Monday, 13 October 2014

Pancreatic cancer


What and where the pancreas is

Diagram showing the parts of the digestive system

The pancreas is part of the digestive system.

The pancreas is quite high up in your abdomen. It lies across your body where your ribs meet at the bottom of your breastbone, just behind your stomach. It is about 6 inches (15 centimetres) long and shaped like a leaf. The wide end of the pancreas is called the head. The thin end is called the tail. The bit in the middle is called the body.

Diagram showing the position of the pancreas
The pancreas is a large gland. It makes digestive juices and insulin. The digestive juices flow down a tube into the duodenum. This tube is the pancreatic duct. The duodenum is the first part of the small bowel, where it is joined to the stomach. There is another duct that joins the duodenum. The bile duct comes down from the gallbladder and liver and joins the duodenum right next to the pancreatic duct. Where the 2 bile ducts join and meet the bowel is called the ampulla of Vater.
Diagram showing the bile ducts in the pancreas and the ampulla of vater
 

What the pancreas does

The pancreas has 2 important jobs in the body. The first is to produce the pancreatic digestive juices. The second is to produce insulin and other hormones to do with digestion. The part of the pancreas which produces the digestive juices is called the exocrine pancreas. The part of the pancreas which produces hormones, including insulin, is called the endocrine pancreas. Thecancers that develop from these two different parts of the pancreas can behave differently and can cause different symptoms.
The digestive system breaks up and digests the food we eat. After 2 hours or more in the stomach, the partly digested food moves into the beginning of the duodenum. When the food reaches the duodenum, the pancreas releases its digestive juices which flow down the pancreatic duct and mix with the food. The juices contain enzymes that help to break down the food into very small fragments. These fragments are absorbed into the body through the small bowel.
 

Insulin

The pancreas also makes insulin. Insulin is very important in the body because it helps to keep the level of sugar in the blood at a stable level. This means that the body cells get enough food, but not too much. If the level of sugar in the blood is high, the pancreas makes and secretes more insulin. If the level is too low, it secretes less. If you do not make enough insulin, you have diabetes.
 

What happens if your pancreas is removed

If you have part of your pancreas taken out, you will probably still make enough insulin. But your doctor will need to keep a very close eye on your blood sugar to make sure you do not develop diabetes. You may not make enough digestive juices. You can take supplements of pancreatic enzymes when you eat to help you digest fat. The supplements come in different forms. Usually capsules that you can swallow or empty onto your food.
If you have your pancreas completely removed, you will have to take pancreatic enzyme supplements and insulin. Because you won't be making your own insulin, you will effectively have diabetes.
You have insulin as a small injection under the skin. Before you have an insulin injection, you have to check your blood sugar level so that you know how much to inject. You do this by pricking your finger and squeezing a drop of blood onto a testing strip. There is a lot to learn at first. But your doctors and nurses will help you until you feel confident.

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