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Pancreatic cancer - Types, Symptoms, Causes, Risk

Factors, Tests, Treatment

Summary : Pancreatic cancer is when cancer cells grow in an uncontrolled manner and form masses or tumours in the pancreas. Tumours can impair the pancreas's ability to function, producing pain and other symptoms. It’s hard to detect pancreatic cancer at an early stage, as cancer may not show symptoms until it has advanced. The pancreatic cancer prognosis tends to be poor because of the disease's aggressiveness and delayed detection.

What is pancreatic cancer ?

Pancreatic cancer occurs when pancreatic cells develop mutations and become cancerous (malignant). These abnormal cells multiply uncontrollably, grow to form a mass (tumour), and then spread to other body parts.

Pancreatic cancer affects the pancreas, which is challenging to identify in its early stages because it can grow for some time before it causes pressure in the stomach or cause any pain sensation.

What are the Pancreas, and what are its normal functions ?

The pancreas is located behind the stomach in the abdomen and front of the spine. The pancreas is an essential organ in our body, performing both endocrine and exocrine functions. It is crucial in maintaining proper digestion and regulating blood sugar levels. It also aids in digestion through the release of digestive enzymes.

What are the types of pancreatic cancer ?

Pancreatic cancer types are divided into two main categories :

exocrine pancreatic cancer, which includes adenocarcinoma, and neuroendocrine pancreatic cancer.

Exocrine (non-endocrine) pancreatic cancer : Adenocarcinoma begins in exocrine cells responsible for producing pancreatic enzymes.

Neuroendocrine pancreatic cancer : Begins in endocrine cells responsible for producing hormones.

What are pancreatic cancer symptoms ?

Pancreatic cancer symptoms may be changeable, often non-specific, and represent a variety of possibilities besides pancreatic cancer. Characteristically, pale bowel movements, itching, dark urine, and jaundice may indicate the growth of pancreatic cancer. Weight loss, tiredness, loss of appetite, and less energy. Pain may be present if the tumour is advanced.

Studies have indicated that pancreatic polypeptide is frequently secreted by pancreatic endocrine tumours and is considered a sign of such tumours. Blood clots are strongly linked with pancreatic cancer and can be the initial symptom of the disease.

The common signs and symptoms of pancreatic cancer may include:

  • Pain, usually in the abdomen or back
  • Pancreatitis (swelling of the pancreas)
  • Weight loss
  • Diarrhea
  • Nausea
  • Jaundice with or without itching
  • Changes in stool
  • Recent-onset diabetes
  • Loss of appetite

When should I see a doctor ?

Schedule an appointment with your general practitioner if you have any bothersome, unexplained symptoms. The physician might suggest a few diagnostic tests to rule out pancreatic cancer in addition to other medical issues. If the cancer is confirmed, you will be referred to an oncologist or gastroenterologist for additional pancreatic cancer treatment.

What are the causes of pancreatic cancer ?

Pancreatic Cancer occurs due to alterations in the DNA; it can happen slowly or be inherited from your parents. The changes that occur over time may result from exposure to harmful factors or a random process.

The actual cause of pancreatic cancer is unclear. Nearly ten per cent of pancreatic cancer cases are believed to be inherited or familial. Cancer may appear at any time, but smoking, obesity, and old age increase the risk of getting it.

Which factors increase the risk of pancreatic cancer ?

The pancreatic cancer risk factors are as follows :

  • Smoking
  • Obesity
  • Old age
  • Type 2 diabetes
  • Excess alcohol consumption
  • Male gender
  • Liver Cirrhosis
  • Pancreatitis (Chronic inflammation of the pancreas)
  • Family history of pancreatic cancer
  • A family history of DNA mutations that can raise the risk of cancer

How to prevent pancreatic cancer ?

Pancreatic cancer cannot be completely avoided, but it’s possible to avoid its risk factors, like :

  • Quit smoking
  • Maintain healthy weight
  • Exercise regularly
  • Avoid excess alcohol consumption
  • Stay away from toxic chemicals, especially at your workplace
  • Keep diabetes under control
  • Get reguslar health check-ups

What are pancreatic cancer diagnostic tests ?

Detecting pancreatic cancer can be challenging during the initial stages. If your healthcare provider thinks you might have pancreatic cancer, they might ask you to take some tests to look at your pancreas. These tests will help them see if there are any signs of cancer.

  • Blood tests : A blood test for the pancreas can identify tumour markers. The chemical substances released by cancer are known as tumour markers.High levels of carbohydrate antigen (CA) 19-9, a marker detects pancreatic cancer.

  • Abdomen ultrasound : An ultrasound scan uses sound waves to make pictures of the blood vessels and organs in your abdomen. The ultrasound scan of the abdomen shows abnormal growth (pancreatic tumour) and changes, including blood flow.

