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Pancreatic Cancer

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  3. Pancreatic Cancer

Overview of Pancreatic Cancer

Pancreatic cancer is one of the leading cancers among all. It is caused by abnormal growth of pancreatic endocrine and an exocrine group of cells. The survival rate is about 5 years.

Pancreatic cancer (Lablabay ka Sartan/لبلبے کا سرطان) is defined as the abnormal multiplication of cells in the pancreas. The pancreas is a vital endocrine organ that lies behind the stomach. The main function of the pancreas is to produce enzymes for the digestion of fats, carbohydrates, and proteins.
The pancreas is responsible for the production of two main hormones: glucagon and insulin. These hormones are responsible for controlling glucose (sugar) metabolism. Insulin metabolizes glucose for energy while glucagon raises glucose levels when it gets too low.
Pancreatic cancer is difficult to diagnose at its early stages because of the location of the pancreas. Therefore, it is usually identified at more advanced stages.

Prevalence of Pancreatic Cancer

In 2018, about 18 million people worldwide were diagnosed with cancer worldwide. From this, a half-million population suffered from pancreatic cancer. This is an alarming statistic in which more than 430,000 people cause death.
The survival rate is the percentage of people who are still living with the same type and stage of pancreatic cancer after a specified period. Globally, the survival rate of pancreatic stage estimates 5 years, in which the percentage of people varies according to its stage such as:

  • The percentage of localized pancreatic cancer in stages 0, 1, and 2 is almost 34%.
  • The percentage of regional pancreatic cancer that spreads to nearby organs and lymph nodes is about 12%. Stage 3 is included in this category.
  • If the pancreatic spreads to other organs like the liver, lungs, etc then the survival rate is about 3%. This type of stage is 4.

Signs and Symptoms of Pancreatic Cancer

Pancreatic cancer symptoms become obvious as it becomes at the advanced stages of the disease. For this reason, there aren’t any early signs of pancreatic cancer.
Following are The most common symptoms of pancreatic cancer include:

  • Loss of appetite
  • Sudden weight loss
  • Abdominal (stomach) pain
  • Lower back pain
  • Blood clots
  • Jaundice (yellow skin and eyes)
  • Depression

 

These symptoms become worse as cancer spreads to other areas of the body.

Types of Pancreatic Cancer

Following are the two types of pancreatic cancer based on the type of pancreatic cells.

Pancreatic Adenocarcinoma- This is one of the most common types of this cancer, about 95 % of people are affected by pancreatic adenocarcinomas. It starts in the exocrine cells of the pancreas which produces the enzymes or builds up in the ducts.
Pancreatic Neuroendocrine Tumors (NETs) – This is not as common as adenocarcinoma. It begins in the endocrine cells of the pancreas which are responsible for producing hormones. These hormones are beneficial for managing glucose.

Stages of Pancreatic Cancer

Depending on the expansion of tumors, it is divided into four main types which include:

  • Stage 1: Tumour is localized in the pancreas only
  • Stage 2: tumor starts to expand nearby abdominal tissues or lymph nodes
  • Stage 3: The pancreatic tumor affects the major blood vessels and lymph nodes
  • Stage 4: It is a malignant stage in which the tumor spread to other areas of the body, such as the liver

Causes of Pancreatic Cancer

Pancreatic cancer is a complex disease, and its exact causes are not yet fully understood. However, several risk factors have been identified that may increase a person's chances of developing pancreatic cancer.

  • Age: The risk of developing pancreatic cancer increases with age, with most cases diagnosed in people over the age of 60.
  • Smoking: Smoking is one of the leading causes of pancreatic cancer, and smokers are two to three times more likely to develop the disease than non-smokers.
  • Family history: A history of pancreatic cancer in close family members, such as parents, siblings, or children, increases the risk of developing the disease.
  • Obesity: Obesity is a risk factor for many types of cancer, including pancreatic cancer.
  • Chronic pancreatitis: People with chronic inflammation of the pancreas have an increased risk of developing pancreatic cancer.
  • Diabetes: Diabetes is associated with an increased risk of pancreatic cancer, although the exact relationship between the two is not yet fully understood.
  • Certain genetic mutations: Inherited genetic mutations, such as mutations in the BRCA2, PALB2, or CDKN2A genes, can increase the risk of developing pancreatic cancer.

It's important to note that not everyone with these risk factors will develop pancreatic cancer, and some people without any risk factors may still develop the disease. If you are concerned about your risk of developing pancreatic cancer, you should talk to your oncologist. 

