Pancreatic Cancer: All you need to know

The pancreas is an abdominal organ located behind the stomach's lower portion. It is one of the most important endocrine organs that play a vital role in the digestion of various macronutrients, such as carbohydrates, fats, and proteins. In addition, the pancreas produces certain crucial hormones like insulin and glucagon that help regulate glucose (sugar) levels in the body. 

Pancreatic cancer occurs in the tissues of the pancreas and is characterized by mutations in the pancreas cells, causing uncontrolled multiplication of the cells. The tissue mass thus formed can sometimes be benign (not cancerous); however, in pancreatic cancer, the tissue mass is mostly malignant (cancerous). The symptoms of pancreatic cancer include:

• Fatigue

• Poor appetite and acute weight loss

• Indigestion, diarrhea, or constipation

• Dark-colored urine or pale grayish stool

• Swollen liver

• Jaundice

• Distended gallbladder

Types and Stages of Pancreatic Cancer

Depending upon the site of cancerous growth and its associated effects, pancreatic cancer can be classified into two major types:

• Pancreatic ductal adenocarcinoma is the most common form of pancreatic cancer that initiates in the exocrine cells.

• Pancreatic neuroendocrine tumors are rare tumors that start in endocrine cells.

Depending upon the advancement, pancreatic cancer can be categorized into different stages:

Stage 0 - The pancreas contains aberrant cells that have the potential to develop into cancer (pre-cancer).

Stage 1 -The cancer is confined to just the pancreas.

Stage 2 - Cancer has spread to the bile duct and other structures but has not yet reached the lymph nodes (localized cancer).

Stage 3 - Cancer has spread to the major blood vessels and lymph nodes but is still considered localized.

Stage 4 - Cancer has spread to other distant organs and body parts (metastatic cancer).

Causes and Risk Factors of Pancreatic Cancer

The exact causes of pancreatic cancer are not known yet; however, certain factors which might trigger the onset of cancerous growth are:

Genetics - Certain genetic conditions and mutations can be associated with pancreatic cancer.

Sex - Males are more commonly affected than females.

Age - Aging more than 55 can be an associated risk factor. However, pancreatic cancer may develop during childhood too.

Lifestyle Factors - Sedentary lifestyle, unhealthy dietary habits, and tobacco use can increase the risk of pancreatic cancer.

Medical Conditions – clinical manifestations such as hereditary predisposition, obesity, diabetes, chronic pancreatitis, cirrhosis, a stomach infection, etc., can lead to the development of pancreatic cancer.

Diagnosis and Treatment Modalities

The likelihood of recovery from pancreatic cancer is considerably increased by early diagnosis. However, because of the location of the pancreas, the detection of pancreatic cancer is difficult and is generally diagnosed only at the advanced stages.

Doctors examine the symptoms and review the medical history to make a diagnosis. Screening for pancreatic cancer can be performed by:

• Imaging tests like CT and MRI scans to get a complete picture of your pancreas within the abdomen.

• An endoscopic ultrasound — a thin, flexible tube with a camera attached to take pictures of the pancreas is introduced into the stomach.

• Pancreas biopsy

• Blood tests to detect the presence of tumor markers indicative of pancreatic cancer, like CA 19-9.

Once diagnosed, doctors perform additional tests to determine the condition's advancement, including imaging tests such as a PET scan or blood tests. The results of these tests are then used to establish the cancer stage. Staging helps to determine the severity and decide the best-suited treatment option.

The ultimate aim of the treatment is to kill malignant cells and halt the spread of cancer. The primary forms of treatment are:

• Surgery. A piece of the pancreas is removed during surgical therapy for pancreatic cancer. It can get rid of the initial tumor, but it cannot treat cancer that has spread to other places. Therefore, surgery is typically not advised for pancreatic cancer in its advanced stages.

• Radiation therapy. High-energy beams such as X-rays are used to kill cancer cells.

• Chemotherapy. Anticancer medications are used to eradicate cancer cells and prevent their further development and disease progression.

• Targeted therapy. Drugs and antibodies are used to specifically target cancer cells, avoiding the damage that chemotherapy and radiation therapy might cause to healthy cells.

• Immunotherapy. Your immune system is triggered using various methods to target cancer.

A doctor might advise combining various treatment modalities in specific circumstances. For instance, chemotherapy may be administered before surgery. Treatment options for pancreatic cancer in advanced stages may emphasize symptomatic relief and palliative care.

The Bottom Line

If you notice any symptoms related to pancreatic cancer, consult your doctor as soon as possible. People with high risk should undergo frequent screening to avert chronic complications. Early detection of pancreatic cancer leads to early elimination of the disease before it progresses to an untreatable stage.