Pancreatic cancer is one of the most insidious and dangerous cancers that remain asymptomatic for a longer-term. It becomes difficult to cure once symptoms and complications appear. Even if the diagnosis is made early, the five-year survival rate is not more than 15%. The pancreas lies deeply behind your stomach, surrounded by other organs of the abdominal cavity. Therefore, surgical treatment of pancreatic cancer is complex and requires great skill from the surgeon. There is a high risk of severe and sometimes fatal postoperative complications.
Pancreatic cancer symptoms
The first symptom of pancreatic cancer appears in the late stage when the tumor squeezes the nearby organs, causing abdominal pain due to obstruction of the ducts.
Pancreatic cancer pain
Pain is usually the first sign of illness. Its appearance suggests that the tumor has grown into the nerve endings. The intensity of pain is different, from a feeling of discomfort to severe attacks. The localization of pain depends on which part of the organ is affected:
- head – under the right rib
- tail – in the upper abdomen on the left
- the whole pancreas – the pain of a girdle nature
The pain increases when the patient lies on his back after taking fatty, spicy foods and alcoholic beverages.
Sometimes the first sign of pancreatic cancer is deep vein thrombosis in the leg. This condition causes the following symptoms:
- increased temperature of the skin of the legs.
This complication develops when the tumor compresses the bile duct. Symptoms are typical:
- the skin, mucous membranes, and sclera of the eyes become icteric
- urine darkens, looks like dark beer
- the stool becomes colorless
- the abdomen increases due to the enlargement of the liver and gallbladder
- worried about the itching
The jaundice is slow onset. At first, the skin is bright yellow, then gradually acquires a greenish tint. Over time, renal and hepatic failure develops, intense bleeding, and the patient dies.
Other manifestations and symptoms
- sudden weight loss
- decreased appetite, especially with fatty foods, meat
- weakness and increased fatigue
- increased body temperature
- frequent depression
- lethargy, apathy
- If the tumor invades the intestines, symptoms of intestinal obstruction occur. The failure of the endocrine islets leads to diabetes mellitus. When the splenic veins are compressed, the spleen increases in size. If the tumor spreads into any organ, bleeding may begin.
Pancreatic Cancer Causes
There are risk factors that provoke the development of malignant tumors in the pancreas. The main ones are:
- Diabetes:- For unknown reasons, the risk of the disease increases in people with type 2 diabetes.
- Chronic pancreatitis:- The risk is high in smokers. However, not all people have chronic inflammation in the pancreatic tissue causing the development of a tumor.
- Cirrhosis of the liver:- There is some evidence that this disease is a cause of pancreatic cancer.
- Some hereditary factors:- cases of pancreatic cancer in the family, a mutation in the BRCA2 gene, Lynch syndrome, multiple dysplastic nevi syndromes.
- Tobacco smoking:- One of the main risk factors that contribute about 20-30% of cases are associated with smoking cigarettes, pipes, cigars.
- Frequent alcohol consumption:- A direct relationship between alcohol intake and pancreatic cancer is not fully established, but the study indicates that regular alcohol consumption increases the risk of chronic pancreatitis.
- Overweight:- Obese people have a 20% increased risk. A high threat is posed by excess fat in the abdominal area, even if the person has an average weight.
- Age over 60–65 years:- Almost all pancreatic cancer patients are over 45 years old. Two-thirds are over 65. Most often, the disease is prevalent in people over 70 years old.
- Cysts and adenomas of the pancreas are considered precancerous diseases.
Pancreatic Cancer Diagnosis
In the early stages, it is difficult to detect pancreatic cancer. Symptoms arise when the tumor affects nearby organs. During the examination, the doctor can feel an enlarged liver, gallbladder, and spleen. In later stages, ascites, an accumulation of fluid in the abdomen, can be detected.
All these signs are non-specific; they are found in other diseases as well. Usually, if pancreatic cancer is suspected, the examination begins with an ultrasound scan. It is an easy, most convenient, and inexpensive diagnostic method, while in most cases, it helps to detect a neoplasm.
- Endosonography (endoscopy) is more informative. During this study, the doctor inserts a special probe into the duodenum. At the end of the device, there are a miniature video camera and an ultrasonic sensor. Since the sensor is brought as close to the pancreas as possible, it allows you to get a more detailed picture.
- Computed tomography and MRI:- It helps evaluate the size and location of the tumor, the spread of cancer to other organs, and finds out if the tumor can be removed surgically.
- Cholangiopancreatography is a study that helps assess the condition of the pancreatic ducts and bile ducts. It can be done in three different ways:
- Endoscopic retrograde cholangiopancreatography (ERCP):- The doctor inserts a probe into the duodenum, finds an opening through which the bile duct flows, and injects a radiopaque contrast agent through it. Then an X-ray is taken: the “stained” ducts become visible on the images.
