Pancreatic Cancer

Pancreatic cancer is characterized by the uncontrolled multiplication of cells in the pancreatic tissues. The pancreas is an exocrine and endocrine organ that aids in the digestion of foods and helps regulate blood sugar levels.

Associated Anatomy

Pancreas

Signs or Symptoms of Pancreatic Cancer

Signs and symptoms seldom appear in the early stages of pancreatic cancer. However, the symptoms become more prominent when cancer advances. Some signs and symptoms may include-

• Light-coloured stools
• Dark-coloured urine
• Abdominal and lower back pain
• Weight loss for no apparent reason
• Loss of appetite
• Tiredness
• Yellowing of eyes and skin (Jaundice)
• Stomach bloating
• Fever
• Chills and sweats
• Blood clots
• Worsening of diabetes mellitus

Causes of Pancreatic Cancer

Genetic mutation: There is not much information on what exactly causes pancreatic cancers. However, researchers have identified certain factors and gene mutations that increase the risk of pancreatic cancers.

Possible Pancreatic Cancer Treatment

Pancreatic Cancer Treatment depends upon various factors like the location of the tumor, the health condition of the individual, the stage of pancreatic cancer, etc. Pancreatic Cancer Treatment options include surgery, chemotherapy, radiation therapy, immunotherapy, or a combination of these. 

Surgery

It consists of removing the cancerous part of the organ. Depending upon the extent of the tumor following surgeries may be performed-  

• Whipple procedure
• total pancreatectomy
• distal pancreatectomy

Radiation Therapy

Radiation therapy uses high-energy radiation to kill tumorous cells.

Chemotherapy

In chemotherapy, drugs are used to stop the spread of cancer cells. Some drugs prescribed for pancreatic cancer include gemcitabine, irinotecan, capecitabine, etc. In some instances, chemotherapy may be combined with radiation therapy (chemoradiation therapy).

Immunotherapy

This therapy helps the immune system in fighting cancer.

Palliative Therapy

This therapy aims to improve the quality of life by alleviating the complications associated with pancreatic cancer. This therapy generally includes the management of pain, diabetes management, jaundice management, etc. 

Risk Factors Associated With Pancreatic Cancer

Some factors that increase the risk of pancreatic cancer include-

• Cigarette smoking or consumption of tobacco in any form
• Obesity or overweight.
• Family history of pancreatic cancer or pancreatitis. 
• Diabetes mellitus
• Pancreatitis (a condition characterized by chronic inflammation of the pancreas).
• Having hereditary syndromes such as Lynch syndrome, Peutz-Jeghers syndrome, Familial malignant melanoma and pancreatic cancer (FAMM-PC), and Hereditary pancreatitis (HP), among others.
• Exposure to certain chemicals like dyes, pesticides, petrochemicals, etc.

Stages of Pancreatic Cancer

The doctors assign the stages based on the size, location, and extent of pancreatic cancer. In brief, there are 5 stages of pancreatic cancer.

• Stage 0 (carcinoma-in-situ) - In stage 0, abnormal cells are observed in the lining of the pancreas. They could spread to adjoining tissues.
• Stage I - The tumor is localized to the pancreas only.
• Stage II - The tumor is localized to the pancreas and spreads to nearby lymph nodes (1-3).
• Stage III - The tumor spreads to more than 4 lymph nodes and major blood vessels near the pancreas.
• Stage IV - cancer spreads to different body organs like the lungs, liver, and abdominal cavity.

Typical Test Required For Pancreatic Cancer

Before recommending diagnostic tests, the doctor would thoroughly examine the patient's medical history. Additionally, the doctor may also perform some physical exams to suspect pancreatic cancer. If the doctor suspects pancreatic cancer, the following tests or a combination of these would be recommended-

• Blood tests - Blood tests like complete blood count and liver function tests are routinely performed to assess an individual's overall health. They also aid in diagnosing conditions like jaundice. In addition, blood tests that detect specific pancreatic cancer markers like CA 19-9 or Carcinoembryonic antigen (CEA) may also be recommended.
• Imaging tests - Imaging tests like magnetic resonance imaging (MRI), ultrasound, computed tomography (CT), etc., are suggested to assess the tumor growth in the pancreas.
• Biopsy - This test involves removing a small amount of pancreatic tissue and examining it for cancerous growth.

