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On August 16, the world lost a legend when Aretha Franklin, the one and only “Queen of Soul,” passed away from advanced pancreatic neuroendocrine cancer at the age of 76. With memorial services and tributes beginning Tuesday, August 28 in Detroit, Michigan.
The pancreas is an organ that helps facilitate digestive function and blood sugar regulation. When cancer spreads from the pancreas to other parts of the body, doctors classify it as stage 4 pancreatic cancer.According to research from 2015, about of people with receive a diagnosis when the is in stage 4. Treatment aims to prolong life and manage pain and other symptoms.In this article, we describe the symptoms of pancreatic cancer and outline the treatment options when the cancer is in stage 4.
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A doctor will aim to manage pain and prolong lifespan when treating stage 4 pancreatic cancer.Stage 4 cancer has spread to other parts of the body, possibly including the:. bowel. liver. lungs. spleen. stomachAt this stage, a may be any size. Sometimes, doctors can only identify the stage of cancer after performing surgery.Stages describe the extent of the cancer’s spread.
For example, in stage 1, pancreatic cancer is only present in the pancreas. In stages 2 and 3, the cancer has spread to nearby lymph nodes.
In stage 3, it may also have reached the blood vessels.The tumor’s size also helps determine the stage of the cancer. In stage 1 pancreatic cancer, a tumor typically measures (cm).If the tumor is larger, or if it has spread to as many as three lymph nodes, the cancer is in stage 2. In later stages, the tumor may be any size.Stage 4 pancreatic cancer has spread to other organs. This means that surgeons cannot remove it, and there is no cure. Treatment involves managing pain and other symptoms to improve a person’s quality of life. Chemotherapy is available in either oral or intravenous formis usually the first-line treatment for stage 4 pancreatic cancer.
It involves using targeted medications to kill cancer cells. The goal is to increase a person’s lifespan.A doctor administers chemotherapy, and the drugs may be oral or intravenous. They can kill cancer cells in the pancreas and those that have spread to other organs.To treat stage 4 pancreatic cancer, doctors typically use gemcitabine (Gemzar), either alone or in combination with other medications. Chemoradiation therapyThe medical team may recommend a combination of chemotherapy and, called chemoradiation, for stage 4 pancreatic cancer.However, chemoradiation generally only treats cancer that has spread to organs near the pancreas, not more distant organs, such as the lungs or liver.Radiation therapy can also help shrink tumors before or after surgery. Palliative surgeryWhile surgery cannot cure stage 4 pancreatic cancer, certain procedures can alleviate symptoms. Examples of palliative surgeries include:Bile duct stent or bypassWhen a tumor blocks a bile duct, a surgeon may use one of these methods to help restore the flow of bile.Bile breaks down fats in the digestive system, and when something blocks a bile duct, the bile builds up. This can lead to jaundice and a loss of appetite.A bile duct bypass involves the surgeon connecting the duct to the small intestine so that the bile can flow around the blockage.Or, the surgeon may insert a small tube, a stent, into the duct to keep it open and prevent a build-up of bile.
A surgeon may eventually need to replace the stent if the tumor grows and blocks it.Gastric bypass surgeryA tumor can prevent food from passing through the stomach and into the intestine. Doctors call this a gastric outlet obstruction.To avoid the blockage, a surgeon can often connect the stomach to the intestine in a different way. MedicationsStage 4 cancerous tumors can cause pain and discomfort. A doctor may prescribe pain relief medications, such as opioid analgesics and drugs that block signals to the nerves.To help a person cope with the emotional impact of a terminal cancer diagnosis, a doctor may also recommend:. antianxiety medications. sleep aidsEmotional support. Emotional support from loved ones can help when dealing with a cancer diagnosis.Receiving a diagnosis of stage 4 cancer can be distressing and overwhelming.
People may experience:. a range of emotions, including anger, fear, and grief. depression.
sleeping difficultiesFinding emotional support can help. Some people benefit from:.
talking with loved ones. building a support network involving friends and family. seeing a therapist to work through emotions and gain coping skills. learning about pancreatic cancer and a stage 4 diagnosis. practicing relaxation techniques, such as meditation, creative therapies, and. exercising, under a doctor’s guidance. discussing medical treatment options with one or more doctors.
connecting with other people who have cancer through. accessing support and advice from the and the.
Pancreatic cancerPancreatic cancer is cancer that forms in the cells of the pancreas.Pancreatic cancer begins in the tissues of your pancreas — an organ in your abdomen that lies behind the lower part of your stomach. Your pancreas releases enzymes that aid digestion and produces hormones that help manage your blood sugar.Several types of growths can occur in the pancreas, including cancerous and noncancerous tumors. The most common type of cancer that forms in the pancreas begins in the cells that line the ducts that carry digestive enzymes out of the pancreas (pancreatic ductal adenocarcinoma). SymptomsSigns and symptoms of pancreatic cancer often don't occur until the disease is advanced. They may include:. Abdominal pain that radiates to your back. Loss of appetite or unintended weight loss.
