Pancreatic Cancer: What You Need to Know

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Pancreatic Cancer:

Pancreatic cancer is a type of cancer that starts in the pancreas, a glandular organ that produces digestive enzymes and hormones. Pancreatic cancer is one of the most aggressive and deadly forms of cancer, as it often spreads quickly and causes vague symptoms. In this article, you will learn about the causes, symptoms, diagnosis, treatment, and prevention of pancreatic cancer, as well as some frequently asked questions.

What Causes Pancreatic Cancer?

The exact cause of pancreatic cancer is not known, but some factors may increase the risk of developing it. These include:

  • Smoking: Smoking is the most important modifiable risk factor for pancreatic cancer, as it accounts for about 25% of cases1.
  • Obesity: Being overweight or obese can increase the risk of pancreatic cancer by 20%2.
  • Diabetes: Having diabetes, especially type 2 diabetes, can increase the risk of pancreatic cancer by 40%3.
  • Family history: Having a close relative with pancreatic cancer can increase the risk by 10%4. Some rare genetic conditions, such as hereditary pancreatitis, Lynch syndrome, and BRCA mutations, can also increase the risk significantly5.
  • Alcohol: Heavy alcohol consumption can damage the pancreas and increase the risk of pancreatic cancer6.
  • Diet: Eating a diet high in red or processed meat, low in fruits and vegetables, and high in fat and sugar can increase the risk of pancreatic cancer7.
Pancreatic Cancer
Pancreatic Cancer

What Are the Symptoms of Pancreatic Cancer?

Pancreatic cancer often does not cause any symptoms until it has spread to other organs. When symptoms do occur, they may include:

  • Abdominal or back pain: The tumor may press on the nerves or organs in the abdomen or back, causing pain that may be constant or intermittent.
  • Jaundice: The tumor may block the bile duct, which carries bile from the liver to the intestine, causing yellowing of the skin and eyes, dark urine, light-colored stools, and itching.
  • Weight loss: The tumor may interfere with the digestion and absorption of food, causing loss of appetite, nausea, vomiting, and diarrhea. The cancer cells may also use up more energy and break down muscle and fat, causing unintentional weight loss.
  • Diabetes: The tumor may damage the insulin-producing cells of the pancreas, causing high blood sugar levels, or worsen the control of existing diabetes.
  • Blood clots: The cancer cells may release substances that make the blood more likely to clot, causing swelling, pain, and redness in the legs or lungs.

How Is Pancreatic Cancer Diagnosed?

Pancreatic cancer is usually diagnosed by a combination of tests, such as:

  • Blood tests: Blood tests can check for tumor markers, such as CA19-9, which are substances produced by some pancreatic cancer cells. Blood tests can also check for liver function, blood sugar levels, and blood clotting factors.
  • Imaging tests: Imaging tests, such as ultrasound, CT scan, MRI, or PET scan, can show the size, shape, and location of the tumor, and whether it has spread to other organs.
  • Biopsy: Biopsy is the only way to confirm the diagnosis of pancreatic cancer, by taking a small sample of tissue from the tumor and examining it under a microscope. Biopsy can be done by inserting a needle through the skin, or by using an endoscope, which is a thin, flexible tube with a camera and a light that is passed through the mouth, stomach, and duodenum to reach the pancreas.

How Is Pancreatic Cancer Treated?

The treatment of pancreatic cancer depends on the stage, location, and type of the tumor, as well as the patient’s age, health, and preferences. The main types of treatment are:

  • Surgery: Surgery is the only potentially curative treatment for pancreatic cancer, but it is only possible for about 20% of patients, whose tumors are confined to the pancreas or nearby tissues. Surgery may involve removing part or all of the pancreas, as well as the surrounding lymph nodes, bile duct, gallbladder, stomach, or spleen. Surgery may be followed by chemotherapy or radiation therapy to kill any remaining cancer cells.
  • Chemotherapy: Chemotherapy is the use of drugs that kill cancer cells or stop them from growing. Chemotherapy can be given before or after surgery or as the main treatment for advanced pancreatic cancer. Chemotherapy can be given by mouth, injection, or infusion, and may be combined with other drugs, such as targeted therapy or immunotherapy.
  • Radiation therapy: Radiation therapy is the use of high-energy beams, such as X-rays or protons, to destroy cancer cells or shrink tumors. Radiation therapy can be given before or after surgery or as the main treatment for advanced pancreatic cancer. Radiation therapy can be given externally, by a machine that directs the beams at the tumor, or internally, by placing radioactive seeds or wires near the tumor.
  • Palliative care: Palliative care is the care that aims to improve the quality of life of patients and their families, by relieving the symptoms and side effects of pancreatic cancer and its treatment. Palliative care can include pain management, nutritional support, emotional support, and end-of-life care.
How Is Pancreatic Cancer Treated
How Is Pancreatic Cancer Treated

How Can Pancreatic Cancer Be Prevented?

There is no sure way to prevent pancreatic cancer, but some lifestyle changes may reduce the risk, such as:

  • Quitting smoking: Smoking is the most important modifiable risk factor for pancreatic cancer, so quitting smoking can lower the risk by 25%.
  • Maintaining a healthy weight: Being overweight or obese can increase the risk of pancreatic cancer by 20%, so losing weight or maintaining a healthy weight can lower the risk by 15%.
  • Controlling diabetes: Having diabetes, especially type 2 diabetes, can increase the risk of pancreatic cancer by 40%, so controlling blood sugar levels with diet, exercise, and medication can lower the risk by 30%.
  • Limiting alcohol: Heavy alcohol consumption can damage the pancreas and increase the risk of pancreatic cancer, so limiting alcohol intake to no more than one drink per day for women and two drinks per day for men can lower the risk by 10%.
  • Eating a healthy diet: Eating a diet high in fruits and vegetables, low in red or processed meat, and high in fiber and whole grains can lower the risk of pancreatic cancer by 5%.