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Risk Factors of Pancreatic Cancer

Many triggers that may increase pancreatic cancer in which includes:

  • Smoking
  • Diabetes
  • Chronic inflammation of the pancreas (pancreatitis)
  • Family history of genetic syndromes that can stimulate cancer such as  a BRCA2 gene mutation, Lynch syndrome, and familial atypical mole-malignant melanoma (FAMMM) syndrome
  • Family history of pancreatic cancer
  • Obesity
  • Older age, especially after age 65

Health Complications of Pancreatic Cancer

Following are the complications that result from the progression of pancreatic cancer:

  • Weight loss- Due to various factors such as stomach problems, lack of energy, nausea, vomiting and difficulty digesting food, etc.
  • Jaundice- By the blockage of the liver's bile duct causes jaundice.
  • Pain- Tumour suppresses the nerves in the abdomen that causes pain.
  • Bowel Obstruction- Block the flow of digested food from the stomach to the intestine. This is due to the accumulation of cells in the small intestine.

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Prevention

Adopting healthy lifestyle approaches may reduce the risk of pancreatic cancer which includes:

  • Quit smoking
  • Less intake of Alcohol
  • Maintain a healthy weight
  • Eat healthy food and juices

Seek medical check-ups if individuals suffer from the following common complications.

  • Weight loss
  • Bowel obstruction
  • Abdominal pain
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Diagnosis

To diagnose pancreatic cancer, a doctor may suggest one of the following tests:

  • Imaging Tests: The imaging tests are quite helpful to create scans of the internal organs. In this way, a doctor can easily identify the affected area and evaluate the growth of cells. The major techniques used to diagnose pancreatic cancer such as ultrasound, computerized tomography (CT) scans, magnetic resonance imaging (MRI), and, sometimes, positron emission tomography (PET) scans.

Can Ultrasound Detect Pancreatic Cancer?

Along with the above techniques, the most advanced technique is endoscopic ultrasound (EUS). It consists of a thin flexible tube with a camera that is inserted down into the stomach. A detailed fine image of the pancreas is obtained.

  • Biopsy:  In this procedure, a small sample of pancreatic tissues is collected through an endoscope, while EUS procedure. Then, examine the sample under a light microscope. Less commonly, the sample is scraped off through fine needle aspiration. It is considered a painful technique.
  • Blood Tests: A doctor may recommend blood tests to identify the presence of tumor markers in pancreatic cancerous cells. The tumor marker test for pancreatic cancer is called CA19-9. This test is beneficial for the cancer response to the treatment, but it is applicable if a person's CA19-9 levels are elevated. In not all cases, these elevations have been observed.
  • Firstly oncologists diagnose the stage and extent of cancer. As they confirm their diagnosis, they then, give the best treatment options to the patients.

Treatment of Pancreatic Cancer | When to Consult a Doctor

The treatment of pancreatic cancer is based on the stages of the cancer. There are two main goals:

  • To kill the cancerous cells
  • To prevent the spread of disease

Several therapies are involved to control this disease. Some are given below:

  1. Surgery

An oncologist recommends the surgery based on the location and severity of the cancer. Following are the surgical operations that are responsible for the removal of pancreatic tumors:

  • Pancreatic Head Surgery: If a person’s cancer is localized at the head of the pancreas, this procedure is known as the Whipple procedure (pancreaticoduodenectomy). In this procedure, the whole head of the pancreas is removed but in some cases, part of the stomach and colon as well. 
  • Pancreatic Body and Tail Surgery: Surgical removal of the left side of the pancreas where the body and tail are located. This treatment of the pancreas is called distal pancreatectomy. A surgeon may also remove the spleen, depending on the condition of the patient.
  • Surgery of the whole Pancreas: If cancer affects the whole pancreas, then it needs to be removed earlier before it spreads more. This is called a total pancreatectomy. A person can survive normally without a pancreas but needs insulin and enzyme replacement lifetime.
  • Blood Vessels Surgery: People suffering from more severe pancreatic cancer are not eligible for other pancreatic surgeries. The most specialized and experienced surgeons suggest this procedure. This operation is used for the removal of tumors nearby the blood vessels and also for reconstructing cancerous blood vessels.

The post-operative effects of surgery that people may experience from the above surgeries are primarily nausea, and vomiting (due to delayed gastric emptying). Patients may also be at risk of bleeding and infections after surgery.

  1. Radiation Therapy

If cancer spreads to other areas of the body, radiation therapy is recommendable. In this therapy, X-rays and other high-energy beams transfer through the affected area of the pancreas and kill the growth of cancerous cells.

  1. Chemotherapy

In some cases, it is conducted along with other treatments. It involves cancer-killing drugs that help to control the growth of cells.

  1. Targeted Therapy 

In this therapy, cancer drugs or other measures are used to target the specific site of cancer cells and destroy them. It is mostly applicable for benign pancreatic cancer because it can't damage other healthy or normal cells.

In some cases, oncologists may suggest clinical trials to the patients if they agree with them.

Clinical Trials for Pancreatic Cancer

Clinical trials are studies to test for the introduction of new treatments, such as systemic therapy, and new approaches to surgery or radiation therapy. Clinical trials for pancreatic cancer may give the chance for targeted therapy, chemotherapy drugs, immunotherapy treatments, or vaccines.

 

Discuss with the doctors that clinical trials may be suitable for them.

 

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