Pancreatic Cancer
Pancreatic cancer arises from the pancreas which is an organ situated behind the stomach and which functions in the excretion of enzymes and hormones especially for digestion. It has two types of cells, the exocrine cells and the endocrine cells. The exocrine cells release enzymes which help in the digestion of fats in combination with bile fluids. The endocrine cells secrete hormones such as glucagon and insulin, which are needed for sugar control in the body.
Causes and Risk Factors
Pancreatic cancer is caused by different risk factors which can be modifiable and non-modifiable.
Modifiable Risk Factors:
- Tobacco use
- Overweight and obesity
- Workplace exposure to certain chemicals
Non-Modifiable Risk Factors:
- Age: The risk for pancreatic cancer increases with age beyond 45 years
- Gender: Men are more prone to this cancer than women
- Race: African Americans are slightly more prone to pancreatic cancer than whites
- Family history: Pancreatic cancer is a high risk in families which have inheritable syndromes
- Inherited Genetic disorders: Inherited gene changes (mutations) can be passed from parent to child.
- Diabetes
- Chronic Pancreatitis
- Cirrhosis of Liver
- Stomach Problems
Unclear Risk Factors:
- Diet
- Physical Inactivity
- Coffee
- Alcohol
Symptoms
The symptoms of pancreatic cancer in its early stages may go undetected. As the symptoms become more prominent, the cancer has usually spread out of the pancreas.
- Jaundice: yellowing of eyes and skin
- Dark Urine: urine may become brown due to increased bilirubin levels
- Light colored or greasy stools: due to blockage in the bile duct which results in undigested fats being excreted in stool
- Itchy skin: due to bile build up under the skin
- Belly or back ache: This is common in pancreatic cancer. As the cancer grows, it puts pressure on neighbouring organs.
- Weight loss and poor appetite
- Nausea and vomiting
- Gallbladder or liver enlargement
- Blood clots
- Diabetes
Diagnosis
During examination, the doctor will take a detailed medical and lifestyle history, then perform a physical examination which will be focused around the abdomen. If, the doctor is suspicious of an abnormality, further tests may include the following:
- CT Scan
- MRI
- Abdominal Ultrasound
- Endoscopic ultrasound
- Endoscopic retrograde cholangiopancreatography (ERCP)
- Magnetic resonance cholangiopancreatography (MRCP)
- Percutaneous transhepatic cholangiography (PTC)
- Somatostatin receptor scintigraphy (SRS)
- PET Scan
- Angiography
- Liver function test
- Tumor Markers
- CA 19-9
- Carcinoembryonic antigen
- Percutaneous (through the skin) biopsy
- Endoscopic biopsy
- Surgical biopsy
Treatment
The treatment for pancreatic cancer is a combination of chemotherapy, radiation therapy and surgical management. There are different methods of removing cancer through surgery. Some of them are mentioned below:
- Radiofrequency Ablation: use of high energy radio waves for treatment
- Microwave therapy: similar to radiofrequency treatment but with the use of microwaves
- Cryosurgery (Cryoablation): the process of destroying the tumor by freezing
- Arterial embolization (Trans-arterial embolization, TAE): a thin flexible tube is inserted through the thigh to plug the artery which is feeding the tumor.
- Chemoembolization (TACE): similar to arterial embolization except a chemotherapy agent is injected to plug the artery.
Authored By : Dr. Shiva Kumar Uppala
