Pancreatic Islet Cell Cancer

Pancreatic Islet Cell Cancer

Pancreatic islet cell cancer is a disease in which cancerous cells first form in tissues of the endocrine pancreas. It is a rare form of cancer, accounting for only about 5 percent of pancreatic cancer cases. Symptoms of pancreatic islet cell cancer may include pain in the abdomen, diarrhea, fatigue, fainting, and unexplained weight gain. Treatment options for pancreatic islet cell cancer may include surgery, chemotherapy, and hormone therapy.

Pancreatic Islet Cell Cancer: An Introduction
Pancreatic islet cell cancer is a rare disease in which cancer cells are found in certain tissues of the pancreas where hormones are produced. It should not be confused with cancer of the exocrine pancreas, which accounts for approximately 95 percent of pancreatic cancer cases.

(Click Pancreatic Cancer for information on the more common form of cancer that develops in the pancreas.)

Understanding the Pancreas and Islet Cell Cancer
The pancreas is about 6 inches long and is shaped like a thin pear. The pancreas lies behind the stomach, inside a loop that is formed by part of the small intestine. The broader right end of the pancreas is called the head, the middle section is called the body, and the narrow left end is the tail.

The pancreas has two basic jobs in the body. The first job is to produce digestive juices that help break down (digest) food. The second job is to produce hormones (such as insulin) that regulate how the body stores and uses food. The area of the pancreas that produces digestive juices is called the exocrine pancreas, which is where approximately 95 percent of pancreatic cancers begin. The hormone-producing area of the pancreas has special cells called islet cells and is called the endocrine pancreas. The endocrine pancreas is where approximately 5 percent of pancreatic cancers begin.

The islet cells make many hormones, including insulin, which help the body store and use sugars. When islet cells become cancerous, they may make too many hormones. Islet cell cancers that make too many hormones are called functioning tumors. Other islet cell cancers may not make extra hormones and are called nonfunctioning tumors. Tumors that do not spread to other parts of the body can also be found in the islet cells. These are called benign tumors and are not cancer. A doctor will need to determine whether the tumor is cancerous or benign.

Symptoms of Pancreatic Islet Cell Cancer
Possible pancreatic islet cell cancer symptoms include:

* Pain in the abdomen
* Diarrhea
* Feeling tired all the time
* Fainting
* Unexplained weight gain.

These possible symptoms of pancreatic islet cell cancer are not sure signs of the disease. Other pancreatic diseases and health problems can cause these symptoms. People who experience possible symptoms of islet cell cancer should see a doctor as soon as possible; only a doctor can diagnose and treat the problem.

Diagnosing Pancreatic Islet Cell Cancer
If a person has what may be possible pancreatic islet cell cancer symptoms, doctors will likely:

* Perform a physical exam
* Ask about the patient's personal and family medical history
* Order blood and urine tests to check hormones levels
* Order other tests, including x-rays and special scans.

Pancreatic Islet Cell Cancer: Stages and Types
Once doctors diagnose islet cell cancer, they will need to order more tests to find out if cancer cells have spread to other parts of the body. This is called staging. The staging system for pancreatic islet cell cancer is still being developed. Islet cell tumors are usually divided into one of three groups:

* Islet cell cancers occurring in one site within the pancreas
* Islet cell cancers occurring in several sites within the pancreas
* Islet cell cancers that have spread to lymph nodes near the pancreas or to distant sites.

Doctors will also need to identify the type of the islet cell tumor in order to plan pancreatic islet cell cancer treatment. Types of islet cell tumors include:

* Gastrinoma (see Gastrinoma)
* Insulinoma (see Insulinoma)
* Glucagonoma (see Glucagonoma)
* Miscellaneous
* Recurrent.

Gastrinoma
A gastrinoma tumor produces large amounts of a hormone called gastrin, which causes the stomach to make too much acid. If there is too much stomach acid, ulcers may develop.

Insulinoma
An insulinoma tumor makes too much insulin and causes the body to store sugar instead of burning it for energy. This will cause hypoglycemia, which is a condition in which there is too little sugar in the blood.

Glucagonoma
A glucagonoma tumor makes too much glucagon and causes hyperglycemia, which is a condition in which there is too much sugar in the blood.

Miscellaneous
Other types of islet cell cancer can affect the pancreas, the small intestine, or both. Each type of tumor may affect different hormones in the body and cause different symptoms.

Recurrent
Recurrent pancreatic islet cell cancer refers to cancer has come back (recurred) after it has been treated. The cancer may come back in the pancreas or in another part of the body.

Treating Pancreatic Islet Cell Cancer
Treatment of pancreatic islet cell cancer will depend on the type of tumor, the stage of the tumor, and the patient's overall health.

Treatments for pancreatic islet cell cancer include:

* Surgery (taking out the cancer)
* Chemotherapy (using drugs to kill cancer cells)
* Hormone therapy (using hormones to stop cancer cells from growing).

Surgery is the most common treatment of islet cell cancer. The doctor may remove:

* Most or part of the pancreas
* The stomach (gastrectomy) if there are ulcers
* Lymph nodes to see if they contain cancer.

Islet cell cancer chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill or it may be put into a vein or muscle by a needle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and kills cancer cells throughout the body.

Hormone therapy uses hormones to stop the cancer cells from growing or to relieve symptoms caused by the tumor. Hepatic arterial occlusion or embolization uses drugs or other agents to reduce or block the flow of blood to the liver in order to kill cancer cells growing in the liver.

Pancreatic Islet Cell Cancer: Treatment by Type
Treatment for pancreatic islet cell cancer will vary by the type of islet cell tumor the patient has.

Gastrinoma
Gastrinoma treatment may include:

* Surgery to remove the cancer
* Surgery to remove the stomach (gastrectomy)
* Surgery to cut the nerve that stimulates the pancreas
* Chemotherapy
* Hormone therapy
* Hepatic arterial occlusion or embolization to kill cancer cells growing in the liver.

Insulinoma
Insulinoma cancer treatment may include:

* Surgery to remove the cancer
* Chemotherapy
* Hormone therapy
* Drugs to relieve symptoms
* Hepatic arterial occlusion or embolization to kill cancer cells growing in the liver.

Glucagonoma
Glucagonoma treatment may include:

* Surgery to remove the cancer
* Chemotherapy
* Hormone therapy
* Hepatic arterial occlusion or embolization to kill cancer cells growing in the liver.

Miscellaneous Islet Cell Cancer
Miscellaneous pancreatic islet cell cancer treatment may include:

* Surgery to remove the cancer
* Chemotherapy
* Hormone therapy
* Hepatic arterial occlusion or embolization to kill cancer cells growing in the liver.

Recurrent Islet Cell Carcinoma
Treatment for recurrent islet cell carcinoma will depend on many factors, including the type of pancreatic islet cell cancer treatment the patient had before and the location of where the cancer has recurred. Treatment may include chemotherapy or patients may want to consider taking part in a clinical trial.

Pancreatic Islet Cell Cancer: Clinical Trials
Patients who have pancreatic islet cancer may want to participate in a clinical trial. Islet cell cancer clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information.

Prognosis for Pancreatic Islet Cell Cancer
The chance of recovery (prognosis) will depend on the type of islet cell cancer that the patient has, how far the cancer has spread, and the patient's overall health.