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Gastrointestinal Cancers
Esophageal Cancer (Carcinoma)
Overview
- What is the esophagus?
The esophagus is a tube that connects the mouth and throat with the stomach (sometimes called the "food tube" or “food pipe”). When a person swallows, the muscles of the esophagus squeeze together to help push food and liquids down to the stomach for digestion.
- What is esophageal cancer?
Esophageal cancer is when the tissue of the esophagus lining begins to grow too fast in an unhealthy way. There are two main types of esophageal cancer. Squamous cell carcinoma usually occurs in the upper or middle part of the esophagus. Adenocarcinoma usually occurs in the lower part of the esophagus. Adenocarcinoma is the most common type of esophageal cancer in the United States.
Symptoms
- What are the signs and symptoms of esophageal cancer?
Patients may not have symptoms early on, when the tumor is very small. However, as tumors grow, they can start to block the esophagus and cause problems with swallowing. Solid foods such as meat, bread, and raw vegetables may feel like they become stuck in the throat or chest. Over time, patients may have trouble swallowing liquids too.
Other symptoms include:
- Weight loss, without trying to lose weight
- Indigestion
- Heartburn
- Chest pain
- Vomiting
- Coughing
- Change in voice
Patients may also throw up blood or see changes in their stool (in which the stool becomes black and sticky), but these symptoms are less common.
Causes/Risk Factors
- Who gets esophageal cancer?
Studies show that esophageal cancer most commonly occurs in people over 55 years old. Men are affected more often than women. Squamous cell carcinoma is more common in black patients, while adenocarcinoma is more common in non-Hispanic white patients
- What are the risk factors for esophageal cancer?
Esophageal cancer is linked to a number of factors that cause long term irritation of the esophagus. These factors include:
- Smoking
- Heavy alcohol use
- Chronic heartburn or acid reflux
- Obesity
In some patients with acid reflux (which is when acid from the stomach backs up into the esophagus), the lining of the esophagus can change and begin to look like the lining of the intestine. This condition is called Barrett's esophagus. Patients with Barrett's esophagus have a higher risk of developing esophageal cancer. Esophageal cancer can also run in families.
Diagnosis
- How is esophageal cancer diagnosed?
Your healthcare team will start by asking questions about signs and symptoms. They will also ask questions about your health history and your family’s health history. If you are seen in the clinic, they will perform a physical exam. You may be referred to a gastroenterologist (a doctor who focuses on diseases of the digestive system) to talk about next steps.
There are different kinds of tests that can be used to help diagnose esophageal cancer. These include:
- Upper endoscopy (EGD)
- This is a test that allows the doctor to see directly inside the esophagus and look for signs of cancer. A thin, flexible tube with a camera at the end is passed through the mouth and into the esophagus. Samples can be taken during an upper endoscopy to confirm the diagnosis of esophageal cancer.
- Esophagram (Barium swallow study)
- This is a test that allows the doctor to see the overall shape of your esophagus, because esophageal cancer can change the shape of your esophagus. The patient drinks a liquid that coats the esophagus. This liquid makes the esophagus easier to see on x-ray. X-rays can show if there are changes to the shape of your esophagus .
Once a diagnosis is made, there are tests to help see if the cancer has spread. These may include:
- Endoscopic ultrasound (EUS)
- This is test that allows the doctor to see how big the cancer is within the esophagus wall and if areas outside of the esophagus are affected. A flexible tube with both a camera and special probe (ultrasound) at the end is passed through the mouth and into the esophagus. The ultrasound allows the doctor to see parts of the chest and abdomen outside of the esophagus. The ultrasound also allows the doctor to use a small needle to take samples to confirm if cancer has spread.
- Computed tomography scan (CT scan)
- This is a test that gives the doctor an overall look at the organs and tissues inside the body using x-rays. The patient lays down on a table that slides into an x-ray tube that takes many pictures from different angles. These pictures allow the doctor to see if cancer may have spread.
