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Pancreatic Cancer

Pancreatic Cancer

Pancreas is an important organ of the digestive system. Pancreatic cancer is one of the most common types of gastrointestinal tract cancers. This article provides some information about cancer of the pancreas, its causes, symptoms, and treatment.
Reshma Jirage
Last Updated: Jan 21, 2018
Insulin, the hormone that maintains the blood glucose level, is produced by a gland known as pancreas. Pancreas is located behind the stomach and adjacent to the small intestine in the upper part of the abdomen. This organ also produces certain enzymes that play an important role in the digestion of food in the gastrointestinal tract.
Pancreatic cancer occurs when there is an uncontrolled growth of malignant cells in the pancreas. When this growth starts in the channels carrying the pancreatic juices, it is referred to as exocrine pancreatic cancer, and sometimes referred to as adenocarcinoma.
On the other hand, when the cancer starts in the cells which produce insulin, it is known as islet cell pancreatic cancer or endocrine cancer. This particular type of cancer spreads through the lymphatic system to other body parts such as liver, bones, lungs, etc, which makes it the fifth leading cause of death by cancer. Every year, about 30,000 people in the United States are diagnosed with this medical condition.
Risk Factors
Although the exact causes are not known, there are certain factors that can increase the risk of this medical condition in the human body. Some of the main risk factors are smoking, age, obesity, family history, race, and gender. Smoking is one of the major risk factors. Those who smoke are likely to develop this medical condition 2-3 times more than the nonsmokers. Chronic pancreatitis is another main cause. Those affected by diabetes mellitus are also more prone to this cancer.
This medical condition is more commonly observed in people older than 50 years of age. A family history of genetic syndromes including Peutz-Jeghers syndrome, BRCA2 gene mutation, Familial atypical mole-malignant melanoma (FAMMM), and Lynch syndrome could increase the risk. This cancer can lead to pain in the abdomen, loss of appetite, diarrhea, etc.
Symptoms
This medical condition is asymptomatic until it is in the advanced stage. This means that in the early stage of cancer, there are no significant symptoms. Hence, it is known as a silent disease. As the cancer develops, the affected person experiences pain in the upper abdomen and sometimes in the back. The pain worsens after eating or lying down. Some other signs and symptoms are loss of appetite, nausea, weakness, and weight loss.
If the common bile duct is blocked by the tumor, the bile cannot pass into the digestive system. As a result, there is yellowing of the skin and whites of the eyes. This condition is referred to as jaundice. In case of islet cell pancreatic cancer, there may be excessive production of insulin. It may lead to weakness, dizziness, muscle spasms, chills, and diarrhea.
In the later stages, there may be severe itching due to accumulation of high levels of bile acids in the skin. There is a reduction in the release of pancreatic enzymes due to cancer, which can give rise to a number of digestive problems. Hence, this should be diagnosed in the early stage, so that one can get the appropriate medical treatment.
Diagnosis
To diagnose this medical condition, a physical examination of the affected person is carried out. Further, the doctor would inquire about the personal and family medical history. Some laboratory investigations and imaging tests are advised for an accurate diagnosis. Certain blood tests are performed for the determination of levels of serum bilirubin, gamma-glutamyl transpeptidase, and alkaline phosphatase.
The levels of serum lipase and amylase are also checked. Some of the imaging tests that are conducted for the diagnosis include ultrasound, CT scan, MRI scan, endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasound (EUS), and percutaneous transhepatic cholangiography (PTC). During the biopsy, a small sample of pancreatic tissue is taken for the microscopic examination.
Once the diagnosis is confirmed, staging of the cancer is carried out with chest X-ray, laparoscopy, CT scan, MRI scan, bone scan, and positron emission tomography (PET) scan. Blood test for the tumor marker and CA19-9 are also significant. Elevated levels of CA19-9 indicate an advanced stage of pancreatic cancer. The three major stages can be described as respectable, locally advanced, and metastatic. Once one is diagnosed with this condition, one should immediately seek medical treatment.
Treatment
The treatment would depend on the location and stage of the cancer. Further, the treatment options are decided depending upon the affected person's age, overall health, and personal preference. The various options are surgery, chemotherapy, and radiation therapy. A surgery is recommended so as to remove a part of the pancreas, or the entire organ.
This is performed to remove the tumors in the pancreatic head (Pancreatoduodenectomy), the pancreatic tail, and body (Distal Pancreatectomy). However, if it spreads to the other organs, blood vessels, or lymph nodes, then, surgery would not be the right option. In such cases, one may have to go for chemotherapy or radiation therapy.
Chemotherapy and radiation therapy are used to destroy the cancer cells. In case of the advanced stage, targeted drug therapy is also used along with chemotherapy. Targeted drug therapy focuses on the specific abnormalities within the cancer cells. The drugs such as erlotinib and cetuximab are used in this therapy.
Although there are various treatment options available, it is always better to take the necessary precautions to prevent the cancer of pancreas. Quit smoking, maintaining a healthy body weight, regular exercises, and having a healthy diet are some of the ways to minimize the risk of this medical condition. These preventive measures are also important for eliminating other health problems, thus, leading to a healthy life.
Disclaimer: This HealthHearty article is for informative purposes only, and should not be used as a replacement for expert medical advice.