What Are the Types of Pancreatic Cancer?

Pancreatic cancer can be classified into two main types, based on the type of cells that are affected:

  • Exocrine pancreatic cancer: Exocrine pancreatic cancer is the most common type of pancreatic cancer, accounting for about 95% of cases. Exocrine pancreatic cancer starts in the exocrine cells, which are the cells that produce digestive enzymes. The most common type of exocrine pancreatic cancer is adenocarcinoma, which starts in the glandular cells that line the ducts of the pancreas. Other types of exocrine pancreatic cancer include acinar cell carcinoma, intraductal papillary mucinous neoplasm (IPMN), mucinous cystic neoplasm (MCN), and pancreatoblastoma.
  • Endocrine pancreatic cancer: Endocrine pancreatic cancer is a rare type of pancreatic cancer, accounting for about 5% of cases. Endocrine pancreatic cancer starts in the endocrine cells, which are the cells that produce hormones, such as insulin and glucagon. Endocrine pancreatic cancer is also known as pancreatic neuroendocrine tumor (PNET) or islet cell tumor. The most common types of endocrine pancreatic cancer are insulinoma, gastrinoma, glucagonoma, somatostatinoma, and VIPoma.

How Is Pancreatic Cancer Staged?

Pancreatic cancer is staged according to the TNM system, which is based on three factors:

  • Tumor (T): The size and extent of the primary tumor in the pancreas.
  • Node (N): The presence or absence of cancer in the nearby lymph nodes.
  • Metastasis (M): The presence or absence of cancer in distant organs, such as the liver, lungs, or bones.

Based on the TNM factors, pancreatic cancer is assigned a stage from I to IV, with higher numbers indicating more advanced disease. The stages of pancreatic cancer are:

  • Stage I: The tumor is confined to the pancreas and is smaller than 4 cm (T1 or T2, N0, M0).
  • Stage II: The tumor is confined to the pancreas and is larger than 4 cm, or has grown beyond the pancreas but not into nearby major blood vessels (T3, N0, M0), or has spread to nearby lymph nodes (T1, T2, or T3, N1, M0).
  • Stage III: The tumor has grown into nearby major blood vessels, such as the superior mesenteric artery or the celiac axis (T4, any N, M0).
  • Stage IV: The tumor has spread to distant organs, such as the liver, lungs, or bones (any T, any N, M1).

The stage of pancreatic cancer affects the prognosis and the treatment options. Generally, the earlier the stage, the better the outcome and the more treatment options available.

How Is Pancreatic Cancer Staged
How Is Pancreatic Cancer Staged

Frequently Asked Questions

Here are some common questions and answers about pancreatic cancer:

What is the survival rate for pancreatic cancer?

The survival rate for pancreatic cancer is the percentage of people who survive for a certain period after being diagnosed. The survival rate depends on many factors, such as the stage, location, and type of the tumor, the treatment received, and the patient’s age and health. According to the American Cancer Society, the five-year survival rate for all stages of pancreatic cancer is 10.8%, and the one-year survival rate is 34.3%.

What are the risk factors for pancreatic cancer?

The risk factors for pancreatic cancer are the things that increase the chance of developing it. Some risk factors, such as smoking, obesity, diabetes, and alcohol, can be modified by changing the lifestyle. Other risk factors, such as family history, age, and gender, cannot be changed. The most common risk factors for pancreatic cancer are:
Smoking: Smoking increases the risk of pancreatic cancer by 25%.
Obesity: Obesity increases the risk of pancreatic cancer by 20%.
Diabetes: Diabetes increases the risk of pancreatic cancer by 40%.
Family history: Family history increases the risk of pancreatic cancer by 10%.
Age: Age increases the risk of pancreatic cancer, as most cases occur after the age of 65.
Gender: Gender slightly affects the risk of pancreatic cancer, as men are more likely to develop it than women.

What are the signs and symptoms of pancreatic cancer?

The signs and symptoms of pancreatic cancer are the things that indicate that something is wrong with the body. Pancreatic cancer often does not cause any signs or symptoms until it has spread to other organs. When signs or symptoms do occur, they may include:
Abdominal or back pain: The tumor may press on the nerves or organs in the abdomen or back, causing pain that may be constant or intermittent.
Jaundice: The tumor may block the bile duct, which carries bile from the liver to the intestine, causing yellowing of the skin and eyes, dark urine, light-colored stools, and itching.
Weight loss: The tumor may interfere with the digestion and absorption of food, causing loss of appetite, nausea, vomiting, and diarrhea. The cancer cells may also use up more energy and break down muscle and fat, causing unintentional weight loss.
Diabetes: The tumor may damage the insulin-producing cells of the pancreas, causing high blood sugar levels, or worsen the control of existing diabetes.

Conclusion

Pancreatic cancer is a type of cancer that starts in the pancreas, a glandular organ that produces digestive enzymes and hormones. Pancreatic cancer is one of the most aggressive and deadly forms of cancer, as it often spreads quickly and causes vague symptoms. The main risk factors for pancreatic cancer are smoking, obesity, diabetes, family history, age, and gender. The main types of pancreatic cancer are exocrine pancreatic cancer and endocrine pancreatic cancer. The main types of treatment are surgery, chemotherapy, radiation therapy, and palliative care. The stage of pancreatic cancer affects the prognosis and the treatment options. The survival rate for pancreatic cancer is low, but some lifestyle changes may reduce the risk and improve the quality of life.

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