Testicular Cancer: Quick Facts

Testicular Cancer: Quick Facts

What is Testicular Cancer?

About 8,000 men are diagnosed with testicular cancer and 390 die each year in the US. Testicular cancer originates in the part of the male reproductive system known as the testes, or testicles. The various types of testicular cancer differ by types of cells where cancer begins. Over 90% of testicular cancer cases are germ cell carcinoma, which begins in the germ cells that are located in the testes and are precursors to sperm cells. The two main types of germ cell carcinoma are seminoma (normally grow slowly and rarely metastasize) and nonseminoma (normally occur at an early age and grow more aggressively). Stromal cell tumors arise from the stroma, which is the hormone-producing tissue of the testicles. The two main types of stromal tumors are Leydig cell tumors and Sertoli cell tumors. Leydig cell tumors develop from cells that produce androgen (male sex hormone) and rarely metastasize. Sertoli cell tumors develop from cells that nourish & support germ cells and rarely spread. However, when Leydig or Sertoli cell tumors do spread, they are tough to treat.

Who’s at risk?

Age: Most common in men 15-40 years old.

Caucasians at greater risk than Asians or African-Americans

Family history of testicular cancer

Personal history of testicular cancer

Occupation: Miners, oil/gas workers, janitors, & utility workers are at high risk due to exposure to certain chemicals.

Carcinoma in situ: Symptom-less condition that almost always progresses to cancer.

Cryptorchidism: “Undescended testicle” is a condition that affects about 3% of newborns. Even men who have the condition corrected early in life are at higher risk.

Prevention

Certain lifestyle & dietary habits can reduce your risk, including:

Not smoking

Regular exercise

Moderate, if any, alcohol consumption

Low fat, high fiber diet

Symptoms

Testicular cancer normally is detected by the patient himself. Other symptoms include:

Heaviness or aching in the lower back or scrotum

Breast tenderness or growth

Fluid accumulation in the scrotum

How is it diagnosed?

If the patient or doctor suspects testicular cancer, a number of tests can be done to determine if cancer is present, including:

Self-Exams: Periodic self-exams of the testicles are an important way to detect changes/abnormalities. Males should begin performing self-exams in adolescence.

Ultrasound: Sound waves used to create an image of the testicle and surrounding tissue; normally used to rule out non-cancerous causes of the symptoms.

MRI: An imaging test that allows the physician to see the structure of the testicle & identify any abnormalities.

Blood test: High levels of certain proteins indicate cancer.

Biopsy: A tissue sample is removed surgically & examined for presence of cancer cells. Sometimes a testicle is removed.

Lymphangiography: A special dye injected into the lymph vessels travels to the lymph nodes. This helps the doctor determine if the cancer has spread.

CT scan: X-ray beams are used from a variety of angles to create an image of the infected area.

Treatment options

Treatment options for testicular cancer vary with stage of diagnosis. Treatment plans differ by individual, but surgery is usually part of the treatment. Here are several common options:

Radical Inguinal Orchiectomy: A testicle is removed by making an incision through the groin and cutting the spermatic cord, which attaches the testicle to the body.

Retroperitoneal Lymph Node Dissection: A large incision is made in the abdomen to access the affected area and remove lymph nodes from the groin area. Often this is done at the same time as radical inguinal orchiectomy or is performed later.

Radiation Therapy: External beam radiation or x-rays are used to kill or shrink cancer cells. It affects only a specific area of the groin where the tumor is located.

Chemotherapy: Drugs given by mouth or injection enter the blood stream & kill cancer cells; affects all areas of the body.

Clinical Trials: Experimental treatments are always being tested. The effectiveness & side effects aren’t always known. They can offer hope, especially for end-stage patients. Talk to your doctor or the RI Cancer Council for more information.

Testicular Cancer Facts

· This disease occurs most often in men between the ages of 20 and 39. It accounts for only 1 percent of all cancers in men.

· Risk factors include having an undescended testicle, previous testicular cancer, and a family history of testicular cancer.

· Symptoms include a lump, swelling, or enlargement in the testicle; pain or discomfort in a testicle or in the scrotum; and/or an ache in the lower abdomen, back or groin.

· Diagnosis generally involves blood tests, ultrasound, and biopsy.

· Treatment can often cure testicular cancer, but regular follow-up exams are extremely important.

CHILDHOOD CANCER FACTS


CHILDHOOD CANCER FACTS

Presently there are 10,000 children living with cancer in Canada today, that is 10,000 too many!

