Diagnosis: Too Often it Doesn't Come Soon Enough...

              So, you’re not feeling well? How do nurses and doctors determine what is wrong? Testing, observation and personal health history (as told by you or a significant other/ family member). It goes the same with pancreatic cancer. However, to get a pancreatic cancer diagnosis they must do some sort of imaging and then a biopsy of the pancreas to verify and determine the stage (or how far along it has progressed). Now we all know that no doctor in the world is going to allow you a CT scan or an MRI just because you don’t feel good (which is the general sign and symptom of this cancer), they need a reason to do these very expensive, and possibly damaging (as with a CT scan) tests. Yes, you can have them done any time you want but if the doctor doesn’t give your insurance company a good reason for it the test will not be covered and you’ll end up with the entire bill – so, unless you’re independently wealthy I wouldn’t try that route (if you are independently wealthy… can I be your personal nurse??? J/K :o) ).

               Once your doctor is convinced, or strongly suspects pancreatic cancer he will send you for an ultrasound, CT scan or MRI to help confirm. Occasionally they may order an endoscopic retrograde cholangiopancreatography (ERCP) which uses a dye to highlight the bile ducts in your pancreas. In this procedure you get a small camera sent down your throat (over the river and through the woods to your bile ducts) and inject a dye (that is picked up by x-ray) directly into the ducts (and maybe take a sample for biopsy). Once all dyed up you will then get your “lit up” X-ray confirming cancerous looking tissue. The biopsy will then tell the doctor about the cells they pinched off. If cancer cells are confirmed they will then try to stage it by sending another scope (via your abdomen) to see the size of the mass. They will note if the cancer is still within the pancreas or if it has spread outward (or “metastasized”). The degree of the spread determines the stage.

·        Stage I – The cancer cells are still within the pancreas.

·        Stage II – Cancer has spread to surrounding tissues, organs and possibly lymph nodes.

·        Stage III- Cancer has spread beyond the immediate surroundings into the blood vessels and possibly lymph nodes.

·        Stage IV- Cancer has moved beyond all previous sites and now includes liver, lungs and tissue surrounding your abdomen (peritoneum).

Treating the disease gets progressively harder as the stage increases. (More on treatment in a later submission)

Please visit this site to see some stories about people surviving with Pancreatic Cancer and also to see how you can help with research CurePC: The Fight Against Pancreatic Cancer

[This week I was also to tell you how pancreatic cancer progresses… That was also something I was supposed to cover last week. Since there has been no new evidence that any of that has changed I will simply refer you to the post directly before this to read about (simplified) progression.]

What's causing this thing? What's going on as it grows?

               

From http://livewithoutreservations.com/2013/03/16/pancreatic-cancer-and-you/pancreatic-cancer-explainer/

                Surprise!!! It’s all but super impossible to tell exactly what causes pancreatic cancer. Many studies have been done to explain possible risk factors and some causes but it’s very hard to pinpoint why someone may have developed the disease. Studies have shown the cancer is often linked to a genetic mutation in the DNA. This mutation is linked to 3 things: genetics (thanks mom and dad! I thought you loved me!!), behavior (those cigarettes are totally worth it, right?) and, the best reason of all, just because (you pissed off your body somehow and it yelled “you’re not my mom! Let me live my life and stop oppressing me! Stop holding me back from my true potential! I am going to grow out of control now).  So, the prize for major cause goes to “Genetic Mutation”. (Seriously "genetic mutation" don't you have enough awards for causing problems? What are you trying to prove?)

               Now, how does it progress? Well, based on the fact that most people don’t even know they have it until it’s in a much later stage, we can guess that it progresses smoothly and unadventurously. There really isn’t any change going on while the cancer is growing. People feel cold symptoms (sometimes) and fatigue perhaps. They also often have annoying back pain as the tumor invades valuable space where nerves once had room to be free and not pinched and annoyed by this growing brute. Patients just don't experience anything really out of the “ordinary” for anyone who works or goes to school, or has kids, or a dog or essentially is just "alive". At first, pancreatic cancer often feels like being alive, 

               Slight explanation of the most common pancreatic tumor -

“Adenocarcinomas (most common) - Just as the normal exocrine cells of the pancreas do, adenocarcinomas form microscopic glands (collections of cells surrounding an empty space). Adenocarcinomas can grow large enough to invade nerves which can cause back pain. They also frequently spread (metastasize) to the liver or lymph nodes. If this happens the tumor may be considered unresectable.” From this site about pancreatic cancer*

Adenocarcinoma: This is a gland-forming (it makes tubes) cancer.
In this example, the adenocarinoma has wrapped around a nerve (center of the image).*

*What are pancreatic tumors. (2012, November 2). Retrieved April 19, 2015, from http://pathology.jhu.edu/pc/BasicTypes2.php?area=ba