Pancreatic Cancer

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Pancreatic Cancer

Pancreatic Cancer is the cancer that begins in the tissues of the pancreas.

Pancreas is the organ that lies behind the lower part of the stomach. The main function of pancreas is that it releases enzymes that help in digestion & hormones that manages the blood sugar level.

Pancreatic cancer is hardly ever detected in early stages since it shows no symptom in early stages. It gets noticed when it has already spread to other organs (4th or 5th stage), thereby making treatment quite difficult.

Signs & symptoms of Pancreatic Cancer

  • Fatigue
  • Loss of appetite
  • Jaundice
  • Pain in the upper abdomen.
  • Back pain
  • Nausea & vomiting
  • Malaise, feeling of discomfort or unease whose exact cause is not known.

Causes & risk factor of Pancreatic Cancer

  • Smoking
  • Diabetes
  • Family history of pancreatic cancer.
  • Pancreatitis (swelling of pancreas)
  • Ulcer in the stomach
  • Alcohol consumption
  • Obesity
  • Pancreatic cancer is more common in older people

Types of Pancreatic Cancer

There are two major types of Pancreatic Cancer:

  • Exocrine Pancreatic Cancer- It  is the cancer that begins in the exocrine cells, cells that produces pancreatic digestive juices. Exocrine Pancreatic Cancers make up for about 95% of Pancreatic Cancers. The sub-types of Exocrine Pancreatic Cancer are:
    • Adenocarcinomas- These begin in the cells that line the ducts of the pancreas & are the most common type of exocrine pancreatic cancer, accounting for around 90% of Pancreatic cancers.
    • Squamous Cell Carcinoma (rare type)
    • Adenoquamous Carcinoma (rare type)
    • Colloid Carcinoma (rare type)

 

  • Endocrine Pancreatic Cancer- These begin in that part of pancreas where Insulin and other hormones are made and released directly into the blood. Endocrine Pancreatic Cancers are named after the hormone they produce like gastrinomas produce a gastrin & insulinomas produce insulin to name a few. They make up for less than 5% of Pancreatic Cancers.

    *Benign cysts and lesions in Pancreas- These can be precancerous formations and are generally removed once noticed, or closely monitored for malignancy. 

Stages of Pancreatic Cancer

  • Stage 1: Cancer is limited to the pancreas.
  • Stage 2: Cancer is confined to the pancreas but the tumour has grown in size (greater than 2 but no more than 4 centimeters).
  • Stage 3: The tumour is over 4 centimeters in size and the cancer may have spread to nearby lymph nodes.
  • Stage 4: The cancer has spread to the nearby blood vessels or nerves.
  • Stage 5: Cancer has spread to distant organs.

Diagnosis of Pancreatic Cancer

  • Blood Test
  • PET scan- It helps to check the degree of pancreatic cancer spread
  • Endoscopic Ultrasound
  • MRI
  • Biopsy- Tissue sample from the suspicious area is taken & send for examination. Biopsy can be performed in the following way:
    • Percutaneous needle biopsy also known as fine needle aspiration (FNA)- A needle is inserted into the mass & some tissue is captured.
    • Endoscopic retrograde cholangiopancreatography (ERCP)- In this process a flexible tube with a camera and other tools on its end (endoscope) is put through the mouth to the small intestine, near the pancreas. & helps to collect images as well as tissue sample of the affected area.

Treatment of Pancreatic Cancer

The Treatment of Pancreatic Cancer depends on the stage and grade of cancer. After evaluation of the aforesaid through proper investigations, your oncology team will decide on your treatment plan or protocol. Following are the options considered for effective Pancreatic Cancer Treatment.

Surgery

There are quite a few different types of surgery that are done for Pancreatic Cancer depending on the size of the tumor and organs involved. 

Whipple Procedure

 It is also known as pancreaticoduodenectomy. In this procedure, the head of the pancreas, the first part of the small intestine (duodenum), the gallbladder and the bile duct and nearby lymph nodes are removed. In some situations, part of the stomach and colon can be removed. The surgeon that reconnects the remaining parts of pancreas, stomach and small intestine to enable digestion of food.

Distal Pancreatectomy

In this procedure, the tail of the body of the pancreas are removed, but not the head. In some cases, spleen can also be removed.

Total Pancreatectomy

The entire pancreas and the spleen are removed. You can actually lead a normal life after Pancreatectomy. However, you will need lifelong insulin and enzyme replacement as these are the functions of the pancreas.

Chemotherapy

Chemotherapy is the use of anti-cancer drug that helps to slow or stop the growth of rapidly dividing cells that cause cancer. It prevents the growth of rapidly dividing cells by killing the dividing cells.

Despite its side effects, chemo is still the most widely used cancer treatment option. Unlike radiation and surgery which treats cancer cells at particular locations, chemotherapy drugs can kill cancer cells that have metastated (spread) to different organs in the body.

Targeted drug therapy

Targeted therapy is a type of cancer treatment that uses cancer drugs. However, it is different from traditional chemotherapy, which also uses drugs to kill cancer cells. In Targeted therapy, the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival are targeted. Targeted therapy is generally used with chemotherapy and other interventions.

Radiation therapy

Radiation Therapy is a kind of cancer treatment that uses high doses of radiation beams to kill cancer cells to shrink the tumors. Radiation kills the cancer cells by destroying the DNA. Cancer cells with damaged DNA fail to multiply and die. They are then removed by the body’s mechanism.

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