Pancreatic Cancer
Pancreatic cancer is a type of cancer that develops in the pancreas tissues, an endocrine organ situated at the back of the stomach. The key role of the pancreas involves manufacturing enzymes that the body requires to break down fats, carbs, and proteins.
Glucagon and insulin are two essential hormones that the pancreas produces. These hormones play the role of glucose or sugar metabolism regulation. Insulin aids in the metabolism of glucose for energy production, while glucagon aids in the elevation of sugar levels whenever they are low.
Pancreatic cancer can be hard to diagnose because of its location. On the other hand, it is frequently detected in later stages of the condition. Generally, pancreatic cancer accounts for roughly 3% of all cancer diagnoses and 7% of cancer deaths.
Signs and Symptoms of Pancreatic Cancer
Pancreatic cancer symptoms usually do not develop until the disease advances. It may also cause symptoms that are similar to those of other illnesses, making diagnosis more difficult.
The most common signs and symptoms are:
- Back or abdominal pain
- Constipation or diarrhea
- Diabetes
- Fatigue
- Fever and chills in other cases
- Gallbladder or liver swelling
- Indigestion
- Jaundice (yellowing of the skin and the whites of the eyes)
- Pulmonary embolism, deep vein thrombosis, or blood clots
- Reduced appetite and weight loss
- Stool that is pale gray or fatty
- Vomiting or nausea
- A jaundice-related rash
New symptoms may occur elsewhere around the body in case pancreatic cancer metastasizes.
Causes of Pancreatic Cancer
The causes of pancreatic cancer are not known. If the abnormal cells in the pancreas start to multiply and form tumors, this form of cancer develops. Healthy cells usually develop and die in small quantities. In a situation of malignancy, abnormal cell production increases. Eventually, these cells control the healthy cells.
Medical experts and researchers aren't sure of what causes the mutations in the cells. However, they believe that certain factors can raise the chances of one acquiring pancreatic cancer.
Inheritable and acquired genetic mutations are the two most major risk factors. Typically, changes in genes can cause cancer because by influencing how cells behave.
Risk Factors of Pancreatic Cancer
The following pancreatic cancer risk factors may raise your risk of developing the disease:
- Being diabetic
- Smoking
- Pancreatitis, chronic inflammation of the pancreas
- Family background of genetic syndromes, which might elevate the chances of getting pancreatic cancer. Examples are Lynch syndrome, BRCA2 gene mutation, and familial atypical mole-malignant melanoma (FAMMM) syndrome.
- Pancreatic cancer history in the family
- Being obese
- Being older (beyond the age of 65)
Stages of Pancreatic Cancer
The stage of cancer generally describes the extent to which it has spread. The stages of pancreatic cancer are as follows;
Stage 1: The malignancy is in the pancreas at this stage. It is restricted to a specific area.
Stage 2: At this stage, cancer has spread to the bile duct and other surrounding structures, except to the lymph nodes. It's basically regional.
Stage 3: Cancer has spread to the lymph nodes but remains localized.
Stage 4: Cancer has spread to other organs and body parts. It is relatively distant.
Pancreatic Cancer Diagnosis
If the oncologist thinks that you have pancreatic cancer, they can order one or more diagnostic tests and procedures such as;
- Imaging tests to obtain images of the inner body organs
These diagnostic tests allow your doctors to see the inside of the body, as well as the pancreas. Computerized tomography (CT) scans, ultrasound, and magnetic resonance imaging (MRI), and, in certain cases, positron emission tomography (PET) scans can help detect pancreatic cancer.
- Creating ultrasound images of the pancreas with a scope
Endoscopic ultrasound (EUS) is a procedure that employs an ultrasound instrument to produce pictures of the pancreas from within the belly. The tool is passed down your throat and into the stomach using a tiny, flexible tube called an endoscope to get the images.
- A biopsy (extracting a small sample of tissue for more analysis)
A biopsy refers to a technique in which a small tissue sample is removed and examined on a microscope. During EUS, tissue is usually extracted by passing specific tools via the endoscope. Fine needle aspiration is a less typical procedure to obtain a tissue sample. It involves putting a needle via the skin and into the pancreas.