Each year, about 1500 new cases of childhood cancer are diagnosed in Canada.

Cancer is the leading disease related cause of death among kids in Canada after the first year of life. More deaths than asthma, diabetes, cystic fibrosis and AIDS combined.

In contrast to many of the cancers affecting adults, the causes of cancer in childhood are largely unknown.

Leukemias, tumours of the brain and nervous system, the lymphatic system, kidneys, bones and muscles are the most common childhood cancers.

Childhood cancers have close to a 75% cure rate, with leukemia leading the success charge with close to 90% overall cure rate.

One in four children who are diagnosed with cancer will die of the disease.

With a mortality rate of close to 25%, Canada loses tens of thousands of years of potential life each year to childhood cancer. In terms of potential life saved, childhood cancer ranks second only to breast cancer.

Approximately 2/3 of survivors of childhood cancer face late effects of their disease and treatment, including neurocognitive impairments, sterility and secondary cancers.

1 in 330 individuals under the age of 20 will be diagnosed with a malignant disease.

Studies show that treatment related out-of-pocket costs add up to approximately 1/3 of after tax income annually which relates to hundreds of millions of dollars on already emotionally and financially burdened families.

More than 82 percent of children diagnosed with cancer become long-term survivors and the majority of them are considered cured.

Long-term effects of surviving the treatments for childhood cancer can affect these children's futures.

In the early 1950s, less than 10 percent of childhood cancer patients could be cured.

Children are most affected by acute leukemia, tumours of the brain and nervous system, the lymphatic system, kidneys, bones and muscles.

Lymphomas and cancers of the central nervous system are the second most diagnosed children's cancer, at 17% of total cancers diagnosed.

Sarcomas, or cancers of the muscles, bones, nerves, fat, blood or connective tissue are next at 12%, with boys 25-30% more likely to contract this form of cancer.

Neuroblastoma, which represents 95% of tumours in the sympathetic nervous system, represents 5% of all childhood cancers.

Because of significant advances in therapy, 82% of these children will survive 5 years or more, an increase of almost 46% since the early 1960s.

Cancer begins with the transformation of a single cell. We have yet to understand why-if we only knew!

Non-Hodgkin Lymphoma

Non-Hodgkin Lymphoma

Definitions

Bone marrow: The bone’s inner, spongy core that produces blood cells.

Immune system: Cells whose function is to fight infections and disease.

Lymph nodes: Part of the immune system, lymph nodes store white blood cells and trap and remove bacteria and other harmful substances. Lymph nodes are located in the neck, underarms, chest, abdomen, and groin and connect to lymph vessels, which circulate white blood cells throughout the body.

White blood cells: Cells that make up the immune system.

Pathologist: A physician who examines tissues and fluids to diagnose disease in order to assist in making treatment decisions.

What is non-Hodgkin lymphoma?

A cancer of the immune system, non-Hodgkin lymphoma often causes enlarged lymph nodes, fever, and weight loss. Some forms of this cancer are aggressive and fast-growing while others are indolent and slow-growing. Each year, about 66,000 new cases of non-Hodgkin lymphoma occur in the United States, making it the fifth most common cancer. About 19,000 Americans die each year from this disease.

While survival rates depend on the type of lymphoma and how much it has spread, the

five-year average survival rate for people with non-Hodgkin lymphoma is 63 percent and 10-year survival is 51 percent. Recent treatment advancements are likely to improve survival rates for newly diagnosed patients.

Who is likely to have non-Hodgkin lymphoma?

Certain risk factors increase the chances of an individual developing this disease. These risk factors include a weakened immune system caused by a medical condition; certain types of infections including HIV, Epstein-Barr virus, H. pylori, (which causes stomach ulcers), hepatitis C, and human T-cell leukemia/lymphoma virus type 1 (HTLV-1); and autoimmune diseases such as rheumatoid arthritis and lupus. Researchers are studying other possible risk factors including obesity and exposure to herbicides. While non-Hodgkin lymphoma can occur at any age, most people with this cancer are older than 60.

Having one or more risk factors does not mean that a person will develop non-Hodgkin lymphoma. Most people who have risk factors never develop cancer.

What characterizes non-Hodgkin lymphoma?

Symptoms include swollen, painless lymph nodes; weight loss; fever; and night sweats.

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How does the pathologist make the diagnosis?

If you have enlarged lymph nodes or another symptom suggesting non-Hodgkin lymphoma, your primary care doctor may ask about your personal and family medical history, perform a physical exam, and order a blood test to check your white cell count. Your doctor may also order a chest x-ray. The pathologist may assist in the review of these test results.

