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PANCREATIC CANCER 

 

The incidence of pancreatic cancer is less when compared to the lung, colorectal and oral cancers.  The prevalence of cancer is equal to both men and women. 

Pancreatic cancer occurs either due to the tumour of the endocrine cell or the exocrine cells.  It is necessary to know the origin of the tumour before the start of the treatment.  The tumour of the exocrine glands accounts for about 95% of the total pancreatic cancer, which includes pancreatic adenocarcinoma, less common type of exocrine cancer and ampullary cancer.  The tumour of the endocrine glands accounts for 5% of the total pancreatic cancer cases. 

Signs and symptoms

The signs and symptoms of pancreatic cancer include:

  • Jaundice:  It is one of the first symptoms that arises due to the accumulation of bilirubin in the body because of pancreatic cancer.
  • Dark urine: It is a sign of jaundice, due to increased levels of bilirubin in the blood.
  • Pain in the abdomen and back:  The tumour that starts to grow in the pancreas and expand, pressing the other organs in the abdomen.  This leads to pain in the abdomen and back.
  • Nausea and Vomiting:  Due to the expansion of the pancreas, it blocks the food to pass through the stomach.
  • Weight loss and poor appetite is observed in the patient
  • Liver and gallbladder enlargement:  Due to blockade of the bile duct, bile begins to accumulate, making it larger.

Causes

Pancreatic cancer may occur due to mutations in certain genes or due to certain treatment modalities.  These mutations result in abnormal growth of pancreas, resulting in the formation of cancer.  The mutated cells may also affect the other parts of the body.

Risk factors

The risk factors associated with cancer may be modifiable or non-modifiable.  The modifiable risk factors include:

  • Smoking or tobacco use
  • Overweight and obesity
  • Exposure to chemicals in workplace in metal and textile industry

The non-modifiable risk factors include:

  • Age:  The incidence of pancreatic cancer, increases with age
  • Gender:  In the past, the prevalence of pancreatic cancer was high in males when compared to females.  But over the time the prevalence of pancreatic cancer in both males and females are equal.
  • Inherited genes:  Family history is one of the main cause of pancreatic cancer.  The most common type of inherited cancer-causing genes is BRCA1 or BRCA2.
  • The other risk factors may also include chronic pancreatitis, cirrhosis of the liver, stomach problems, alcohol consumption.

Diagnosis

X-Ray:  This test provides a basic view of any abnormality in the abdomen.  It detects the change in the size of the organs and detects the spread of any infection to the bones.

Ultrasound scan: It is the most common test performed to get a real-time view of the organs in the body.  It shows the structure and movement of the pancreas, which helps in easy diagnosis.

Computed tomography (CT) scan:  It shows the pancreas fairly clear and also shows the spread of infection to the other organs. 

Cholangiopancreatography:  It is a test performed to study the internal structure of the pancreas.  This test shows whether the pancreatic duct is blocked or narrowed or dilated.

Other imaging tests: Magnetic resonance imaging (MRI) scan and positron emission tomography (PET) scan helps to know the spread of pancreatic cancer to other tissues and the stage of cancer.

 

Liver Function Test:  The test is performed to detect the level of liver enzymes in the body.

Tumour markers:  The blood sample is collected to detect the presence of tumour markers in the blood such as carcinoembryonic antigen and CA19-9.

Biopsy: In this procedure, a sample of affected tissue is removed for laboratory testing. This test helps to determine the presence of malignant cells and also the type of pancreatic cancer.

Treatment

Pancreatic cancer may be treated with one of the following treatment procedures such as surgery, radiation therapy, chemotherapy or ablation or embolization treatments. 

Surgery:

Surgery is the leading procedure involved in the treatment of patients with pancreatic cancer.  Whipple procedure is used to remove the head and upper body part of the tumour affected pancreas.  Distal pancreatectomy is the removal of the tail and a certain portion of the body part of the pancreas.  Total pancreatectomy is the complete removal of the pancreas when cancer has affected the whole pancreas. 

Chemotherapy: 

Chemotherapy is the most effective mode of treatment through which the drug is given either orally or intravenously to kill cancer cells throughout the body. This therapy is effective in an advanced stage of cancers when cancer cannot be removed completely. Chemotherapy can also be given to treat cancers along with radiation therapy or before and after surgery to prevent the spread to another part of the body.

 

Radiation therapy:

Usually, radiation therapy is given along with chemotherapy before surgery, where the tumour is grown beyond the size. This therapy also used to kills cancer cells that may be left behind after surgery.

 

Coping and support

You may feel distressed because of the cancer diagnosis. But, you should find ways to cope with the disease and the treatment for better outcomes and good quality-of-life.

 

Learn about the disease and the treatment options available, so that you can make decisions for your care. You may need physical and emotional support when you are in the hospital or after returning home. So, keep your family and friends close and make them understand your condition.

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