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Quality of Life Interventions from the Columbia University Department of Surgery

Diseases of the Pancreas: Risk factors, Interventions, Treatments

John A. Chabot, MD
Medical Director,
Pancreas Center
Columbia University Medical Center
Phone: 1.800.227.2762

Situated behind the lower portion of the stomach, the pancreas plays an essential role in converting the food we eat into fuel
for our body's cells. There are several disorders that affect the pancreas, including pancreatitis, precancerous conditions, and
pancreatic cancer.

Pancreatitis

Pancreatitis refers to inflammation of the pancreas occurring when pancreatic enzyme secretions build up and begin to digest
the organ itself. Characterized by upper abdominal pain, pancreatitis can occur as a temporary condition, or may be chronic,
developing over a period of years.  Pancreatitis has a variety of causes, including long-term alcohol use, gallstones, and
buildup of certain medications and compounds in the blood.

To treat pancreatitis, a gastroenterologist or surgeon resolves immediate symptoms through careful monitoring and may
temporarily administer fluid and nourishment intravenously. Special endoscopic procedures are used to determine and treat
the cause. Depending upon the extent and the cause, treatment may require surgery.

Pancreatic Cancer

Pancreatic cancer is one of the most challenging diseases physicians face today because it is difficult to treat and can quickly
spread to surrounding organs. A contributing risk factor for cancer of the pancreas is cigarette smoking. A family history of
pancreatic cancer and hereditary cancer syndromes also greatly increase risk. Certain nonmalignant pancreatic conditions are
known to be precursors to pancreatic cancer and call for immediate intervention, such as removal of all or part of the
pancreas.

Treatment for Pancreatic Cancer
Surgery to remove all cancerous tissue currently offers the best chance for a cure. Not every patient is eligible for surgical
intervention because of factors including the location of the tumor, and whether the cancer has spread to other organs.

Risk Analysis for Pancreatic Cancer

Risk analysis can potentially help those living with a family history of cancer or with other risk factors for pancreatic cancer
to avoid the disease through regular screening tests. Steps in risk analysis include:

•        Family medical history of the patient is analyzed.
•        Genetic counseling and testing may accompany this process.
•        The physician may opt to image the pancreas with sensitive instruments to detect pre-cancerous abnormalities or     
small cancers that are surgically curable.
•        If the patient learns there is significant genetic risk, an ongoing testing regimen may be recommended so they may
ultimately avoid the disease

Because pancreas operations are complex, it is important to locate a surgeon and a facility that have extensive experience
with pancreatic cancer and that perform a high volume of the operations. Studies have shown patients treated at such high-
volume centers have fewer operative complications and better surgical outcomes.
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