Understanding Pancreatic Cancer: Symptoms, Diagnosis, and Treatment Options

· The Hindu

Pancreatic cancer is the result of abnormal cells in the pancreas growing and dividing out of control to form a tumour.

The pancreas is a gland that is situated behind the stomach and surrounded by the duodenum, liver and spleen in the abdomen. It produces hormones regulating blood sugar levels and enzymes aiding digestion. It is essential for the regulation of blood sugar levels and the preservation of normal digestion.

Pancreatic cancer is of two types:

  • Exocrine (non-endocrine) pancreatic cancer
  • Neuroendocrine pancreatic cancer

Risk factors of pancreatic cancer

There are a few factors that can lead to a higher risk of pancreatic cancer:

  • Smoking (20% of pancreatic cancers are caused by smoking)
  • Obesity
  • Physical inactivity
  • Chronic pancreatitis
  • HBV and HCV infection
  • Helicobacter pylori infection
  • Exposure to chemicals in the dry cleaning and metalworking industry.
  • Family history
  • Diabetes

Symptoms of Pancreatic Cancer

In the early stage, patients are asymptomatic. Most pancreatic cancer patients present with symptoms in stage 3 & stage 4, where the disease has locally advanced or disseminated to other organs, respectively.

  • Loss of Appetite
  • Unexplained Weight Loss
  • Abdominal Pain
  • Indigestion
  • New-Onset Diabetes
  • Fatigue
  • Changes in Stool
  • Dark Urine
  • Jaundice
  • Blood Clots

When to see a doctor?

You should contact a doctor for further evaluation if any of these symptoms persist for you, especially if you have risk factors for pancreatic cancer (such as smoking, family history, or chronic pancreatitis). The outcomes of early intervention can vary greatly.

An oncologist and gastroenterologist treat pancreatic cancer disease.

Diagnosis of Pancreatic Cancer:

Pancreatic cancer may be detected by one or more of the following tests. These examinations can also be used to determine whether the cancer has spread and whether the treatment is effective.

  • Imaging tests:
  • Abdomen ultrasound
  • CT scan
  • MRI scan
  • Positron emission tomography (PET) scan
  • Endoluminal ultrasonography (EUS)
  • Endoscopic retrograde cholangiopancreatography (ERCP)
  • Endoscopic ultrasound
  • Biopsy
  • Blood tests - Tumour markers associated with pancreatic cancer include CEA and CA 19-9.

Treatment for Pancreatic cancer:

Pancreatic cancer can be treated with surgery, endoscopic procedures, chemotherapy, radiation therapy, or a mix of these.

Surgery:

• With early detection, surgery is the only way to possibly cure pancreatic tumour.

Common surgical procedures are:

◦ Whipple Procedure (Pancreaticoduodenectomy): The procedure involves removing the head of the pancreas and portions of the stomach, small intestine, and bile duct.

◦ Distal Pancreatectomy: The procedure involves removing the tail and body of the pancreas.

◦ Total Pancreatectomy: Removes the entire pancreas, requiring lifelong insulin and enzyme replacement.

Other treatment methods include:

• Chemotherapy - Generally given to downstage borderline respectable tumors and increase chances of resectibility. In stage 4, chemotherapy is administered to control the tumour, palliate the symptoms and prolong the survival of the patient.

• Radiation Therapy - Radiation therapy employs high-energy X-rays or other radiations to either prevent the development of tumours or eliminate cancer cells. Radiation therapy is administered to specific patients to reduce the size of their tumours before surgery.

• Targeted Therapy - Targeted treatment is a cancer care strategy that uses medications or other agents to specific target molecules and processes associated with the growth, progression, and dissemination of cancer cells.

• Immunotherapy - Immunotherapy is a new type of cancer therapy that strengthens the immune system’s ability to identify and fight cancerous cells, using the patient’s immunity to combat the disease.

• Palliative Care - By controlling symptoms and pain, giving emotional and spiritual support, and nursing patients and families to negotiate anxiety and despair, palliative care enhances the quality of life for people living with pancreatic cancer.

Complications: Following pancreatic surgery, anastomotic leaks, delayed gastric emptying, pancreatic fistulas, hemorrhage, and infection are all possible postoperative consequences.

Conclusion:

Pancreatic cancer requires early awareness, prevention, and treatment for good results, which can improve the prognosis of this condition. This vigilance empowers patients and deepens understanding of the disease, aiding in the prevention and effective treatment strategies.

Dr. Ch Mohana Vamsy MBBS, MS, DNB(SURG), MCH (SURG. ONCO), FRCS(EDIN), DIP. LAP.SURG.(FRANCE)

Oncologist & Cancer Specialist

Omega Hospitals

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Published - November 26, 2024 06:20 pm IST