- Positron emission tomography scan (PET scan)
- This is a test that gives the doctor an overall look at how active tissues and organs inside the body are. Cancer looks different from normal tissue because it is very active. To look at how active tissues are, a safe, radioactive form of sugar is injected into a vein. Highly active cancer tissue likes to use this sugar. The patient then lays down on a table that slides into a machine that takes many pictures from different angles to see where the sugar is in the body. These pictures allow the doctor to see if cancer may have spread.
Treatment
- How is esophageal cancer treated?
Treatment for esophageal cancer depends on the cancer size and if the cancer has spread. When patients are diagnosed early with small esophageal cancers that have not spread to other parts of the body, upper endoscopy can sometimes be used to remove the cancer. The cancer is therefore removed completely from the inside.
When esophageal cancer cannot be removed with upper endoscopy, treatment often involves a combination of the following:
- Surgery
- This is called esophagectomy. This involves cutting out the cancer part of the esophagus. Depending on where the cancer is, part of the stomach may also be cut out. There are many things to consider to make sure the patient is a good candidate for surgery and that surgery can be done as safe as possible.
- Chemotherapy
- This involves taking anti-cancer drugs. These are usually injected into a vein to reach the cancer through the bloodstream.
- Radiation
- This involves using a machine to focus strong x-rays on the cancer part of the esophagus.
- Palliative Care
- This is a special kind of health care that helps cancer patients feel better when they are very sick and in pain. Palliative Care team members focus on the patient’s symptoms to make sure that the patient is comfortable and feels supported.
Overall, doctors consider many factors and work directly with their patients to determine the right treatment plan for each patient.
Stomach Cancer (Gastric Cancer)
Overview
- What is the stomach?
The stomach is a major part of the digestive system. When food is swallowed, it passes the throat and goes into the esophagus (“food pipe” or “food tube”). The esophagus then pushes the food down into the stomach. The stomach has strong muscles in order to mix and break up food. The stomach also makes acid to break down food. When food is broken down enough, the stomach moves the food into the small bowel.
- What is stomach cancer?
Stomach cancer is when the tissue of the stomach lining begins to grow too fast in an unhealthy way. The most common type of stomach cancer is called adenocarcinoma. This article focuses on adenocarcinoma.
Symptoms
- What are the signs and symptoms of stomach cancer?
Patients may not have symptoms early on, when the tumor is very small. If patients do have symptoms, the most common are:
- Weight loss, without trying to lose weight
- Abdominal pain
- Indigestion
- Not feeling hungry as usual
- Feeling full after eating only a small amount
- Bloating
- Nausea
- Vomiting
- Feeling tired or weak
Patients may also throw up blood or see changes in their stool (in which the stool becomes black and sticky).
Causes/Risk Factors
- Who gets stomach cancer?
Studies show that stomach cancer most commonly occurs in people over 55 years old. Men are affected more often than women. Stomach cancer is more common in black, Hispanic, Asian American, and Native American patients than non-Hispanic white patients.
- What are the risk factors for stomach cancer?
Stomach cancer is linked to a number of factors that cause long term irritation of the stomach. These factors include:
- Infection with a bacteria called Helicobacter pylori (H. pylori)
- Obesity
- Eating a diet with lots of processed, smoked, or grilled meats
- Smoking
- Heavy alcohol use
Patients can sometimes have conditions that cause their stomach to make less acid than normal. These include stomach surgery or some types of autoimmune diseases. These patients are at higher risk for stomach cancer because with less acid, the stomach cannot protect the body against harmful bacteria as usual. Stomach cancer can also run in families.
Diagnosis
- How is stomach cancer diagnosed?
Your healthcare team will start by asking questions about signs and symptoms. They will also ask questions about your health history and your family’s health history. If you are seen in the clinic, they will perform a physical exam. You may be referred to a gastroenterologist (a doctor who focuses on diseases of the digestive system) to talk about next steps.