In a procedure known as a biopsy, a pathologist examines an entire lymph node or part of one under a microscope, checking the tissue for lymphoma cells. If lymphoma is found, the pathologist reports the type, including whether the lymphoma is fast- or slow-growing.

What else does the pathologist look for?

If lymphoma is found, the pathologist will help evaluate tests that examine if the primary tumor in the lymph node has spread to the liver, lungs, bone, or bone marrow. These tests may include a bone marrow biopsy or spinal tap.

What is meant by the stage of the cancer?

Your pathologist and primary care doctor determine the cancer’s stage to plan the best treatment. Stage I cancers are small and confined to one lymph node group, and stage IV tumors have spread into other parts of the body. Stages II and III describe states in between these two extremes.

How do doctors determine what treatment will be necessary?

Your treatment will depend on the type of non-Hodgkin lymphoma you have, its stage, how quickly the cancer is growing, your age, and whether or not you have other health problems. Medical professionals, including pathologists, oncologists, and radiologists, use their combined experience and knowledge and recommend treatment options most appropriate for your condition It’s important to learn as much as you can about your treatment options and make the decision that’s right for you.

What kinds of treatments are available for non-Hodgkin lymphoma?

If you have slow-growing non-Hodgkin lymphoma without symptoms, you may not need to undergo treatment right away. Instead, your physician will watch your health closely and begin treatment after symptoms begin. This approach is called watchful waiting.

If you have slow-growing lymphoma with symptoms, your physician may recommend chemotherapy and biological therapy. Physicians prescribe cancer-killing drugs delivered through oral or IV medicines, which can kill or slow the progression of tumor cells and reduce symptoms. These drugs are usually given in outpatient treatment cycles scheduled three or four weeks apart. The most common combination of drugs is called CHOP–cyclophosphamide (Cytoxan), doxorubicin (Adriamycin), vincristine (Oncovin), and prednisone. Another common combination called CVP leaves out doxorubicin. Other chemotherapy drugs used to treat this cancer are chlorambucil, fludarabine, and etoposide.

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Biological therapy activates the natural defenses of the immune system–or uses versions of natural substances made in the laboratory–to kill lymphoma cells and slow their growth. Pathologists may request and interpret a special laboratory test that helps the medical team to determine your cancer’s likely response to specialized biologic therapies.

If the slow-growing tumor is in stage I or II, your physician may recommend radiation therapy–pinpointed high-energy beams that can shrink tumors or destroy cancer cells remaining after surgery.

For fast-growing lymphomas, physicians often recommend a combination of chemotherapy and biological therapy and sometimes include radiation therapy.

If a non-Hodgkin lymphoma patient experiences a relapse or recurrence of the cancer after treatment, physicians may recommend high doses of chemotherapy, radiation therapy, or both followed by stem cell transplantation. In this procedure, lymphoma cells destroyed by cancer treatment are replaced by stem cells that produce healthy blood cells and help the bone marrow to recover.

Non-Hodgkin lymphoma and its treatment can lead to other health problems, such as anemia and infections. Drugs or blood transfusions are used to treat anemia, and your physician may prescribe antibiotics or other drugs to manage infections. Any infection you develop can be serious, and you will need treatment as soon as possible.

Complementary and alternative medicine approaches may contribute to healing by helping patients to manage stress and pain. These approaches include massage, behavioral therapy, meditation, and spirituality. Eating right and staying physically active are also very important, even though on some days you will feel tired and not have an appetite.

Patients should consider enrolling in a clinical trial, which tests new treatments. These treatments are experimental in nature but may be an option, especially for advanced cancers. Clinical trials for non-Hodgkin lymphoma may be found at www.cancer.gov/clinicaltrials or by calling NCI’s Cancer Information Service at

800-4-CANCER (800-422-6237).

For more information, go to www.cancer.gov (National Cancer

Institute) or www.cancer.org (American Cancer Society). Type the keywords non- Hodgkin lymphoma into the search box.

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What kinds of questions should I ask my doctors?

Ask any question you want. There are no questions you should be reluctant to ask. Here are a few to consider:

Please describe the type of cancer I have and what treatment options are available.

What is the stage of my cancer?

What are the chances for full remission?

What treatment options do you recommend? Why do you believe these are the best treatments?

What are the pros and cons of these treatment options?

What are the side effects?

Is your medical team experienced in treating the type of cancer I have?

Can you provide me with information about the physicians and others on the medical team?

