Pancreatic Cancer - Types, Symptoms, Causes, Treatments, Diagnosis

Quick Points:

1. Pancreatic cancer is when malignant cells replace the normal tissues of the pancreas.

2. Smoking can increase the risk of pancreatic cancer.

3. It is difficult to diagnose this cancer earlier, as it produces no symptoms.

4. Jaundice, weight loss, and abdominal pain are common signs of late stages of pancreatic cancer.

5. Adenocarcinomas are the most common pancreatic cancers.

What Is Pancreatic Cancer?

The type of cancer that originates in the tissues of your pancreas is called pancreatic cancer. The pancreas is the organ in the abdomen present behind the lower part of the stomach. This organ secretes enzymes needed for the digestion of fats, carbohydrates, and proteins, and also produces insulin and glucagon, which are the hormones that regulate the blood sugar levels. The growths or cancer that occurs in the pancreas can be cancerous or noncancerous. Pancreatic ductal adenocarcinoma, which is a type of pancreatic cancer that originates in the cells that line the pancreatic ducts, is the most common type.

Pancreatic cancer is most curable in the early stages, but as they do not cause symptoms during this stage, they are seldom detected. They usually do not produce any symptoms until cancer has spread to other organs of the body. Depending on the extent of cancer, the treatment options include chemotherapy, radiation therapy, surgery, or a combination of these treatments.

What Are the Types of Pancreatic Cancer?

Based on the type of cells affected, there are two types of pancreatic cancer:

1) Exocrine pancreatic cancer - The glands that produce digestive enzymes are called exocrine glands, and the tumor that affects the functioning of exocrine glands are called exocrine pancreatic cancer. The common cancers include:

1. Adenocarcinomas.

2. Adenosquamous carcinomas.

3. Squamous cell carcinomas.

4. Acinar cell carcinoma.

5. Ampullary cancer.

6. Giant cell carcinomas.

2) Endocrine pancreatic cancer - The glands formed by clusters of cells called islets of Langerhans that release the hormones insulin and glucagon are called endocrine glands. Endocrine pancreatic cancer affects the functioning of the endocrine glands. The common tumors include:

1. Insulinomas.

2. Glucagonomas.

3. VIPomas.

4. Gastrinoma.

5. Somatostatinomas.

What Are the Signs and Symptoms of Pancreatic Cancer?

Pancreatic cancer are often very small to result in any symptoms, and the symptoms seen in the later stages are non-specific. The following are some of the symptoms seen as cancer grows:

• Upper abdominal pain, when the tumor presses a nerve.

• Yellowing of the skin, mucous membrane, and eyes (jaundice).

• Dark-colored urine.

• Pale and fatty stools.

• Loss of appetite.

• Unintended weight loss.

• Nausea and vomiting.

• Itchy skin.

• Blood clots.

• Fatigue.

• Trousseau's sign - spontaneous blood clots form in the deep veins of the body’s extremities.

Cancer affecting the Islet cell can make the pancreas to produce a lot of insulin, resulting in weakness, dizziness, diarrhea, and muscle spasms. New symptoms can occur when cancer spreads to other parts of the body.

What Causes Pancreatic Cancer?

DNA present in the pancreatic cells instructs the cells about what they need to do. When this DNA undergoes mutation, the cells start growing uncontrollably and continue to live longer than normal cells. This results in the accumulation of abnormal cells, which form a tumor. These abnormal cells can spread to nearby organs if left untreated.

The exact cause of this mutation is still not known, but the following risk factors seem to play a role:

• Most cases of pancreatic cancer are related to smoking cigarettes.

• Lack of exercise.

• Consuming a diet rich in fat.

• Alcoholism.

• Presence of liver damage.

• A family history of pancreatic cancer.

• Diabetes.

• Obesity.

• Environmental toxins, such as pesticides and other chemicals.

• Chronic inflammation of the pancreas.

How Is Pancreatic Cancer Diagnosed?

If your symptoms indicate pancreatic cancer, the doctor might suggest you undergo the following tests:

• Imaging tests - help the doctors visualize the pancreas. The commonly used techniques include ultrasound, magnetic resonance imaging (MRI), computerized tomography (CT) scans, and positron emission tomography (PET) scans.

• Endoscopic ultrasound (EUS) - An scope is inserted through the mouth into the stomach, and the tip takes ultrasonic images of the pancreas.

• Biopsy - A sample from the tumor is taken during EUS using special tools or by inserting a needle into the pancreas (fine-needle aspiration).

• Blood test - The blood is tested for the presence of specific tumor markers for pancreatic cancer. CA19-9 is one of the tumor marker tests used for this type of cancer.

How Is Pancreatic Cancer Treated?

The goal of pancreatic cancer treatment is to remove the tumor or if that is not an option, then medicines are given to improve the quality of life and limit cancer from growing. The treatment options include:

1) Surgery:

• A Whipple procedure (pancreaticoduodenectomy) is done if the tumor is located in the head of the pancreas. Here, the head of the pancreas is surgically removed.

• Distal pancreatectomy is done for tumors in the pancreatic body or tail.

• In some cases, a total pancreatectomy (removing the entire pancreas) might be needed.

2) Chemotherapy - It is the use of drugs to kill cancer cells. Chemotherapeutic drugs are either taken orally or injected into a vein.

3) Chemoradiation - Sometimes, a combination of chemotherapy and radiation therapy is used to shrink the tumor before surgery or after surgery to reduce the chance of recurrence or in case cancer has spread beyond the pancreas.

4) Radiation therapy - Here, high-energy X-rays and protons are used to destroy cancer cells.

5) Palliative care - A treatment plan suggested to improve the patient’s quality of life is called palliative care. It is often used with other treatments so that the patient gets better faster.

What Are the Stages of Pancreatic Cancer?

If you have been diagnosed with pancreatic cancer, the doctor will then perform various tests to identify if cancer has spread through a PET scan. Depending on the results of these tests, the doctor will then stage your cancer. The different stages of pancreatic cancer are:

1. Stage 1 - tumors present only in the pancreas.

2. Stage 2 - tumors spread to nearby tissues or lymph nodes.

3. Stage 3 - cancer spread to major blood vessels and lymph nodes.

4. Stage 4 - tumors have spread to other organs of the body.

Prognosis of Pancreatic Cancer:

With the advancement in cancer treatments, the survival rates for this type of cancer is improving. The prognosis is poor for this type of cancer, as it does not cause any symptoms. By the time it gets diagnosed, in most cases, cancer would have metastasized to other body parts. This cancer is difficult to treat and the survival rate after diagnosis is usually five years. But with newer treatment options, these numbers are getting better.

What Are the Complications of Pancreatic Cancer?

Some of the possible complications of pancreatic cancer are:

• Weight loss.

• Jaundice.

• Bowel obstruction.

For more information on pancreatic cancer, consult a cancer specialist online now!