Pancreatic Cancer

Pancreatic Cancer



Definition of Pancreatic Cancer

 

Pancreas is an organ that is located horizontally in the center of upper abdomen. When the cells of pancreas start to multiply in an uncontrolled fashion resulting in increased pancreatic size and lump formation, it is called pancreatic cancer. It is one of the most common types of cancers that occur throughout the world. Majority of pancreatic cancers are of its cells that lines the ducts, the pancreatic cancer of its secretory cells is less common as compared to that.

 

Cause of Pancreatic Cancer

 

Due to any cancer causing factor, there is defect in DNA (genetic makeup) of pancreatic cells that results in continuous and uncontrolled growth of those defective cells, thus forming a lump called cancer.

Following factors are the major cause of pancreatic cancer:

  • Chronic pancreatitis

  • Long term infection and inflammation of pancreas might result in development of pancreatic cancer

  • Inborn genetic defect

  • Smoking

  • Obesity

  • Family history

  • High consumption of red meat in diet

  • Exposure to radiations and cancer causing chemicals

 

Signs and Symptoms of Pancreatic Cancer

 

Pancreatic cancer, like other cancers, does not show any signs and symptoms at its early stage so it is very difficult to detect it. Most of the times, it shows signs and symptoms at its advance stage when it has grown and totally spread and even these signs and symptoms are nonspecific and they vary from patient to patient so it is very difficult to diagnose this type of cancer.

 

Following signs and symptoms might be associated with the patient of pancreatic cancer:

 

  • Pain in the upper abdomen that may radiate to back

  • Jaundice, it is noticed by yellowing of white portion of the eyes and skin

  • Loss of appetite

  • Weight loss

  • Fatigue

  • Weakness

  • Heartburn

  • Depression

  • Diarrhea (loose stools)

  • Trousseau syndrome. In this, the blood clots are formed inside blood vessels (like superficial veins of body, deep veins of arms and legs and the portal blood vessels etc)

  • Sudden onset of Diabetes mellitus

  • Fever

  • Shivering

  • Steatorrhoea (Smelly, oily, large and floating stools)

  • Abdominal discomfort

  • Nausea and vomiting

  • Itching

Additional signs and symptoms are observed in case of the pancreatic cancer of its secretory cells (which is less common), that may include:

  • Abnormally large amount of vasoactive intestinal peptides are produced that may cause high blood pressure and flushing of face

  • Abnormally large amount of somatostatin is produced that may cause gallstones, diabetes and diarrhea

  • Abnormally large amount of insulin is produced that may cause weakness, loss of energy and dizziness

  • Abnormally large amount of glucagon is produced that may cause skin rash, inflammation of cheeks and lips and weight loss

  • Abnormally large amount of gastrin is produced that may cause severe pain, black stools and diarrhea

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Risk factors for Pancreatic Cancer

 

Following are the major risk factors that may contribute in formation of pancreatic cancer:

  • Alcohol consumption

  • Smoking

  • Age (increased risk at old age)

  • Gender (more common in men)

  • Diabetes (it is a risk factor that may cause pancreatic cancer as well as can be a symptom that appear after the development of pancreatic cancer)

  • Obesity

  • Diet (less use of vegetables and fruits and more consumption of meat, carbonated and sweet drinks and smoked food is also an important risk factor)

  • Partial gastrectomy (partial removal of stomach)

  • Infection of H.pylori

  • Race (African-American race at high risk)

  • Family history of pancreatic cancer

  • Family history of any genetic syndrome (that may cause cancer)

 

Diagnosis of Pancreatic Cancer 

 

Pancreatic cancer, due to its non specific and vague signs and symptoms, is very difficult to diagnose and may be misdiagnosed. A doctor uses following approaches to make the diagnosis of pancreatic cancer:

  • Medical history

Various signs and symptoms as mentioned above related to pancreatic cancer are noticed by doctor

  • General physical examination

On examination, the doctor may notice yellowing of eyes, enlarged mass (of gall bladder in case if bile duct is blocked) on right side of abdomen, swollen lymph nodes, and weakness etc. The pancreas cannot be palpated even if it is enlarged because it is covered by the gut

  • Imaging scans

That may include:

CT scan (image of pancreas is seen using a series of x-rays images)

MRI scan (image of pancreas is seen using strong magnetic waves and can show more details)

Endoluminal ultrasonography (in case, if a dark shadow is seen in MRI or CT scan image then to confirm the diagnosis, this procedure can be performed. In this procedure, a small and flexible tube called endoscope, which has an ultrasound probe attached to its mouth is passed from mouth to stomach where it takes pictures of pancreas. As it is very close to pancreas, clear and refined images of pancreas can be taken by this procedure)

  • Laparoscopy (it is a procedure in which the small portion of abdomen is cut and a laparoscope is entered from there to visualize the pelvis and abdomen)

  • Biopsy

A small part of pancreatic tissue is obtained where cancer is suspected, dyed with stain and observed under microscope for confirming the presence of cancer

  • Lab tests

Tumor markers (specific substance that is elevated in that particular type of cancer) for pancreatic cancer are assessed.


Prevention from Pancreatic Cancer 

 

  • Avoid smoking

  • Avoid alcohol consumption

  • Adopt healthy eating habits

  • Maintain a healthy weight

  • Make less use of red meat

  • Take proper control of any disease of pancreas

 

Treatment of Pancreatic Cancer 

 

Pancreatic cancer, even if detected at early stage has very poor prognosis and it develops very rapidly. That is why the death rates due to pancreatic cancer are high.

The treatment of pancreatic cancer, like other cancers depends on following factors:

  • Stage of cancer

  • Preferences by patient

  • Overall health status of patient

 

Following are the treatment options available for pancreatic cancer:

  • Surgery

Removal of part of pancreas with cancer in early stage but in case of advance stage cancer the whole portion of pancreas is removed.

 

  • Radiation therapy

High energy radiations are used to kill cancer cells. Used mostly in early stage of cancer solely or can be used with surgery for fast recovery from cancer.

 

  • Chemotherapy

Drugs are used to target the cancer cells.  This method is used mostly in early stage of cancer solely or can be used with surgery for fast recovery from cancer