If I want a second opinion, could you provide me with the names of physicians and/or institutions that you would recommend?

Pancreatic Cancer -3

PANCREATIC CANCER

4th leading cause of cancer deaths in G and E. 25,000 cases/yr in the U.S. and nearly that # of deaths. Vast majority of pts present w/unresectable disease & 5 yr survival is ~ 5%.

Cause of tumor is unknown. Risk factors include smoking & chronic pancreatitis.

1/2 of pancreatic Ca arise in the head, 1/2 in the body and tail.

Distal common bile duct runs through pancreatic head. Pancreatic Ca most often occur in this area making this tumor the most commonly associated w/malignant biliary obstruction.

Courvoisier' s law: Obstructing malignancies of the distal CBD produce a palpable non-tender gallbladder. Why? Because common duct stones (the main DDx) are usually associated w/chronic cholecystitis à contracted gallbladder.

Pancreatic Adenocarcinoma

Clinical manifestations depend on location where the tumor arises. Does not announce its presence unless bile duct is obstructed.

1. Arising in the head: tend to obstruct the common bile duct, causing jaundice or distended, non-tender gall bladder. May be able to palpate bile duct in thin patient.

2. Otherwise non-specific: weight loss and pain (due to neural invasion of the tumor).

3. Laboratory tests are not specific.

Imaging studies:

Endoscopic US

MRI

Dilated bile duct & pancreatic duct may suggest mass in pancreas.

CEA and CA 19-9 tend to be ­

Although US and radiologic imaging have ­ diagnostic accuracy, it is not easy to make diagnosis in an early stage. Because of the difficulty of diagnosis, only 10-15% are candidates for surgery.

Treatment:

Surgical resection: Potentially "curative" surgery is only possible in 10-15% of pts who present w/early tumors à jaundice due to bile duct obstruction.

1. Whipple's procedure: proximal pancreatectomy, duodenectomy, partial gastrectomy and gastrojejunostomy.

2. Palliation: biliary bypass, chemotherapy, radiation.

Prognosis: Dismal. 5 year survival is approximately 5%. 5-year survival of patients who under surgical resection for cure is only 10%. The mean survival for patients with surgically unresectable tumors is 5 months. Palliative treatment is aimed at relieving biliary obstruction and treating pain.

Pancreatic Islet Cell Tumors

Tumors arising in endocrine portion of the pancreas are rare compared to adenocarcinomas. They can be benign or malignant, and functional (release hormones) or non-functional. Distinct clinical syndromes associated with hyperfunctioning islet cells include insulinoma, gastrinoma (Zollinger-Ellison syndrome), glucagonoma, and somatostatinoma

Pancreatic Cancer

THE PANCREAS

The pancreas is located in the abdomen, tucked behind the stomach. between the upper part of your small intestine (duodenum) and the spleen. It is shaped somewhat like a tadpole - fat at one end and slender at the other - and is around 25cm in length.

Pils Diagram

The pancreas serves two distinct and vital functions;

1. The exocrine pancreas

Once food has been mulched and partially digested by the stomach, it is pushed into the duodenum (first part of the small intestine). The pancreas helps to digest food, particularly protein. Most of the pancreas is compose of cells called exocrine cells that produce digestive enzymes. Pancreatic enzymes flow from these cells through small ducts into the main pancreatic duct, which leads to the duodenum. Pancreatic juices contain enzymes that only become activated once they reach the duodenum. This is to prevent the protein-digesting enzyme trypsin from 'eating' the protein-based pancreas or its duct. Other enzymes produced by the pancreas include amylase (to break down carbohydrate) and lipase (to break down fats).

The exocrine pancreas also makes sodium bicarbonate, which helps to neutralise stomach acid entering the duodenum.


2. The endocrine pancreas

The pancreas makes the hormone insulin, which helps to control blood sugar levels. Insulin is manufactured by a small clump of pancreatic cells called the 'islets of Langerhans'. High blood sugar levels prompt the release of insulin, so that the sugars can pass into cells. The endocrine pancreas also
makes glucagon, another hormone involved in the regulation of blood sugar.

DIAGNOSIS OF PANCREATIC DISEASE

Diagnostic methods depend on the disorder under investigation, but may include:

· General tests - such as blood tests, physical examination and x-rays.

· Ultrasound - sound waves form a picture of the pancreas.

· Computerised tomography (CT) scan - a specialised x-ray takes three-dimensional pictures of the pancreas.

· Magnetic resonance imaging (MRI) - similar to a CT scan, but
magnetism is used to build three-dimensional pictures.