The main test that is used to diagnose stomach cancer is an upper endoscopy, also called an EGD. This is a test that allows the doctor to see directly inside the stomach and look for signs of cancer. A thin, flexible tube with a camera at the end is passed through the mouth and into the esophagus. Samples can be taken during an upper endoscopy to confirm the diagnosis of stomach cancer.
Once a diagnosis is made, there are tests to help see if the cancer has spread. These may include:
- Endoscopic ultrasound (EUS)
- This is test that allows the doctor to see how big the cancer is within the stomach wall and if areas outside of the stomach are affected. A flexible tube with both a camera and special probe (ultrasound) at the end is passed through the mouth, down the esophagus, and into the stomach. The ultrasound allows the doctor to see parts of the chest and abdomen outside of the stomach. The ultrasound also allows the doctor to use a small needle to take samples to confirm if cancer has spread.
- Computed tomography scan (CT scan)
- This is a test that gives the doctor an overall look at the organs and tissues inside the body using x-rays. The patient lays down on a table that slides into an x-ray tube that takes many pictures from different angles. These pictures allow the doctor to see if cancer may have spread.
- Positron emission tomography scan (PET scan)
- This is a test that gives the doctor an overall look at how active tissues and organs inside the body are. Cancer looks different from normal tissue because it is very active. To look at how active tissues are, a safe, radioactive form of sugar is injected into a vein. Highly active cancer tissue likes to use this sugar. The patient then lays down on a table that slides into a machine that takes many pictures from different angles to see where the sugar is in the body. These pictures allow the doctor to see if cancer may have spread.
Treatment
- How is stomach cancer treated?
Treatment for stomach cancer depends on the cancer size and if the cancer has spread. When patients are diagnosed early with small stomach cancers that have not spread to other parts of the body, upper endoscopy can sometimes be used to remove the cancer. The cancer is therefore removed completely from the inside.
When stomach cancer cannot be removed with upper endoscopy, treatment may involve a combination of the following:
- Surgery
- This is called gastrectomy. This involves cutting out the cancer part of the stomach. Depending on where the cancer is, the entire stomach may need to be cut out. If the cancer has spread, parts of nearby tissues and organs may also be cut out. There are many things to consider to make sure the patient is a good candidate for surgery and that surgery can be done as safe as possible.
- Chemotherapy
- This involves taking anti-cancer drugs. These are usually injected into a vein to reach the cancer through the bloodstream.
- Radiation
- This involves using a machine to focus strong x-rays on the cancer part of the stomach.
- Palliative Care
- This is a special kind of health care that helps cancer patients feel better when they are very sick and in pain. Palliative Care team members focus on the patient’s symptoms to make sure that the patient is comfortable and feels supported.
Overall, doctors consider many factors and work directly with their patients to determine the right treatment plan for each patient.
Liver Cancer (Hepatocellular Carcinoma)
Overview
- What is the liver?
The liver is one of the largest organs in the body, located in the upper right abdomen. The liver has many important jobs. These include:
- Breaking down toxins from the blood so the body can get rid of the toxins
- Breaking down medicines so the body can use the medicines
- Making bile, which is a fluid to help the body digest food
- Making proteins that help blood to move important items throughout the body
- Making proteins that clot blood when a person gets cut or hurt
- Storing sugar so that the body can maintain a healthy blood sugar level
- What is liver cancer?
Liver cancer is when the tissue of the liver begins to grow too fast in an unhealthy way. The most common type of liver cancer is called hepatocellular carcinoma (HCC). This article focuses on HCC.
It is important to keep in mind that in the United States, most cancers found in the liver are not actually HCC. They are cancers that started from somewhere else in the body. Cancers that commonly spread to the liver include colon cancer, pancreas cancer, lung cancer, and breast cancer.
Symptoms
- What are the signs and symptoms of liver cancer?
