Pancreatic Cancer
- It is abnormal uncontrolled growth of cells in Pancreas, an organ situated in your tummy/abdomen, just below the ribs, in the middle. It is situated just behind stomach and intestines.
- There are various types of pancreas cancers, but almost 9 in 10 cases, it is due to adenocarcinoma.
- Cancer of pancreas is generally a disease of old age, but may occur in younger patient also. It is an aggressive disease, with early detection and complete removal by operation giving some chance of cure.
Pancreatic Adenocarcinoma
This cancer develops from the cells in Pancreas ducts. As the cells multiply excessively, they form a tumour in and around the ducts.
- It can block the main pancreatic duct or the bile duct. This blocks their drainage in intestine, causing problems like pancreatitis and jaundice.
- It can spread inside pancreas, and eventually, into surrounding organs.
- Some cells may spread through blood to other areas of body to produce tumour.
Other types of Cancer
- Some cancers develop from hormone producing cells in pancreas (example Insulinoma, Glucagonoma, etc.)
- They behave differently to adenocarcinoma, have better outcomes, and can be detected early due to hormonal imbalances produced by them.
What are the risk factors for Pancreas Cancer?
- Ageing – Risk increases above 60yrs age
- Smoking
- Diet – Fatty diet and meat
- Obesity
- Persistent swelling over pancreas (Chronic Pancreatitis)
- Heavy alcohol drinking
- Prolonged exposure to certain industrial chemicals like pesticide, dyes, metal refining chemicals
What are Pancreas Cancer symptoms?
Symptoms due to bile duct blockage –
Around 7 in 10 cases develop in Head of Pancreas. As it grows, it compresses/blocks bile duct, causing
1. Yellow skin and eyes (painless jaundice)
2. Dark coloured urine
3. Pale stools
4. Itching all over body (pruritus)
5. Nausea-vomiting
6. Weight loss, anorexia (First symptoms if tumour in body or tail of pancreas)
7. Diabetes
8. Acute Pancreatitis – tumour may present as attack of acute pancreatitis
9. If spreads to other parts, symptoms develop according to site (Example, breathlessness in lung involvement, bone pain if spreads to bone, unconsciousness if spreads to brain, etc.)
How is Pancreas Cancer diagnosed?
- A thorough history given to the doctor along with examination is most important.
- Supportive blood tests, and imaging in form of USG (sound waves used to determine status of organs inside body), CT scan (specialized kind of x-ray giving accurate images inside body), MRI (strong magnetic field used to create images of organs inside body) as per doctor’s discretion is important for supporting the diagnosis.
- Endoscopic evaluation in form of EUS (Endoscopic ultrasound), and in advanced cases, Biopsy of tumour, when surgery is not possible.
- In some cases, a PET-CT scan, a specialized CT scan is used to see the spread of disease.
- And if there is strong suspicion of cancer, with no evidence on above tests, a laparoscopy procedure, that is, putting a camera through the abdomen to visualize internal organs, may have to be done.
How is Pancreatic Cancer treated?
- Options include Surgery, Chemotherapy, Radiotherapy. Treatment advised for each patient differs on basis of various factors, like size of cancer, spread of cancer, patient’s condition, other illnesses, etc.
- A discussion with specialist, with understanding the pros and cons of each option, success rate, possible side-effects, complications, and other details, is very necessary.
- Treatment may aim to cure cancer. Early detection of tumour I beneficial for such approach.
- It may be to control the cancer. If cure is not possible, treatment is given to limit the growth/spread of cancer. So that patient is symptom free for some time.
- Treatment may be to ease symptoms. In advanced cases, painkillers, nutritional supplements, other techniques can be used to improve quality of life.
- Detailed discussion of treatment is beyond the scope and purpose of this informative article, and is better discussed with your doctor in person.
What is the outcome of patients of Pancreatic cancer?
Early detected tumour, small sized tumour, young age are favourable factors for good outcome. Unfortunately, most tumours are detected late when they start producing symptoms, when cure becomes unlikely.
