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Published on March 09, 2018

Cancer Awareness: Pancreatic and Colorectal

GI Cancer

In this series:

Pancreatic Cancer

Pancreatic cancer occurs when malignant cells grow out of control in the pancreas, a gland located in the abdomen. The pancreas is a dual-function gland, providing the body with essential functions in both the endocrine and digestive systems. Cancer of the pancreas is sometimes called a “silent” disease because symptoms are not usually present in early stages. Unlike many other cancers, there is not a screening test that can always accurately detect pancreatic cancer.

Although pancreatic cancer is known as a silent disease, it is still extremely important to know the symptoms and risk factors associated with pancreatic cancer so those individuals at high risk can begin getting regular scans. People at higher risk of having pancreatic cancer include males, older adults, those with a family history of pancreatic cancer, smokers, African Americans and those with obesity.

Symptoms that commonly lead to diagnosis include:

  • Jaundice
  • Abdominal and/or back pain
  • Digestive difficulties including poor appetite, indigestion and nausea
  • Unexplained weight loss and loss of appetite
  • Ascites (the abnormal buildup of fluid in the abdominal cavity)
  • Blood clots (most often form in the legs)
  • Fatigue, weakness and depression

Surgery is normally an important part of long-term treatment for pancreatic cancer. The two main surgeries performed for pancreatic are:

  1. Whipple (pancreaticoduodenectomy) - This operation is performed to treat cancerous tumors on the head of the pancreas.
  2. Distal Pancreatectomy - removal of the body and tail of the pancreas, and can be done through laparoscopy.

Chemotherapy and radiation are also key parts of treatment for pancreatic cancer.

Through a multidisciplinary approach, the exceptional team of physicians and healthcare professionals at Cone Health Cancer Center meets to discuss each pancreatic cancer patient’s case and develop an individualized treatment plan.

Faera Byerly, MD, is a surgical oncologist at the Cone Health Cancer Center at Wesley Long.

Colorectal Cancer

According to the Centers for Disease Control and Prevention (CDC), colorectal cancer (CRC) is the #2 cancer killer in the U.S. as well as in North Carolina. Fortunately, colorectal cancer is preventable when found early during routine screenings. The CDC has found the rates of new cases and deaths are decreasing, and that 66,000 colorectal cancer cases were prevented between 2003-2007 with the help of screenings.

Screening is recommended for adults over the age of 50 with no family history of colon cancer. If you do have a family history, screenings may start at the age of 40 or earlier depending on when your family member was diagnosed. There are a few different screening methods available, including:

  • Colonoscopy – The gold standard of screening tools that can detect and remove growths during the procedure
  • Stool tests – Recommended every 1-3 years depending on the type of test. If you test positive, you will need a colonoscopy. Can be positive for multiple reasons.
  • CT colonography – Often hard to get insurance approval for this test and has risks of radiation

Talk to your doctor about your risk factors and which screening method is best for you. Other less common risk factors include inflammatory bowel disease, like ulcerative colitis or Crohn’s disease, and a genetic predisposition such as familial adenomatous polyposis or hereditary nonpolyposis coli.

People with early-stage colorectal cancer rarely experience symptoms, but possible signs may involve:

  • Blood in the stool (rectal bleeding)
  • If you are found to be anemic by a blood test
  • Abdominal pain
  • Change in bowel habits - diarrhea, constipation or change in the shape of the stool.

Kiran Anna, MD, is a gastroenterologist at Alamance Gastroenterology and a member of the Cone Health Medical Group.

Colorectal Cancer: the FIT Test

While colonoscopies are the gold standard of screening methods for colorectal cancer, there are other testing methods that people can do from home, such as the FIT test.

The goal of screening is to detect cancer at early stages or even before it develops. The fecal immunochemical test (FIT) looks for hidden blood in the stool, which can be a sign of cancer. If you choose this screening method, your provider will send you home with a packet that includes instructions and tools to collect a stool sample. Once you’ve collected your sample, you simply mail it off to be tested and wait to hear the results from your physician. In the past, stool sample tests required three samples and you had to avoid certain foods before taking the test.

The FIT test doesn’t require any drug or dietary restrictions, but a positive result can be caused by a few different health issues. If your sample is positive, it’s best to discuss your next steps with your physician. They may recommend a colonoscopy for further testing. While you only need a colonoscopy once every ten years if your results are negative, FIT tests should be done annually.

Christine Brannock, RN, BS, OCN, is the oncology outreach manager at the Cone Health Cancer Center at Wesley Long.

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