Patients may not have symptoms early on, when the tumor is very small. As the cancer grows, the most common symptom that patients may have is abdominal pain. Other symptoms include:
Other symptoms include:
- Weight loss, without trying to lose weight
- Not feeling hungry as usual
- Feeling full after eating only a small amount
- Fevers, without a known infection
- Abdominal swelling
- Yellowing of the eyes
- Yellowing of the skin
- Itching
- Dark, brown-colored urine
- Pale, light gray stools
- Nausea
- Vomiting
- Feeling tired or weak
Causes/Risk Factors
- Who gets liver cancer?
Studies show that liver cancer most commonly occurs in people over 55 years old. Men are affected more often than women. Liver cancer is more common in Asian American, Hispanic, and Native American patients than black and non-Hispanic white patients.
- What are the risk factors for liver cancer?
Liver cancer is strongly linked to long-term infection of the liver with one of two viruses: hepatitis B virus or hepatitis C virus.
Liver cancer is also strongly linked to cirrhosis. Cirrhosis is a liver condition in which the liver makes scar tissue because of long-term irritation and damage. Cirrhosis can happen for different reasons. The hepatitis B and C viruses mentioned above can cause cirrhosis. Heavy alcohol use and fatty liver are also common causes of cirrhosis in the United States. Cirrhosis increases the risk of liver cancer regardless of what caused the cirrhosis.
Other risk factors include:
- Heavy alcohol use
- Smoking
- Obesity
- Diabetes
- Using steroids to build muscle
- Exposure to a mold toxin (called aflatoxin) that can contaminate nuts and grains
- Working in a factory that makes plastic
Some patients inherit liver diseases that increase their risk for liver cancer. These diseases include hemochromatosis, Wilson’s disease, and alpha-1 antitrypsin deficiency.
Diagnosis
- How is liver cancer diagnosed?
Your healthcare team will start by asking questions about signs and symptoms. They will also ask questions about your health history and your family’s health history. If you are seen in the clinic, they will perform a physical exam. You may be referred to a gastroenterologist (a doctor who focuses on diseases of the digestive system) to talk about next steps.
To look for liver cancer, your doctor will likely start your work-up with the following tests:
- Blood tests
- Blood samples can be used to look for irritation of the liver, problems with how the liver is working, and signs of unhealthy liver tissue growth that might be associated with liver cancer.
- Abdominal ultrasound
- This is test that allows the doctor to see most of the liver using sound waves. The patient lays down on a table and gel is placed on the abdomen. A small wand device is then pushed into the gel and moved around the abdomen to take pictures from different angles. These pictures give the doctor a general look at the liver and allow the doctor to see if there may be a tumor in the liver.
If the blood tests and abdominal ultrasound show concern for liver cancer, the next step usually involves getting more detailed pictures of the liver. This is important because liver cancer can often be diagnosed with pictures alone. The two main tests are:
- Computed tomography scan (CT scan)
- This is a test that gives the doctor an overall look at the liver using x-rays. A liquid called contrast is injected into the vein to make liver tumors and details easier to see. Sometimes, the patient will also drink contrast at the same time. The patient then lays down on a table that slides into an x-ray tube that takes many pictures from different angles. These pictures allow the doctor to see if there a tumor in the liver and if so, see if it looks and behaves like HCC.
- Magnetic resonance imaging (MRI)
- This is a test that gives the doctor an overall look at the liver using magnets. A liquid called contrast is injected into the vein to make liver tumors and details easier to see. The patient then lays down on a table that slides into machine that takes many pictures from different angles. These pictures allow the doctor to see if there a tumor in the liver and if so, see if it looks and behaves like HCC.
In some cases, a sample of liver tissue, called a biopsy, is needed to confirm the diagnosis of liver cancer. During this test, a needle is used to go through the skin and into the liver to take a small sample of the liver.
Treatment
- How is liver cancer treated?
Treatment for liver cancer depends on the cancer size and if the cancer has spread. It also depends on how healthy the liver is.
