Pancreatic Cancer

Overview

Pancreatic cancer is a type of cancer that begins in the pancreas (a glandular organ in the digestive system and endocrine system).

The pancreas is located in the abdominal cavity behind the stomach. It has a dual function since it produces several important hormones, such as insulin, glucagon, somatostatin or pancreatic polypeptide and in the meantime it secrets pancreatic juice containing digestive enzymes with the aim of assisting digestion and absorption of nutrients in the small intestine. The main role of these is to help the further breakdown of carbohydrates, proteins and lipids in the duodenum.

Pancreatic Cancers typically start in the cells lining the exocrine function, but also can appear in the endocrine part of the organ.

Types of Pancreatic Cancer

Doctors divide Pancreatic Cancer into two major types based on the nature of the cells affected such as:

  • Exocrine Pancreatic Cancer. This kind of cancer is by far the most common type of pancreas cancer. 95% of exocrine cancers are adenocarcinomas and other, less common exocrine cancers include adenosquamous carcinomas, squamous cell carcinomas, signet ring cell carcinomas, undifferentiated carcinomas, and undifferentiated carcinomas with giant cells.
  • Endocrine Pancreatic Cancer. As a group, they are often called pancreatic Neuroendocrine Tumours (NETs) or islet cell tumours and they represent less than 5% of all pancreatic cancers. About half of pancreatic NETs make hormones that are released into the blood and cause symptoms. Some examples are: gastrinomas, glucagonomas, somatostatinomas, etc.

Risk Factors

A number of factors may increase your risk of Pancreatic Cancer. Some risk factors can be managed, for instance, by quitting smoking, but other factors cannot be controlled, such as family history.

Risk factors for Pancreatic Cancer include:

  • Age
  • Male gender
  • African-American race
  • Family history
  • Inherited genetic syndromes
  • Diabetes
  • Chronic pancreatitis
  • Cirrhosis of the liver
  • Smoking
  • Excess body weight

Signs and Symptoms

Pancreatic cancer is hard to find early. The pancreas is deep inside the body, so early tumours cannot be seen or felt by health care providers during routine physical exams. Patients usually have no symptoms until the cancer has already spread to other organs.

Signs and symptoms for Pancreatic Cancer include:

  • Upper abdominal pain that may radiate to your back
  • Yellowing of your skin and the whites of your eyes (jaundice)
  • Loss of appetite
  • Weight loss
  • Depression
  • Blood clots

Prognosis

As the pancreas is an endocrine organ in charge of controlling some vital parameters, such as sugar levels in blood, survival rates are very low and for this reason, it is crucial an early diagnose.

If the cancer has not spread outside of the pancreas and surgery is possible, between 7 and 25 out of 100 people will survive for 5 years or more.

For locally advanced disease (stage III) which cannot be removed by an operation, the median survival is about 6 to 11 months.

For cancer which has spread to another part of the body (stage IV) the median survival is only between 2 and 6 months. However, this can vary depending on how much the cancer has grown and where it has spread.

Pancreatic Cancer Diagnosis

PLEASE NOTE: EARLY DIAGNOSIS IN CANCER IS VERY IMPORTANT BECAUSE CANCER THAT’S DIAGNOSED AT AN EARLY STAGE ―BEFORE IT’S HAD THE CHANCE TO GET TOO BIG OR SPREAD―, IS MORE LIKELY TO BE TREATED SUCCESSFULLY. IF THE CANCER HAS SPREAD, TREATMENT BECOMES MORE DIFFICULT, AND GENERALLY A PERSON’S CHANCES OF SURVIVING ARE MUCH LOWER.

State of the Art

For years, imaging techniques and biopsies have been at the forefront of cancer diagnosis. In addition, in pancreatic cancer there are some special procedures because of the importance of detecting the cancer in the pancreas. An endoscope is used in order to apply ultrasounds and to inject dye in the pancreatic ducts that will be subsequently detected with X-rays. These procedures can be very harmful for the organs and tissues because of their aggressively and in addition there is a stress associated with biopsy can be hard on patients. It may be also important to mention that all these procedures add significant costs over the course of treatment.