Pancreatic Cancer Prevention

Primary Prevention

The risk of pancreatic cancer can be decreased by making the following lifestyle modifications-

• Quit smoking and avoid the consumption of tobacco in any form.
• Have a nutritious and healthy diet.
• Exercise regularly.
• Maintain a healthy weight.
• Reduce the frequency of alcohol consumption or abstain from alcohol completely.

Secondary Prevention

• Regular follow-ups with your doctor may reduce the risk of recurrence. The doctor may recommend routine diagnostic tests to examine the possible recurrence of pancreatic cancer.
• Following the lifestyle modifications described above will also reduce the risk of cancer recurrence.

Types of Pancreatic Cancer

There are two types of pancreatic cancer depending upon the initial location of the cancer development-

• The exocrine tumor is the most common form of pancreatic cancer and begins in the exocrine part of the pancreas like ducts or acini. They account for almost 93 % of pancreatic cancers.
• Neuroendocrine tumors are also referred to as pancreatic neuroendocrine tumors (PNETs) or islet cell tumors, and they account for about 7 % of pancreatic cancers. 

Epidemiology

At a global level, cancer of the pancreas ranks 11th in incidence. However, pancreatic cancer is the seventh leading cause of mortality worldwide. The risk of pancreatic cancer increases with age and is slightly more prevalent in the male population.

Expected Prognosis

Pancreatic cancer goes undetected in its early stage and therefore accounts for a significant number of cancer deaths every year. The patient survival rate increases if the cancer is localized to the pancreas alone. It becomes difficult to control once it starts spreading to other parts of the body.

Natural Progression

If pancreatic cancer is left untreated, it spreads to other body parts. This results in severe, life-threatening conditions.

Pathophysiology

Pancreatic cancer arises because of the rapid multiplication of cells. This occurs when the rate at which cells divide exceeds the rate at which they die. Pancreatic cancer metastasizes to neighboring lymph nodes, blood vessels, and different organs like the stomach, colon, liver, and lungs. It rarely spreads to the bone and the brain. 

Possible Complications

As cancer advances, it can lead to secondary cancer of the liver or other organs. The cancer cells consume a lot of energy, leading to weight loss. Additionally, pancreatic cells cannot perform their normal function, leading to improper absorption. Other complications associated with pancreatic cancer include jaundice, severe pain, abdominal obstruction, etc.

Frequently Asked Questions

1. What are The Best Hospitals for Pancreatic Cancer Treatment in Mumbai?

Nanavati Max Hospital in Mumbai is considered one of the best hospitals for pancreatic cancer treatment in the city, offering a range of advanced treatments and experienced specialists.

2. Is Pancreatic Cancer Curable?

The curability of pancreatic cancer depends on several variables, including its type, stage, the patient's overall health, and specific individual considerations. At Nanavati Max Hospital in Mumbai, we pride ourselves on being a leading cancer treatment centre, offering vast clinical expertise and cutting-edge treatment options for pancreatic cancer.

3. What Is The Recovery Time After Surgery For Pancreatic Cancer?

Recovery time post-surgery for pancreatic cancer is influenced by multiple factors like the type of surgical procedure, patient's overall health, and the severity of the cancer. Typically, recovery spans from several weeks to a few months. It may necessitate hospital stays, subsequent check-ups, and potential rehabilitation.

4. Can Pancreatic Cancer Be Removed?

The potential for pancreatic cancer removal depends on aspects like the cancer's stage and location, patient's health status, and the treatment strategy. In specific cases, surgical removal might be feasible. Detailed discussions with the attending oncologist will provide clarity on this.

5. What Are The Early Signs Of Pancreas Cancer?

Detecting pancreatic cancer can be intricate due to its overlapping symptoms, resembling other ailments. Notable symptoms encompass nausea, abdominal pain, vomiting, jaundice, discomfort during meals, fatigue, unexpected weight loss, and alterations in stool consistency. Experiencing such signs warrants an immediate evaluation for potential pancreatic cancer.

6. How Effective Is Chemotherapy For Treating Pancreatic Cancer?

Chemotherapy has shown efficacy as a treatment for pancreatic cancer, especially when complemented by other interventions like surgery or radiation. However, chemotherapy's success is contingent on various parameters, such as the cancer's stage, location, and the patient's overall health condition.