Surgery gives the best chance to cure liver cancer. There are many things to consider to make sure the patient is a good candidate for surgery and that surgery can be done as safe as possible. If surgery is possible, there are two main types of liver surgery:
- Liver resection
- This is called partial hepatectomy. This involves cutting out the cancer part of the liver. The tumor needs to be small and the liver has to be otherwise healthy for liver resection to work well.
- Liver transplantation
- This involves cutting out the entire liver and putting in a healthy liver (which is called the transplanted liver) donated from another person. The entire liver is removed because the tumors may be hard to remove with liver resection or because the liver overall is not healthy. Liver transplantation is a very complicated surgery with many risks and long-term side effects. It is an option only for a very small number of patients with liver cancer.
If surgery is not possible, then treatment may involve one or more of the following:
- Ablation
- Ablation means to destroy. This involves using microwave heat, cold, or alcohol to help destroy the cancer. A needle goes through the skin and into the tumor to send the microwave heat, cold, or alcohol directly to the tumor.
- Embolization
- Embolization means to block a blood vessel. This involves injecting special liquid or small beads to plug the blood vessel that feeds the tumor. The tumor will then starve, which helps to destroy the cancer. A very thin tube is placed into a large blood vessel in the thigh that eventually leads to the blood vessel that feeds the tumor. The special liquid or small beads are then pushed through the thin tube into the blood vessel that feeds the tumor. The special liquid or beads may also have anti-cancer drugs or radioactive material to help destroy the cancer.
- Chemotherapy
- This involves taking anti-cancer drugs. These are usually injected into a vein to reach the cancer through the bloodstream.
- Radiation
- This involves using a machine to focus strong x-rays or energy rays on the cancer part of the liver.
- Palliative Care
- This is a special kind of health care that helps cancer patients feel better when they are very sick and in pain. Palliative Care team members focus on the patient’s symptoms to make sure that the patient is comfortable and feels supported.
In some cases, patients may undergo the treatments listed above to shrink the tumor to make surgery a possibility. Overall, doctors consider many factors and work directly with their patients to determine the right treatment plan for each patient.
Pancreatic Cancer
Overview
- What is the pancreas?
The pancreas is a small organ that sits behind the stomach. The pancreas is like a little animal, with a head, neck, body, and tail. The head of the pancreas is near where the stomach connects to the small intestine, towards the right side of the abdomen. The neck and body of the pancreas run along the stomach, and the tail of the pancreas is next to the spleen towards the left side of the abdomen.
The pancreas has two main jobs:
- Helping with digestion. The pancreas makes special juices that break down food so the body can use the nutrients. The juices collect in the main drain pipe in the pancreas, called the main duct, and then drain into the small intestine to mix with and digest food.
- Controlling blood sugar. The pancreas makes a hormone called insulin. Insulin helps the body to maintain a healthy blood sugar level.
- What is pancreatic cancer?
Pancreatic cancer is when the tissue of the pancreas begins to grow too fast in an unhealthy way. The most common type of pancreatic cancer is called adenocarcinoma. Adenocarcinoma is when the cancer comes from the tissue that lines the main duct of the pancreas. This article focuses on pancreatic adenocarcinoma.
Symptoms
- What are the signs and symptoms of pancreatic cancer?
Patients often do not have symptoms early on, when the tumor is very small. In many cases, patients were having tests done for other health reasons but these tests happen to notice a tumor in the pancreas.
As the cancer grows and/or spreads, patients may develop blockage of nearby structures, especially if the tumor is in the head of the pancreas. This is because the main drain pipe of the liver (called the common bile duct) goes through the pancreas head. If the common bile duct is blocked, bile backs up and can cause the following symptoms:
- Yellowing of the eyes
- Yellowing of the skin
- Itching
- Dark, brown-colored urine
- Pale, light gray stools
The pancreas head is also near where the stomach connects to the small intestine. A tumor in the pancreas head can block this area so that food is not able to leave the stomach. This can lead to nausea, vomiting, and feeling full after eating only a small amount of food.