Yellowing of your skin and the whites of your eyes (jaundice). Light-colored stools.
Dark-colored urine. Itchy skin. New diagnosis of diabetes or existing diabetes that's becoming more difficult to control. Blood clots.
FatigueWhen to see a doctorSee your doctor if you experience any unexplained symptoms that worry you. Many other conditions can cause these symptoms, so your doctor may check for these conditions as well as for pancreatic cancer. CausesIt's not clear what causes pancreatic cancer. Doctors have identified some factors that may increase the risk of this type of cancer, including smoking and having certain inherited gene mutations. Understanding your pancreasYour pancreas is about 6 inches (15 centimeters) long and looks something like a pear lying on its side. It releases (secretes) hormones, including insulin, to help your body process sugar in the foods you eat. And it produces digestive juices to help your body digest food and absorb nutrients.
How pancreatic cancer formsPancreatic cancer occurs when cells in your pancreas develop changes (mutations) in their DNA. A cell's DNA contains the instructions that tell a cell what to do. These mutations tell the cells to grow uncontrollably and to continue living after normal cells would die.
These accumulating cells can form a tumor. When left untreated, the pancreatic cancer cells can spread to nearby organs and blood vessels and to distant parts of the body.Most pancreatic cancer begins in the cells that line the ducts of the pancreas. This type of cancer is called pancreatic adenocarcinoma or pancreatic exocrine cancer. Less frequently, cancer can form in the hormone-producing cells or the neuroendocrine cells of the pancreas.
These types of cancer are called pancreatic neuroendocrine tumors, islet cell tumors or pancreatic endocrine cancer. Endoscopic retrograde cholangiopancreatography (ERCP)Endoscopic retrograde cholangiopancreatography (ERCP) uses a dye to highlight the bile ducts on X-ray images. A thin, flexible tube (endoscope) with a camera on the end is passed down your throat and into your small intestine. The dye enters the ducts through a small hollow tube (catheter) passed through the endoscope.As pancreatic cancer progresses, it can cause complications such as:. Weight loss. A number of factors may cause weight loss in people with pancreatic cancer. Weight loss might happen as the cancer consumes the body's energy.
Nausea and vomiting caused by cancer treatments or a tumor pressing on your stomach may make it difficult to eat. Or your body may have difficulty processing nutrients from food because your pancreas isn't making enough digestive juices.Jaundice. Pancreatic cancer that blocks the liver's bile duct can cause jaundice. Signs include yellow skin and eyes, dark-colored urine, and pale-colored stools.
Jaundice usually occurs without abdominal pain.Your doctor may recommend that a plastic or metal tube (stent) be placed inside the bile duct to hold it open. This is done with the help of a procedure called endoscopic retrograde cholangiopancreatography (ERCP). During ERCP an endoscope is passed down your throat, through your stomach and into the upper part of your small intestine.
A dye is then injected into the pancreatic and bile ducts through a small hollow tube (catheter) that's passed through the endoscope. Finally, images are taken of the ducts.Pain. A growing tumor may press on nerves in your abdomen, causing pain that can become severe.
Pain medications can help you feel more comfortable. Treatments, such as radiation and chemotherapy, might help slow tumor growth and provide some pain relief.In severe cases, your doctor might recommend a procedure to inject alcohol into the nerves that control pain in your abdomen (celiac plexus block).
This procedure stops the nerves from sending pain signals to your brain.Bowel obstruction. Pancreatic cancer that grows into or presses on the first part of the small intestine (duodenum) can block the flow of digested food from your stomach into your intestines.Your doctor may recommend that a tube (stent) be placed in your small intestine to hold it open. In some situations, it might help to have surgery to place a temporary feeding tube or to attach your stomach to a lower point in your intestines that isn't blocked by cancer.PreventionYou may reduce your risk of pancreatic cancer if you:. Stop smoking.
If you smoke, try to stop. Talk to your doctor about strategies to help you stop, including support groups, medications and nicotine replacement therapy. If you don't smoke, don't start. Maintain a healthy weight. If you are at a healthy weight, work to maintain it. If you need to lose weight, aim for a slow, steady weight loss — 1 to 2 pounds (0.5 to 1 kilogram) a week. Combine daily exercise with a diet rich in vegetables, fruit and whole grains with smaller portions to help you lose weight.
Choose a healthy diet. A diet full of colorful fruits and vegetables and whole grains may help reduce your risk of cancer.Consider meeting with a genetic counselor if you have a family history of pancreatic cancer. He or she can review your family health history with you and determine whether you might benefit from a genetic test to understand your risk of pancreatic cancer or other cancers.
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