· Endoscopy (ERCP) - a thin telescope is inserted down the throat. This device may be used to inject contrasting dye into the pancreatic duct prior to x-rays.

· Laparoscopy - the pancreas is examined through a slender instrument
inserted into the abdomen.

· Biopsy - a small tag of pancreatic tissue is taken out with a needle and examined in a laboratory.



PANCREATITIS

The pancreas plays important roles in both digestion and metabolism. These functions may be affected by pancreatitis, an inflammatory condition that occurs when pancreatic digestive enzymes become active within the gland and attack the pancreas itself.

Pancreatitis can be acute — appearing suddenly and lasting for a few days — or it can be chronic, developing gradually and persisting over many years. Both acute and chronic pancreatitis are marked by mild to severe abdominal pain, often with nausea, vomiting and fever. Both can lead to serious complications.

Heavy alcohol use and gallstones are the primary causes of pancreatitis, but other factors, including certain medical conditions, some drugs and genetic mutations also can lead to the disorder. Sometimes the cause is never found..

ACUTE PANCREATITIS

Acute pancreatitis is inflammation of the pancreas. This is a medical emergency and requires prompt treatment. It occurs when the pancreas suddenly becomes inflamed - the enzymes can't leave the pancreas and so cause irritation and burning. Enzymes may also leech into the abdominal cavity.

The two most common causes for pancreatitis are:

· Drinking too much alcohol

· Gallstones

Other causes include:

· Medications such as corticosteroids, nonsteroidal anti-inflammatory drugs, thiazides used for blood pressure lowering, antibiotics including tetracyclines and sulphonamides and immunosuppression with azathioprine and 6-mercaptopurine.

· Increased levels of triglycerides (fats) or calcium in the blood.

· Viral infections including mumps

· Damage or trauma to the pancreas

· Pancreatic cancer

Acute pancreatitis comes on suddenly, usually with mild to severe pain in the upper abdomen that may radiate through to the back and occasionally to the chest. The pain may be nearly constant for hours or even days and is likely to be worse with food. Bending forward or curling into a fetal position may provide some temporary relief.

Apart from pain the presentation may feature:

· Nausea and vomiting

· Fever

· Rapid pulse

· Swollen, tender abdomen

When severe, dehydration, internal bleeding, low blood pressure or shock

DIAGNOSIS


If acute pancreatitis is suspected, the doctor will arrange blood tests to look for:

· Elevated levels of pancreatic enzymes—amylase or lipase

· Elevated white cell count

· High blood sugar

· Elevated liver enzymes and bilirubin

· Low calcium levels

· Oxygen status

Because laboratory tests can't confirm a diagnosis of acute pancreatitis, the doctor may request an ultrasound or computerized tomography (CT) scan of your abdomen to examine your pancreas and to check for gallstones, a duct problem, or destruction of the gland. You may also have X-rays of your abdomen and chest to rule out other reasons for your symptoms.

COMPLICATIONS

Severe cases of acute pancreatitis may lead to a number of complications:

· Infection A damaged pancreas may become infected with bacteria that spread from the bowel into the inflamed pancreas. The infection may also spread to the blood-stream. Signs of infection include fever and an elevated white blood cell count. Pancreatic infections can be fatal without intensive treatment which may include drainage and surgical removal to remove infected and/or dead tissue. Sometimes multiple such operations are needed. Multi-organ failure may also occur.

· Pseudocysts These are collections of pancreatic fluid and tissue debris that form within the pancreas or in an obstructed duct. If small no specific treatment may be necessary but if large, bleeding or infected then urgent measures are needed.

· Abscess A collection of pus in or near the pancreas. Treatment involves drainage by needle, catheter or surgery.

· Respiratory failure Chemicals circulating in the blood can effect lung function, causing the level of oxygen in the blood to fall to low levels.

TREATMENT

Acute pancreatitis usually requires admission to hospital. Severe cases or those with complications often need admission to an Intensive Care Unit. Treatment goals include controlling the pain, allowing the pancreas to rest, careful fluid balance and maintaining full respiratory function.

Because the pancreas goes into action whenever you eat, you won't be able to eat or drink for a few days. Instead, you'll receive fluids and nutrition through a vein (intravenously). Your doctor may also feed you through a tube that's been passed into your stomach and intestine so that it goes past the pancreas. Placing the tube in the bowel beyond the pancreas ensures that the pancreas is not stimulated, yet you can still receive the nutrition you need.