  • Computerised tomography (CT) scan : A CT scan is an imaging test that accurately pictures organs inside the body. It is helpful in diagnosing pancreatic cancer and its spread to surrounding organs.

  • Magnetic resonance imaging (MRI) scan : MRI scans produce precise images of body parts using radio waves and magnets instead of X-rays. Advanced MRI scans can also be used to monitor pancreatic cancer, such as :
    ⦁ MR cholangiopancreatography (MRCP)
    ⦁ MR angiography (MRA)

  • Positron emission tomography (PET) scan : A PET scan is a diagnostic imaging technique that uses radiotracers to examine metabolic processes in the body. It can analyse changes in blood flow, metabolism, and regional chemical composition. PET scans are an effective tool for evaluating the degree of pancreatic cancer progression.

  • Endoluminal ultrasonography (EUS) : Endoluminal ultrasonography (EUS) is a minimally invasive test that uses endoscopy and ultrasound. It examines the area around your pancreas, stomach, and nearby lymph nodes. Doctors do it to check for pancreatic cancer and see how big it is. They also check if it has spread nearby.

  • Endoscopic retrograde cholangiopancreatography (ERCP) : ERCP is a procedure that uses X-rays and an upper GI endoscopy to diagnose and treat liver, bile, gall bladder, and pancreatic duct problems. It could be used to learn more about pancreatitis or liver, pancreas, or bile duct cancer.

  • Percutaneous transhepatic cholangiography (PTC) : This procedure helps doctors see the bile ducts to find blockages. It can help to diagnose pancreatic tumours as they can be one of the reasons for bile duct obstruction.

  • Laparoscopy : It is a surgical operation using small incisions to access the inside of your abdomen and pelvis. Doctors perform this test to confirm if someone has pancreatic cancer and to check if it has metastasised.

  • Biopsy : A biopsy is when doctors take a small piece of tissue to check if it's cancerous. During certain medical procedures like EUS, ERCP, or laparoscopy, a tiny tool attached to the endoscope can collect cells for a biopsy.

What are the pancreatic cancer treatments ?

Treatment for pancreatic cancer is based on the patient's age, overall health, and the tumour's kind, size, and extent. Pancreas cancer is often complicated to treat because it's often discovered too late. Pancreatic cancer is curable if detected early on before it has metastasised to other organs.

Radiation therapy, chemotherapy, and surgery are the treatments used to treat pancreatic cancer. Three types of curative surgeries are commonly done to treat pancreatic cancer disease, they are:

  • Pancreatoduodenectomy (Whipple Procedure)
  • Distal pancreatectomy
  • Total pancreatectomy

Radiation therapy (also called radiotherapy) : With radiation therapy, cancer cells are destroyed, or tumour growth is inhibited by using high-energy X-rays or other types of radiation. To reduce tumour size before surgery, some patients receive radiation therapy. Three types of radiotherapy are mainly used to treat pancreatic cancer: external beam therapy (EBT), stereotactic body radiotherapy (SBRT) and proton therapy.

Chemotherapy : Drugs are administered intravenously (via a vein) or orally as part of this treatment to either kill or prevent cancer cells from expanding. Radiation therapy and chemotherapy can be used separately or together.

Cancers of the endocrine pancreas are sometimes minor, and no treatment is necessary. However, they can provoke serious hormonal disorder that has to be treated.

Similar to all cancers, treatment for pancreatic cancer uses the latest technologies. Various imaging techniques, including intravenous pyelogram (IVP), ultrasound scan, computerised tomography (CT) scans, and magnetic resonance imaging (MRI), provide very detailed images of the pancreas, uncovering masses and allowing physicians to tailor treatment options and recommendations precisely.

FAQ’S

1. What is pancreatic cancer disease?

Pancreatic cancer is when cancer cells grow in an uncontrolled manner and form masses or tumours in the pancreas. Tumours can impair the pancreas's ability to function, producing pain and other symptoms.

2. How to prevent pancreatic cancer?

Although it is not possible to completely prevent pancreatic cancer, it is possible to lower the risk by avoiding pancreatic cancer risk factors. On rare occasions, precancerous lesions can be found and removed early to stop the development of pancreatic cancer.

3. What are the pancreatic cancer symptoms?

Early-stage pancreatic cancer does not have any particular symptoms. Still, you should consult your healthcare provider if you experience stomach pain, jaundice (yellowing of the skin), or unintentional weight loss.

4. Can pancreatic cancer patients make a full recovery?

Yes, pancreatic cancer patients can make a full recovery.

5. Is it possible to survive without the pancreas?

It is possible to survive without a pancreas, but you will develop diabetes and need to take insulin regularly. To aid in food digestion, you will also need to take enzyme supplements.

6. Which doctor treats pancreatic cancer disease?

A medical oncologist and gastroenterologist treat pancreatic cancer disease.