Other symptoms of pancreatic cancer include:
- Weight loss, without trying to lose weight
- Not feeling hungry as usual
- Abdominal pain
- Back pain
- Feeling tired or weak
Pancreatic cancer can cause diabetes as the cancer replaces the healthy pancreas tissue that normally makes insulin. Testing for pancreatic cancer should be considered if a patient older than 50 years old has a new, unexpected diagnosis of diabetes or if a patient has diabetes that is getting harder to control when it was easy to control before.
Causes/Risk Factors
- Who gets pancreatic cancer?
Studies show that pancreatic cancer most commonly occurs in people over 65 years old. Men are affected slightly more often than women. Pancreatic cancer is slightly more common in black patients compared to non-Hispanic white patients.
- What are the risk factors for pancreatic cancer?
Pancreatic cancer is linked to a number of factors that cause long term irritation of the pancreas. These factors include:
- Smoking
- Heavy alcohol use
- Diabetes
- Obesity
- Working with dry cleaning chemicals
- Working as a metalworker
Pancreatic cancer is also linked to chronic pancreatitis. Chronic pancreatitis is a condition in which the pancreas makes scar tissue because of long-term irritation and damage. Chronic pancreatitis can happen for different reasons. Heavy alcohol use and smoking are the most common causes of chronic pancreatitis. Chronic pancreatitis increases the risk of pancreatic cancer regardless of what caused the chronic pancreatitis.
Some patients inherit diseases that increase their risk for pancreatic cancer. These diseases include hereditary pancreatitis, Lynch syndrome, Peutz-Jeghers syndrome, ataxia telangiectasia, familial atypical multiple mole melanoma syndrome, and hereditary breast and ovarian cancer syndromes.
Pancreatic cancer can also run in families.
Diagnosis
- How is pancreatic cancer diagnosed?
Your healthcare team will start by asking questions about signs and symptoms. They will also ask questions about your health history and your family’s health history. If you are seen in the clinic, they will perform a physical exam. You may be referred to a gastroenterologist (a doctor who focuses on diseases of the digestive system) to talk about next steps.
There are different kinds of tests that can be used to help diagnose pancreatic cancer. These include:
- Computed tomography scan (CT scan)
- This is a test that gives the doctor an overall look at the pancreas using x-rays. A liquid called contrast is injected into the vein to make pancreas tumors easier to see. The patient then lays down on a table that slides into an x-ray tube that takes many pictures from different angles.
- Magnetic resonance imaging (MRI)
- This is a test that gives the doctor an overall look at the pancreas using magnets. A liquid called contrast is injected into the vein to make pancreas tumors easier to see. The patient then lays down on a table that slides into machine that takes many pictures from different angles. This test can give the doctor very detailed pictures of the pancreas and nearby structures.
- Blood tests
- Blood samples can be used to look for signs of unhealthy pancreas tissue growth that might be associated with pancreatic cancer.
A test to get tumor samples is often done next to confirm the diagnosis. The main test that is used is endoscopic ultrasound (EUS). This is test that allows the doctor to see how big the cancer is in the pancreas and if areas outside of the pancreas are affected. A flexible tube with both a camera and special probe (ultrasound) at the end is passed through the mouth and into the stomach and small intestine. The ultrasound allows the doctor to see past the stomach wall and small intestine wall where the pancreas is. The ultrasound allows the doctor to use a small needle to take samples from the pancreas and also nearby areas if needed to see if the cancer has spread.
Once a diagnosis is made, there are other tests to help see if the cancer has spread. These may include:
- Surgery
- This is called a staging laparoscopy. Small cuts are made through the skin on the abdomen. These allow the surgeon to put a small camera into the abdomen to look directly at the pancreas and other organs. The surgeon can also get samples to see how far the cancer has spread.