- A blood test
The doctor can perform a blood test to look for certain proteins (tumor markers) released by the pancreatic cancerous cells. CA19-9 is a tumor marker test that is used in pancreatic cancer. It could help figure out how your cancer reacts to the treatment. However, it’s not often reliable as some patients do not have increased levels of CA19-9.
Pancreatic Cancer Treatment
Pancreatic cancer treatment is determined by cancer's stage, location, overall health, and at times personal preferences. The primary goal of pancreatic cancer treatment for most patients is to get rid of cancer. It also helps stop or slow down the progression and ease the symptoms.
Treatment for pancreatic cancer in its later stages is unlikely to be successful. During the diagnosis period, it is typically too late to have the pancreas surgically removed.
There are, however, a variety of approaches for treating pancreatic cancer. Some of them include the following;
Surgery:
Pancreatic cancer may be limited to one area at the period of diagnosis. In that case, the doctor can suggest removing a section or the entire pancreas to eliminate the malignant cells. The following are the three most common pancreatic cancer surgeries:
- Whipple procedure
A surgeon removes the pancreas head and sometimes the entire pancreas, as well as a piece of the stomach, duodenum, lymph nodes, and other tissue, in a Whipple procedure. Leakage, bleeding, infections, and gastrointestinal issues are some of the possible complications.
- Distal pancreatectomy
The surgeon takes out a portion of the pancreas as well as the spleen during a distal pancreatectomy. Because the spleen aids the immune system, its loss may increase the risk of frequent infections.
- Total pancreatectomy
The surgeon removes the whole pancreas as well as the spleen during a total pancreatectomy. Although one can survive without a pancreas, diabetes can occur if the body stops producing insulin cells.
Palliative surgery:
Palliative surgery can assist in alleviating symptoms like bile duct or duodenal blockages. A bypass can be created to allow bile to keep on flowing from the liver. As a result, this could reduce discomfort and stomach issues.
Another alternative is to maintain the bile duct open with a tiny stent. With the use of an endoscope, this operation is generally less invasive.
Embolization:
The physician injects a substance into an artery that prevents blood from getting to the cancerous cells during embolization. These cancer cells will eventually die if they don't have access to blood. Abdominal pain, fever, nausea, infections, and the possibility of blood clotting in the injection site are the potential side effects of embolization.
Chemotherapy:
Pancreatic cancer chemotherapy involves the use of drugs to destroy malignant cells while also preventing them from spreading. It may be prescribed alone or in combination with other forms of treatment. In the later stages of pancreatic cancer, chemotherapy may also help ease symptoms.
Treatment is administered in two to three-week cycles, after which a resting period follows. This gives the body a chance to recover between doses. Hair loss, vomiting, nausea, and tiredness are among the side effects.
Radiation therapy:
Radiation therapy kills cancerous cells by concentrating high-energy beams on them. It has the ability to shrink and even eliminate the cells. It can also assist in alleviating symptoms in advanced stages by removing or minimizing an obstruction.
It can have side effects similar to chemotherapy, including skin changes, exhaustion, and gastrointestinal difficulties. Nevertheless, these symptoms normally subside once treatment is complete.
Radiation therapy can be given alone or in combination with other treatments. Also, it is normally administered five days a week for a particular duration.
Immunotherapy:
Immunotherapy assists the immune system in recognizing and eliminating cancerous cells. One major form of immunotherapy that might aid in the treatment of pancreatic cancer is PD-1 inhibitors. This treatment is given as an infusion every two to three weeks to cancer patients. Fatigue, rash, coughing, and joint pain are the possible adverse effects.
Targeted therapy:
This is a more recent treatment option, unlike chemotherapy. It inhibits cancer cell growth by destroying the compounds that cancer cells require to thrive. There are various types of targeted therapy. Some of them are EGFR inhibitors (drugs that stop the EGFR protein from working), PARP inhibitors that block PARP enzymes, and NTRK inhibitors.
Conclusion
Early detection of pancreatic cancer can improve a person’s prognosis. However, this isn't always attainable since most people don't show symptoms till the later stages.
Individuals who think that they might be at risk for pancreatic cancer should immediately consult their doctor about undergoing some tests. Generally, there are no screening principles for pancreatic cancer.
On the other hand, the doctor may recommend genetic and other forms of testing to those who have a family history of the disease.