When gallstones block the pancreatic duct, your doctor may recommend a procedure to remove the stones. You may eventually need surgery to remove your gallbladder if gallstones continue to pose problems.

Mild cases of acute pancreatitis generally improve in a week or less. Moderate to severe cases take longer.

CHRONIC PANCREATITIS


Chronic pancreatitis means recurring bouts of inflammation, even when known triggers (such as alcohol) are eliminated. Alcoholics are at increased risk of developing this condition. The relentless inflammation eventually damages or destroys parts of the pancreas, reducing its function. Symptoms include digestive upsets and passing fatty, foul-smelling stools.

In addition to pain, one may experience the following with chronic pancreatitis:

· Nausea and vomiting

· Fever

· Weight loss, even when appetite and eating habits are normal

· Oily, malodorous stools resulting from poor digestion and malabsorption of nutrients, particularly fats (steatorrhea)

· Diabetes

DIAGNOSIS

Diagnosing chronic pancreatitis can be challenging because some tests may yield normal results. It can also be difficult to distinguish acute from chronic pancreatitis. Even so, certain tests can help rule out other problems and aid in the diagnosis.

These include:

· Blood tests.

· Stool test. This measures the fat content in feces. Chronic pancreatitis often causes excess fat in the stool because the fat isn't digested and absorbed normally by the small intestine.

· Pancreatic function test. If there is weight lost or the doctor suspects a malabsorption problem, a pancreatic function test can be used. Several tests exist but are not commonly used.

· Ultrasound. In standard (external) ultrasound, a wand-like device (transducer) is placed on the body. It emits inaudible sound waves that are reflected to the transducer and then translated into a moving image by a computer.

· Endoscopic ultrasound may provide images of the pancreas and bile and pancreatic ducts that are superior to those produced by standard ultrasound.

· ERCP (X-ray of bile and pancreatic ducts). The doctor gently threads an endoscope down the throat and through the stomach to the opening of the bile and pancreatic ducts in the duodenum. A dye passed through a thin, flexible tube (catheter) inside the endoscope allows for X-ray images of the ducts.

The complications common to acute pancreatitis can also occur in the chronic form of the disease. In addition, chronic pancreatitis can lead to:

· Bleeding. Ongoing inflammation and damage to the blood vessels surrounding the pancreas can cause potentially fatal bleeding.

· Malnutrition and weight loss. Lack of digestive enzymes prevents your body from absorbing nutrients from food. The result is often unintended weight loss and malnutrition.

· Diabetes. Damage to insulin-producing cells can lead to diabetes, a disease that affects the way your body uses blood sugar.

· Drug addiction. Because medical treatments for severe pancreatic pain aren't always effective, people with pancreatitis may become addicted to pain medications.

· Pancreatic cancer. Long-term inflammation of the pancreas increases your risk of pancreatic cancer, one of the most serious of all malignancies.

TREATMENT


The main goals of treatment for chronic pancreatitis are to help stop alcohol and drug abuse, control pain and improve malabsorption problems.

. Pain relief. Unlike acute pancreatitis, in which the pain often disappears within a few days to weeks, chronic pancreatitis pain can linger. However, conventional pain relievers can be ineffective and pose a real risk of addiction. Using potent pancreatic enzymes to treat pain has proved effective for some people. Enzyme therapy works by increasing the levels of enzymes in the duodenum, which in turn decreases the secretion of enzymes by the pancreas. This is thought to reduce secretion pressure — and hence, pain — within the pancreas. For severe pain that can't be controlled, treatment options include surgery to remove damaged tissue or procedures to block pain signals or deaden the nerves transmitting the pain.

Enzyme therapy. Enzyme supplements such as pancreatic lipase (Pancrease) can help treat malabsorption problems. By replacing missing enzymes, these tablets help restore normal digestion and improve steatorrhea, leading to weight gain and enhanced well-being. These supplements are generally taken before and during meals and snacks.

Dietary changes. Your doctor may recommend eating smaller meals and limiting fats, which will help reduce your need for as many digestive enzymes.

Diabetes
Chronic pancreatitis can cause diabetes in some people. Treatment usually involves maintaining a healthy diet and getting regular exercise. Some people also need insulin injections, although insulin must be used cautiously because of the risk of low blood sugar (hypoglycemia).

Therapy for alcohol dependency. This may be the most important step in treating alcohol-related pancreatitis. In the early stages of the disease, simply stopping drinking may relieve even severe pain. People who don't stop drinking have a significantly higher chance of dying of pancreatitis