Meaning and Definition of Pancreatic Cancer Pancreas is one the major glands present behind the stomach and strategically situated in front of your spine. It mainly helps produce digestive enzymes as well as hormones aiding the process of digestion. And this major organ helps keep your blood sugar under control.When cancer develops in the pancreatic tissue or its ducts it is known as Pancreatic Cancer. There are two types of cells in the pancreas. Exocrine cells produce digestive enzymes and hormones, which are specialized proteins, that aid in digestion. And endocrine cells, within the pancreas, produce hormones like insulin and glucagon, which maintain blood sugar levels. Pancreatic cancer most commonly arises from the exocrine cells. Although the exact cause of Pancreatic Cancer is unknown, there are few risk factors, which increase one’s chance of developing pancreatic cancer.
Causes / Risk factors for Pancreatic Cancer
Genetic - Few people have one of their family members affected with pancreatic or other types of cancer. Its basically due to different types of mutations affecting different genes.
Cigarette smoking - Risk of pancreatic cancer increases with number of cigarettes smoked per day and duration of smoking.
Age factor – Elderly people above 60 years have an increased risk of developing pancreatic cancer.
Obesity and sedentary lifestyle – Excess body weight is one of the major risk factors, and this combined with sedentary life style increases the risk of pancreatic and few other forms of cancer.
Diet – A diet high in fruits and vegetables is considered protective against most forms of cancer and a diet high in smoked and processed fat and meat has a particularly high risk of cancer.
Chronic pancreatitis – It’s a form of long standing inflammation of the pancreatic tissue that converts the pancreas into a firm woody tissue. These patients have a higher risk of developing pancreatic cancer.
Symptoms of Pancreatic Cancer
The pancreas is strategically divided into head, body and tail. The symptoms depend on the location of the cancer within the pancreas.
The common symptoms associated with Pancreatic Cancers include
Loss of appetite and loss of weight
Jaundice – Yellowish discoloration of skin, eyes and urine
Pale / clay colored stools
Fever , chills
Upper abdomen pain that radiates towards the back
If you have any of the above symptoms, it may be a sign of Pancreatic Cancer, Clarify your doubts on pancreatic cancer, through our expert chat
Diagnosis of a Pancreatic Cancer
It is quite a challenge to detect a pancreatic cancer, during the early stages. A typical pancreatic cancer patient is an elderly chronic smoker with weight loss, clay colored stools and yellowish discoloration of eyes and urine and upper abdomen pain. Investigations done to detect or exclude pancreatic cancer include:
Blood tests will show abnormalities like elevated Bilirubin – marker of jaundice and increased levels of enzymes related to the liver like SGOT, SGPT and ALP. A marker of pancreatic cancer is a protein named CA 19.9 which will be elevated in most cases
Common imaging tests that a physician uses to diagnose pancreatic cancer include – USG abdomen, CT scan abdomen and MRI. These tests will provide information regarding the site, size and location of the pancreatic cancer. They will also let your physician know if the disease is early or fairly advanced and whether any surgical cure is possible.
Endoscopic Ultrasound and Biopsy
This is again an endoscopic procedure, where in your physician passes a long tube down your throat, and it traverses to the part of your gut – the duodenum. This tube is fitted with a camera and mini ultrasound probe at its tip, thus can help in proper visualization of the area of involvement by the cancer and local extent of the disease. This is Endoscopic Ultrasound scan. A needle can simultaneously be used to take biopsies from suspicious areas.
Sometimes a biopsy is taken by passing a needle into the pancreatic cancer through the skin under scan guidance
Treatment options depend on the type and stage of the cancer, the age and general health of the patient and patient preferences
Surgical proceduresSurgery depends on the location of the cancer in the pancreas
Whipple’s procedure – This major surgery is done for cancer involving the head of the pancreas. Here the head of the pancreas along with the adjacent duodenum, lower aspect of bile duct, a portion of stomach and surrounding lymph nodes. Sometimes the cancer can involve adjacent important blood vessels. In this situation the involved segment of the blood vessels may be excised and reconstructed.
Distal pancreatectomy - This procedure involves removal of the body and tail for cancer of the body or tail of pancreas.
Stent Placement / Surgical Bypass
When the preoperative investigations indicate an advanced disease or if the patient is very elderly or sick to undergo a major surgical procedure, your physician decides to place a stent - metallic tube across the tumour to relieve the jaundice. A surgical by pass to relieve jaundice or vomiting is done depending on the physical health and symptoms of the patient. Sometimes during surgery, it may be found that the cancer is fairly advanced. In these situations a surgical bypass may be carried out.
Chemotherapy is the use of drugs to kill cancer cells. It involves an intravenous injection or capsules taken orally and can involve a single drug or combination of drugs. Chemotherapy may be given before or after surgery depending on the stage of the disease. Some common side effects of chemotherapy include fatigue, nausea, vomiting and diarrhea.
Radiation therapy uses high energy X rays to destroy cancer cells. It is given in the form of external beam radiation therapy. Its usually given after surgery depending on the stage of the tumour.
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