Pain is usually the complaint that motivates one to seek a physician's care, but by the this time the cancer has spread to the metastatic state. Almost all patients will have pain at some point caused by pressure from the tumor or splenic nerve intervention. Screening tests for asymptomatic patients are unreliable due to the deep anatomical location of the pancreas. Invasive procedures such as endoscopic retrograde for the asymptomatic patient. Conventional ultrasonograpghy is limited by visual difficulties in the obese or in the presence of bowel, gas and a limited range of resolution.
Surgery involves removal of the head of the pancreas, or the total removal of the pancreas.
These surgical resections are performed only when the potential for a cure exists. Bypasses are done for areas which are obstructed by tumor growth. Surgery is not performed if the disease has spread beyond the pancreas. Radiation Therapy is used to kill cancer cells and shrink tumors by use of x-rays or internal radiation therapy with radioisotopes. It is also used post operatively as an adjutant to chemotherapy, but the decrease in mortality is not conclusive and gastrointestinal bleeding and distress are adverse effects.