, fear or the devastation one must feel after being diagnosed. And yet, contrary to what most people would believe, this disease commonly affects those older than 65 years of age.

What is Pancreatic Cancer?

Pancreatic cancer starts in the cells that line the duct that joins the pancreas and the small bowel. It then spreads into the pancreas itself and then to nerves and nearby blood vessels. If untreated, the disease spreads to other organs within the abdomen  and to other parts of the body if it enters the lymphatic system. The exact causes of pancreatic cancer are not known, however those who smoke are at greatest risk as well as those over the age of 65. Surprisingly, it is quite uncommon for those to be diagnosed with pancreatic cancer under the age of 50.

Risks and Causes

• Besides age, inheriting a defective gene
  
• 10-20% of people with pancreatic cancer also have diabetes
• people who have had a gastrectomy

Symptoms

Unfortunately, typical symptoms might not be that serious, that often they may be confused with other illnesses. It is isn’t until more severe symptoms are present that it is determined that there is cancer present. By this time, it is often too late. Symptoms include:

• Persistent pain in the abdomen
• loss of appetite and nausea
• weight loss
• bowel problems (diarrhea and constiptation)
• severe back pain — (this is what my sister’s best friend experienced before she went to see her doctor for the devastating news.)

If the bile duct is blocked, there may be:

• jaundice
• dark urine
• pale feces

Diagnosis

The doctor may order a series of tests to include:

• Blood tests – liver and kidney functions; look for protein CA19.9 which is what is sent by pancreatic cancer. This protein gives the doctor some important information about the cancer though usually not used for diagnosis.
• CT scan
• Magnetic resonance imaging (MRI)
• Ultrasound
• Endoscopy
• Laparoscopy
• Tissue biopsy
• Positron emission tomography (PET) scan

Treatment

• Surgery
  
• Radiotherapy
  
• Chemotherapy
• Palliative care for cases that cannot be cured.

See the American Cancer Society for more information

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