- Positron emission tomography scan (PET scan)
- This is a test that gives the doctor an overall look at how active tissues and organs inside the body are. Cancer looks different from normal tissue because it is very active. To look at how active tissues are, a safe, radioactive form of sugar is injected into a vein. Highly active cancer tissue likes to use this sugar. The patient then lays down on a table that slides into machine that takes many pictures from different angles to see where the sugar is in the body. These pictures allow the doctor to see if cancer may have spread.
Treatment
- How is esophageal cancer treated?
Treatment for pancreatic cancer depends on the cancer size and if the cancer has spread.
Surgery gives the best chance to cure pancreatic cancer. There are many things to consider to make sure the patient is a good candidate for surgery and that surgery can be done as safe as possible. If surgery is possible, the type of surgery depends on where the tumor is. These include:
- Whipple procedure
- This is also called pancreaticoduodenectomy. This is done when the tumor is in the pancreas head. This surgery involves cutting out the pancreas head, as well as part of the small intestine, part of the common bile duct, and sometimes part of the stomach.
- Distal pancreatectomy
- This is done when the tumor is in the pancreas body or tail. This surgery involves cutting out the pancreas body, pancreas tail, and sometimes the spleen.
- Total pancreatectomy
- This may be an option if cancer has spread to more than one part of the pancreas but not yet outside of the pancreas. This surgery involves cutting out the entire pancreas, part of the small intestine, the common bile duct, the gallbladder, part of the stomach, and the spleen. Any surgery on the pancreas is complicated, but total pancreatectomy is an especially complicated surgery with many risks and long-term side effects. It is an option only for a very small number of patients with pancreatic cancer.
If surgery is not possible, then treatment may involve one or more of the following:
- Ablation
- Ablation means to destroy. This involves using microwave heat, cold, or alcohol to help destroy the cancer. A needle goes through the skin and into the tumor to send the microwave heat, cold, or alcohol directly to the tumor.
- Embolization
- Embolization means to block a blood vessel. This involves injecting special liquid or small beads to plug the blood vessel that feeds the tumor. The tumor will then starve, which helps to destroy the cancer. A very thin tube is placed into a large blood vessel in the thigh that eventually leads to the blood vessel that feeds the tumor. The special liquid or small beads are then pushed through the thin tube into the blood vessel that feeds the tumor. The special liquid or beads may also have anti-cancer drugs or radioactive material to help destroy the cancer.
- Chemotherapy
- This involves taking anti-cancer drugs. These are usually injected into a vein to reach the cancer through the bloodstream.
- Radiation
- This involves using a machine to focus strong x-rays on the cancer part of the pancreas.
- Palliative Care
- This is a special kind of health care that helps cancer patients feel better when they are very sick and in pain. Palliative Care team members focus on the patient’s symptoms to make sure that the patient is comfortable and feels supported.
In some cases, patients may undergo the treatments listed above to shrink the tumor to make surgery a possibility.
In cases where the common bile duct is blocked, a test called endoscopic retrograde cholangiopancreatography (ERCP) is often the next step. This is test that allows the doctor to place a stent, which is like a small plastic straw or metal mesh tube, inside the duct to keep it open. For this test, a flexible tube with a camera at the end is passed through the mouth and into the small intestine, where the opening of the bile duct is.
Small tools can go through the tube and into the bile duct, which allow the doctor to place the stent. X-rays are also used during this test to get pictures of the bile duct and make sure the stent is in the right place.
Overall, doctors consider many factors and work directly with their patients to determine the right treatment plan for each patient.
Author(s) and Publication Date(s)
Radha Tamerisa, MD, University of Texas Medical Branch, Galveston, TX, and Manoop S. Bhutani, MD, FACG, UT MD Anderson Cancer Center, Houston, TX – Published June 2004, Updated May 2008, Updated July 2013.
Abbas Rupawala, MD, Alpert Medical School at Brown University, Providence, RI – Updated April 2021.
Yuri Hanada, MD, University of Minnesota Medical School, Minneapolis, MN – Updated April 2025.