Do you know? Pancreatic cancer is the fourth leading cause of cancer death in western countries and seventh leading cause of death globally. Additionally, it is one of the common types of cancer with the worst survival rates with only 9% of patients with advanced or malignant tumors surviving for more than 5 years.
This cancer usually occurs within tissues of the pancreas, the most vital organ located behind the stomach. Due to location and absence of symptoms, early diagnosis of pancreatic cancer is difficult. As a result, most of the cancers are diagnosed in advanced stages and the treatment becomes limited.
To explore why pancreatic cancer presents such a complex challenge, a better understanding of the basics of pancreatic cancer including its symptoms, causes, risk factors, prevention and management strategies is needed. Let’s discuss the basics of pancreatic cancer in detail:
What is pancreatic cancer?
Pancreas is an essential gland which produces enzymes and hormones such as insulin and glucagon to aid digestion and regulate blood sugar levels in the human body, respectively. It is composed of two types of cells:
- Exocrine cells which releases enzymes for process of digestion
- Endocrine cells which produces and release hormones in blood
Abnormal or uncontrolled cell growth in any part of the pancreas can lead to formation of tumors. Approximately 93-95% of pancreatic cancer begins in the exocrine cells and is called pancreatic adenocarcinoma or exocrine pancreatic cancer. Remaining 5-7% cancers are observed in the endocrine cells and referred to as pancreatic neuroendocrine tumors (NETs or PNETs).
Various types of growth can occur which may cause cancerous and non cancerous tumors. Some tumors are benign and others are malignant, which can spread to other parts of the body.
What are the causes and risk factors?
Cancer usually occurs when a mutation occurs in your genetic material (DNA and genes). These changes occur due to exposure to harmful carcinogenic agents or transfer of mutated genes from parents to offspring.
The exact causes of pancreatic cancer are not well understood yet. Approximately 10% of pancreatic cancer are assumed to be hereditary cancer, however the majority of it are caused by additional risk factors such as increased age, smoking, and obesity.
Major risk factors which increases your risk of pancreatic cancer are as follow:
- Older age, 60 years or above
- Gender, with males at higher risk
- First degree relative of someone diagnosed with pancreatic cancer
- Genetic syndromes such as von Hippel-Lindau syndrome, Peutz-Jeghers syndrome and Lynch syndrome
- Lifestyle disorders such as obesity and diabetes
- Medical conditions such as chronic or hereditary pancreatitis, H pylori infection and liver cirrhosis
- Diets rich in red and processed meats
- Smoking and drinking alcohol
Signs and Symptoms
As discussed earlier, the signs and symptoms of pancreatic cancer appear at an advanced or metastatic stage. Most of the symptoms are similar to other conditions, thus making its diagnosis more difficult.
Some common signs and symptoms of pancreatic cancer include:
- Abdominal pain which radiates towards back
- Nausea and vomiting
- Diarrhea and constipation
- Loss of appetite
- Low energy and fatigue
- Inflammation of liver and gallbladder
- Yellowing of eyes and skin (Jaundice)
- Fever and chills in some cases
- Blood clots
These symptoms if left untreated, can lead to severe complication such as debilitating pain, excess weight loss and bowel obstruction, if cancer presses the first part of small intestine.
How is pancreatic cancer diagnosed?
Pancreas is located deep below your stomach, so it is difficult to diagnose using physical examination. Your doctor will undertake a few diagnostic tests including:
- Computed tomography (CT) scan, magnetic resonance imaging (MRI) or endoscopic ultrasound (EUS) for detailed imaging of pancreas
- Blood tests such as liver function tests to detect presence of tumor markers (CA19-9)
- Biopsy or tissue sample to confirm diagnosis
However, there are no specific tests to diagnose pancreatic cancer, thus making its diagnosis difficult and complicated.
How can pancreatic cancer be treated?
Treatment of pancreatic cancer is solely dependent on the stage of pancreatic cancer and condition of the patient. The stage of the pancreatic cancer will show how far it has spread and thus its treatment options.
Clinical trials have suggested that pancreatic cancer have four stages:
- Stage 0: When abnormal cells are found in the lining of pancreas, and spread to nearby tissue only.
- Stage I: When tumor is in the pancreas (Localized).
- Stage II: When the tumor has begun to grow outside pancreas and has reached the bile duct and other structures (Regional).
- Stage III: When the tumor has invaded large blood vessels and nearby lymph nodes (Regional).
- Stage IV: When the tumor has spread to other organs and parts of the body (Distant).
The treatment options for pancreatic cancer includes surgical removal of tumor (such as whipple procedure), radiation therapy, chemotherapy, immunotherapy and targeted therapy. In the early stage, treatment options aimed to remove the tumor from pancreas. However, the treatment becomes challenging as the cancer progresses to an advanced stage.
Surgery is the best option to control pancreatic cancer, however due to diagnosis at an advanced stage, most patients are not eligible for surgery. Recent cancer research trials have aimed to focus on biomarker testing and develop more targeted therapies to improve diagnosis and treatment.
Some preventive measures to lower risk of pancreatic cancer:
As the exact cause of pancreatic cancer is still unknown, it is difficult to suggest specific measures to prevent pancreatic cancer. However, you can improve your daily lifestyle to become healthier and reduce risk of pancreatic cancer:
- Eat healthy diet and limit intake of red and processed meat
- Exercise regularly and practice relaxation strategies such as yoga
- Maintain healthy weight
- Control your blood sugar levels
- Quit drinking alcohol, smoking and tobacco
Pancreatic cancer is a deadly disease and receiving an early diagnosis can improve the outlook of disease. But, its early diagnosis is difficult as patients experience symptoms at an advanced stage.
It is recommended to go for routine screening testing to determine any abnormalities in your body. People with a strong history of pancreatic cancer should undergo genetic testing. And, if you have been diagnosed with pancreatic cancer, you should discuss prognosis and treatment options with your oncologist.
You can also practice some supportive interventions including complementary therapies and palliative care for managing symptoms associated with cancer, reducing complications of disease, improving side effects of therapy and patient quality of life.
Also, Explore the role of complementary therapies for reducing pain in cancer patients.