- Percutaneous transhepatic cholangiography:- The doctor performs it if ERCP fails. During this, he injects the radiopaque substance through the needle.
- Magnetic resonance cholangiopancreatography (MRCP) is essentially a conventional magnetic resonance imaging (MRI) scan. It is a non-invasive study, but during MRCP, unlike ERCP, it is impossible to conduct a biopsy or perform medical manipulations.
- Biopsy:- examination of a sample of pancreatic tissue under a microscope. It is the most accurate diagnostic method that helps to confirm or exclude the presence of cancer cells.
- PET scanning helps to detect distant metastases in the diagnosis of malignant pancreatic tumors with metastases.
Pancreatic cancer treatment
Surgical removal of the tumor is possible only in 10-15% of cases. In this case, three conditions must be met:
- pancreatic cancer should not grow into adjacent organs;
- there should be no metastases ;
- the patient’s health and severeness of the disease
Whipple procedure (pancreatoduodenectomy)
During the operation, the head of the pancreas or all of it is removed. Sometimes affected parts of the small intestine (duodenum), the gallbladder, and the bile duct are also removed.
- Distal pancreatectomy is a procedure in which the tail and, or the portion of the pancreas are removed.
- Total pancreatectomy:- During this intervention, the pancreas is completely removed, also the gallbladder, spleen, part of the stomach, and small intestine. Total pancreatectomy is possible when a malignant tumor affecting a neighboring organ but does not go beyond it.
- Nano-knife in the treatment of pancreatic cancer:- The doctor recommends Nano-Knife technology if the tumor is malignant and the surgery carries high risks.
- The essence of the procedure is that under the control of ultrasound or CT, electrodes are placed in or around a malignant tumor by applying series of high voltage electrical impulses to them. As a result, tumor cells are destroyed and then excreted from the body naturally.
- Research data show that the nano-knife is an effective palliative treatment for inoperable liver and pancreatic cancers. It helps to prolong the life of patients by two times or more. Also, the technique is minimally invasive and does not carry such risks as classical surgical interventions.
- Radiation therapy for pancreatic cancer
Most often, radiation therapy is given after surgery to kill the remaining cancer cells in the body. Sometimes a course of preoperative (neoadjuvant) radiation therapy is given to help remove the tumor. For unresectable cancers, radiation therapy may become an essential treatment for pain relief.
Pancreatic cancer has relatively low five-year survival rates. In the early stages, they amount to 5-14%, in the later stages – 1-3%. Even if the cancer is diagnosed late, and the prognosis is unambiguously poor, this does not mean that nothing can be helped to the patient. Modern treatment methods help relieve pain and other severe symptoms and ensure quality prolong life.
Can pancreatic cancer be prevented?
Not all risk factors can be affected, but some effective prevention measures exist. First of all, it is worth quitting smoking – this will help reduce the risk of several types of cancer at once. Try to maintain a healthy weight, avoid alcohol – according to some studies, there are no safe doses.
What is the best nutritional diet for pancreatic cancer Treatment?
People with pancreatic cancer experience a sharp loss of weight, constant weakness, anemia, and other complications. Therefore, it is always necessary to adhere to a healthy diet as suggested by your doctor. Many patients need to take pancreatic enzyme tablets regularly. If there is difficulty in swallowing food, a nasogastric tube is used.
What are preventive measures for pancreatic cancer?
As with other cancers, there are no reliable measures that can guarantee the prevention of pancreatic cancer. However, there are some ways to reduce the risks:
- Stop smoking. It is one of the most significant risk factors.
- Maintain a healthy weight. The two main measures are a healthy diet and regular physical activity.
- Limit your alcohol intake. Doctors recommend refraining from frequent and excessive drinking.
- Observe good occupational hygiene and use protective equipment. This recommendation applies to people who work in manufacturing and deal with hazardous chemicals.
Does the risk of pancreatic cancer increase as we get older?
Among other oncological diseases in adults, pancreatic cancer ranks sixth in number. According to American statistics, malignant neoplasms of the pancreas account for about 3% of all cancers. It contributes to 7% of deaths from all types of cancer. Most often, the tumor occurs in people over 60–65 years old.
What part of the body is affected by pancreatic cancer?
Pancreatic cancer primarily affects the pancreas, and in the advanced stage, it affects nearby organs. In 50-60% of cases, the tumor affects only the pancreas head, in 10% – the body, in 6-8% – the tail. In 25-30% of cases, the entire pancreas is affected.