Program Operations Manual System (POMS)
TN 1 (10-08)
DI 23022.265 Pancreatic Cancer
COMPASSIONATE ALLOWANCE INFORMATION
Pancreatic Cancer is a disease in which malignant (cancer) cells form in the tissues of the pancreas. Most pancreatic cancers begin in the ducts that carry pancreatic juices. The digestive juices are produced by exocrine pancreas cells and the hormones are produced by endocrine pancreas cells. About 95% of pancreatic cancers begin in exocrine cells.
Symptoms of this disease may include: pain in the upper abdomen or upper back; yellow skin and eyes, and dark urine from jaundice; weakness; loss of appetite; nausea and vomiting, and weight loss.
Exocrine cancer, Pancreatic Adenocarcinoma
DIAGNOSTIC TESTING AND CODING
To diagnose the disease the following may be done: physical exam, lab tests including blood, urine, and stool samples to check for bilirubin and other substances, CT scan, Ultrasonography: Transabdominal ultrasound or Endoscopic ultrasound (EUS), endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography (PTC), and biopsy. To determine the stage of the cancer tests such as CT scan, ultrasonography, laparoscopy or angiography may be appropriate.
People with pancreatic cancer may have several treatment options. Depending on the type and stage, pancreatic cancer may be treated with surgery, radiation therapy or chemotherapy. Some individuals have a combination of therapies. When a cure or control of the disease is not possible, some patients and their doctors choose palliative therapy.
Pancreatic cancer can be cured only when it is found at an early stage, before it has spread. However, other treatments may be able to control the disease and help patients live longer and feel better.
SUGGESTED PROGRAMMATIC ASSESSMENT*
Suggested MER for Evaluation: A pathology report showing the presence of a non-islet cell adenocarcinoma in the pancreas is the only test that can definitively make the diagnosis.
Suggested Listings for Evaluation:
13.20 A & B
* Adjudicators may, at their discretion, use the Medical Evidence of Record or Listings suggested to evaluate the claim. However, the decision to allow or deny the claim rests with the adjudicator.
Last Updated: 9/30/08
Office of Disability Programs