A diagnosis of pancreatic cancer is uncommon but nevertheless devastating. Learn what it is, what its types are, how it’s caused, diagnosed, and treated, and how you can prevent it.
What is pancreatic cancer?
Pancreatic cancer is a type of cancer that arises from the pancreas, a glandular organ present behind the stomach. Even though it’s rare in India, it’s hard to detect in its early stages and is associated with a higher mortality rate.
What are the types of pancreatic cancer?
Depending on where the cancer originates, there are two types:
- Exocrine tumours: These called ductal adenocarcinoma, usually start in the ducts of the pancreas. They are the most common type and make up approximately 80-90% of all pancreatic tumours
- Endocrine tumours: Also called neuroendocrine tumours, these may arise from the beta cells (most commonly), alpha cells, or delta cells of the pancreas
What are the stages of pancreatic cancer?
Staging is useful in knowing the location and spread of cancer, and the other parts of the body affected. The four stages
- Stage I: The tumour is approximately 2-4 cm in size and is confined only to the pancreas
- Stage II: In this stage, the tumour is equal to or greater than 4 cm but is still confined to the pancreas
- Stage III: In this, the tumour grows beyond the pancreas and has spread to nearby blood vessels or nerves, although the cancer cells have not yet affected other tissues
- Stage IV: The cancer cells have migrated to distant organs such as the liver, lungs, or peritoneal cavity
What are the risk factors of pancreatic cancer?
Some risk factors are:
- You have someone in your family suffering from pancreatic cancer
- You regularly smoke
- You have diabetes
- You’re suffering from chronic pancreatitis
- You are overweight
- You have a rare inherited condition such as hereditary pancreatitis, Peutz-Jeghers syndrome, or familial atypical mole multiple melanoma syndrome (FAMMM)
What are the symptoms of pancreatic cancer?
Most people do not have any symptoms until the more advanced stages of the disease. They can experience:
- Jaundice (yellowing of the skin and eyes)
- Dark-coloured urine
- Incessant and gnawing type of abdominal pain that can radiate to the back and
- Alleviate on bending forward
- Unexplained weight loss
- Loss of appetite
- Nausea and vomiting
- Weakness
- Severe itching of the skin
- Sometimes the person can develop diabetes or recurrent episodes of blood clots in the deep veins (DVT, or deep vein thrombosis)
How is pancreatic cancer diagnosed?
Your doctor will take a detailed medical history and carry out:
- General physical examination: Your doctor will conduct a physical examination to check for general signs such as weight loss, abdominal masses, and any other signs of disease
- Blood tests, specifically to check the presence of CA 19-9, a protein present in the blood. Increased levels can indicate pancreatic cancer
- Imaging tests such as:
- Ultrasound
- CT Scan: It can confirm the presence of cancer and also check if it has spread to other parts
- PET Scan: A small amount of radioactive material is injected into your body and, a scanner then detects this substance to produce images of your internal organs
- Endoscopic retrograde cholangiopancreatography (ERCP): This process combines endoscopy and X-rays. It helps confirm the diagnosis.
- Biopsy: In case your doctor finds any abnormal areas during the diagnosis, he can take samples of the tissue and send them for further testing
- Molecular testing: Your doctor may recommend this to look for changes in specific genes and proteins. This is especially useful if you have a family history of cancer and can help plan your treatment course
What are the treatment options for pancreatic cancer?
Treatment options include:
Surgery is the mainstay of treatment.
- Whipple procedure: If the cancer is confined to the head of the pancreas, your doctor may recommend Whipple’s procedure. In this, the head of the pancreas, gallbladder, part of the stomach and small intestine, and the bile duct are surgically removed
- Total pancreatectomy: If the cancer has spread further, the entire pancreas, part of the stomach and small intestine, the common bile duct, the gallbladder, the spleen, and nearby lymph nodes are surgically removed
- Distal pancreatectomy: In this procedure, the cancer involves the body or tail of the pancreas, and these are surgically removed
- Radiation therapy: High-energy X-rays or other types of radiation can be helpful to decrease the chances of the tumour returning or re-growing in the original location
- Chemotherapy: Drugs are injected through your veins which can shrink the tumour before surgery or remove traces of cancer cells after surgery and improve your outcomes
- Targeted therapy: In this, the drugs specifically act on the cancer cells while leaving the normal cells intact. Thus, there are minimal systemic side effects
Can pancreatic cancer be prevented?
A few measures that can lower your risk include:
- Quitting smoking
- Exercising regularly
- Eating a balanced diet
- Drinking alcohol in moderation
- Taking adequate precautions to minimise your exposure to hazardous chemicals such as pesticides, petrochemicals, benzene, and industrial dyes
