Pancreatic Cancer

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Pancreatic cancer begins in the tissues of your pancreas — an organ in your abdomen that lies behind the lower part of your stomach. Your pancreas releases enzymes that aid digestion and … Read More

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Pancreatic Cancer

What is pancreatic cancer?

Pancreatic cancer begins in the pancreas’s tissues— an organ in the abdomen that lies behind the lower part of the stomach. The pancreas produces enzymes that aid digestion and hormones that manage blood sugar levels. There are many types of growth that can occur in the pancreas. 

The most common type is called pancreatic ductal carcinoma. It begins in the cells of the ducts that carry digestive enzymes from the pancreas. It occurs when cancer starts in the tissues surrounding the pancreas. Uncontrolled cell growth in one part of the pancreas can lead to pancreatic cancer. This interferes with the way the pancreas works. Many growths can occur in the pancreas, i.e., cancerous and noncancerous. The most common cancer that forms in the pancreas starts in the cells that line the ducts that carry digestive enzymes out of the pancreas (pancreatic ductal adenocarcinoma).

Pancreatic cancer usually shows no symptoms until later stages. This makes it seldom detected at its early stages when it’s most curable. Thus, it may be challenging to manage. The extent of the treatment depends on its severity. There are many treatment options available, including chemotherapy, surgery, radiation therapy or a combination thereof.

Pancreatic Cancer
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Types

types of pancreatic cancer
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There are two types of pancreatic cancer:

  • Pancreatic adenocarcinoma: This accounts for about 95% of pancreatic cancers. This type develops in the exocrine cells of the pancreas.
  • Pancreatic neuroendocrine tumors (NETs): This is a less common type that develops in the endocrine cells of the pancreas.

What are the stages of pancreatic cancer?

stages of pancreatic cancer
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There are four stages of pancreatic cancer : 

Stage 1: The tumors only exist in the pancreas.

The Stage 2: At this stage, the tumors have spread to the nearby abdominal tissues or lymph nodes.

Stage 3: The spread has spread to major blood vessels and lymph nodes.

Stage 4: The spread has spread (metastasis) to other organs, such as the liver.

Causes

Pancreatic cancer occurs when pancreas cells develop changes in their DNA, which houses the guidelines of the cell’s activities. These mutations cause the cells to grow and divide uncontrollably and to continue living after normal cells have died. These accumulating cells end up forming a tumor. If left untreated, the cancer cells can spread to nearby organs, blood vessels and even distant body parts.

  • Smoking
  • Obese and overweight
  • Continuous exposure to chemicals in the workplace
  • Excessive alcohol intake
  • Poor oral hygiene and treatment

Symptoms

The symptoms don’t often occur until the disease is advanced.

  • Abdominal pain that radiates to the back.
  • Loss of appetite. 
  • Undeliberate weight loss.
  • Jaundice.
  • Light colored stools.
  • Dark colored urine.
  • Itchy skin.
  • Newly diagnosed or existing diabetes that’s becoming more difficult to control.
  • Blood clots.
  • Fatigue.
  • Depression.
  • Nausea, vomiting, and weakness.

How is pancreatic cancer diagnosed?

Pancreatic cancer diagnosis
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The following investigations may be carried out to diagnose the disease:

  • Imaging tests that create pictures of the internal organs: These help get a clear view of the internal organs, including the pancreas. Imaging techniques that can be used are computerized tomography (CT) scan, ultrasound, magnetic resonance imaging (MRI) and positron emission tomography (PET) scans.
  • Using an endoscope to create ultrasound pictures of the pancreas: An endoscopic ultrasound (EUS) with the use of an ultrasound device generates images of the pancreas from inside the abdomen.
  • ERCP (endoscopic retrograde cholangiopancreatography) is an invasive technique involving endoscopy and x-ray to visualize the bile ducts. It is considered to be the most sensitive test in diagnosing the disease.
  • Octreoscan: It is also called somatostatin receptor scintigraphy (SRS). This test is performed if there is concern about neuroendocrine tumors of the pancreas.
Octreoscan for pancreatic cancer
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  • Tissue biopsy: Collecting a small tissue sample for examination under a microscope. 
  • Blood test: For specific proteins (tumor markers) shed by pancreatic cancer cells.
  • Tumor markers: CA 19-9 is increased in pancreatic cancer patients.

Treatment

Pancreatic cancer treatment
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The treatment depends on the stage and location of cancer. Also, it depends on the patient’s overall health and personal preferences.

  • Surgery includes:
  1. Whipple procedure (pancreaticoduodenectomy): Removal of the tumors located in the pancreatic head. 
  2. Distal pancreatectomy: Removal of tumors in the pancreatic body and tail. The spleen may also be removed.
  3. Total pancreatectomy: Removal of the entire pancreas. This may require lifelong use of insulin and enzyme replacement.
  4. Removal of the tumors affecting nearby blood vessels.
  • Chemotherapy involves the use of drugs to kill the cancerous cell. These drugs are either injected directly into the vein or administered orally. 
  • Radiation therapy involves the use of high-energy beams in order to kill cancer cells.
  • Supportive (palliative) care: This is a specialized medical care that focuses on relief from pain and other symptoms of a severe illness.

FAQ

What is the pancreatic cancer survival rate?

The survival rate for a five-year rate for localized pancreatic cancer (stages 0, 1, and 2) is 34%.
The five-year survival rate for regional pancreatic cancer (stages 2B and 3) that has spread to nearby structures or lymph nodes is 12%.
The survival rate for a distant or stage 4 cancer that has spread to other sites like the lungs, liver, or bones has only a 3% survival rate.

How can I prevent pancreatic cancer?

The risk of the disease may be reduced by following the below-mentioned rules strictly:
a)       Quit smoking.
b)       Reduce alcohol intake
c)       Incorporate whole food.
d)       Maintain a healthy weight.
e)       Choose a healthy and balanced diet.

What are tips for coping and support?

1)      Learn about the disease.
2)      Bring together a support system. 
3)      Find someone to talk to and share your mind.  
4)      Connect with other cancer survivors.
5)      Consider hospice – Hospice care provides comfort and support to people who are terminally ill and their loved ones.

What are the risk factors for pancreatic cancer? 

The following are the risk factors.
1)       Smoking.
2)       Diabetes.
3)       Chronic inflammation of the pancreas (known as pancreatitis).
4)       Family history of genetic syndromes that increase cancer risks. These include BRCA2 gene mutation, Lynch syndrome and familial atypical mole-malignant melanoma (FAMMM) syndrome.
5)       Family history of pancreatic cancer.
6)       Obesity.
7)       Old age; most people are diagnosed after age 65
8)       Lack of regular exercise. 
9)       High-fat diets.
10)   Heavy consumption of alcohol.
11)   Working with pesticides and chemicals.
12)   Liver damage.
13)   Being an African-American.
pancreatic cancer risk factors
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What are the complications of pancreatic cancer? 

Pancreatic cancer could lead to:
a)       Weight loss.
b)       Jaundice.
c)       Pain.
d)       Bowel obstruction.

Can pancreatic cancer be hereditary?

There is a possibility that it is passed from parents to their children.

Can pancreatic cancer be detected in the blood?

Yes, it can be detected through the tumor marker CA 19-9, which is increased in pancreatic cancer patients.

What makes pancreatic cancer so deadly?

Pancreatic cancer is considered the 3rd leading cause of cancer death in the USA. It is considered deadly because most times, it is detected late. Usually, these cancers are asymptomatic in their early stage. However, the prognosis is bad at a late stage when cancer has spread to other body parts.