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COURTESY: PROVIDENCE - Dr. Paul Hansen  is a liver and pancreas surgeon as well as medical director for surgical oncology at Providence Cancer Center.Doctors at Providence Cancer Center, who work on patients with pancreatic conditions, have been recognized by a national foundation.


The center becomes one of only 30 centers in the nation, and the first in the state, to earn the National Pancreatic Foundation Center designation.

Dr. Paul Hansen is a liver and pancreas surgeon as well as medical director for surgical oncology at Providence Cancer Center. He is pleased with the designation.

“It’s a very nice acknowledgement of the team we’ve put together over the last many years,” Hansen said, noting the National Pancreatic Foundation was put together to help patients with various types of pancreatic disease.

“The foundation started accrediting programs,” Hansen said. “You have to have surgeons who are fellowship trained in liver and pancreas surgery. You have to have gastrointestinal doctors, who have a specific interest and skill set in taking care of patients with pancreatic diseases.”

Providence Cancer Center has a group of between 20 and 25 doctors. Doctors meet weekly to discuss patients with liver and pancreatic disorders.

Pancreatic disease is relatively uncommon. According to Hansen, breast cancer may have in the neighborhood of 225,000 patients per year, whereas pancreatic cancer strikes about 40,000 patients per year.

At Providence Cancer Center, doctors focus on conditions, such as pancreatitis. Two groups are affected.

In one group, Hansen said, there is a relationship between the consumption of moderate to large amounts of alcohol and the development of pancreatitis. The other group has patients whose pancreatitis was caused by gall stone disease.

“Pretty much anybody can be afflicted with disease of the pancreas,” he said, noting that symptoms for acute pancreatitis can include significant stomach pain that can radiate to the back, nausea and vomiting.

Doctors face a much tougher foe in pancreatic cancer.

“It’s really a difficult one to diagnose. It has such an insidious onset,” Hansen said, pointing out that symptoms can include nausea, abdominal pain, weight loss and skin that turns yellow (or jaundice).

“By the time they present with those symptoms, usually it’s thought that the cancer has probably been there between two and five years,” Hansen said. “When tumors are small, they just don’t cause a lot of symptoms and our bodies are incredibly effective at living well even though there are problems.”

He added, “We can only operate on between 10 and 20 percent of patients who get the diagnosis. In those other 80 percent, it has already spread beyond the pancreas at the time that we find out about it.”

Between 20 and 25 percent of patients are cured of the cancer through surgery, Hansen added.

Another factor that’s frustrating, for both doctors and patients, is that there are no effective screenings for pancreatic cancer.

“There are no screening tools (such as X-rays or blood tests) that we have that are accurate enough to identify patients early on in the disease process,” he said.

The stats are certainly scary, but Hansen said, for some patients, there are new options.

“We have some new chemotherapeutic options, which have been developed in the last couple of years,” he said. “We’re starting to see better responses to chemotherapy than we’ve ever seen before. That’s opening a lot of doors right now, allowing us to operate on a lot of patients that we couldn’t before.”

Hansen gets satisfaction from working in this particular branch of medicine.

“From a technical and medical perspective, it’s a very challenging series of problems,” Hansen said. “You’re interacting with patients at a time when they’re at their most distressed. For me, it’s rewarding to be able to step in and really make a difference, at that point.”

CONDITIONS OF THE PANCREAS

Diabetes, type 1: The body’s immune system attacks and destroys the pancreas’ insulin-producing cells. Lifelong insulin injections are required to control blood sugar.

Diabetes, type 2: The pancreas loses the ability to appropriately produce and release insulin. The body also becomes resistant to insulin, and blood sugar rises.

Cystic fibrosis: A genetic disorder that affects multiple body systems, usually including the lungs and the pancreas. Digestive problems and diabetes often result.

Pancreatic cancer: The pancreas has many different types of cells, each of which can give rise to a different type of tumor. The most common type arises from the cells that line the pancreatic duct. Because there are usually few or no early symptoms, pancreatic cancer is often advanced by the time it’s discovered.

Pancreatitis: The pancreas becomes inflamed and damaged by its own digestive chemicals. Swelling and death of tissue of the pancreas can result. Although alcohol or gallstones can contribute, the cause of most pancreatitis is unknown.

Pancreatic pseudocyst: After a bout of pancreatitis, a fluid-filled cavity called a pseudocyst can form. Pseudocysts may resolve spontaneously, or they may need surgical drainage.

Islet cell tumor: The hormone-producing cells of the pancreas multiply abnormally, creating a benign or cancerous tumor. These tumors produce excess amounts of hormones and then release them into the blood. Gastrinomas, glucagonomas, and insulinomas are examples of islet cell tumors.

Enlarged pancreas: An enlarged pancreas may mean nothing. You may simply have a pancreas that is larger than normal. Or, it can be because of an anatomic abnormality. But other causes of an enlarged pancreas may exist and require treatment.

Webmd.com

Scott Keith is a freelance writer for the Portland Tribune and Pamplin Media Group. If you have a health tip, or a story idea, contact Scott at: This email address is being protected from spambots. You need JavaScript enabled to view it.

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