Cancer is a class of disease characterized by mutated cell growth in an uncontrolled way. Pancreatic cancer occurs when this uncontrolled cell growth begins in any part of the pancreas. Rather than developing into normal, healthy pancreas tissue, these abnormal cells continue dividing and form lumps or masses of tissue called tumours. Tumours then interfere with the main functions of the pancreas.
If a tumour stays in one spot and demonstrates limited growth, then it is considered to be benign. The tumor which sheds cells that migrate to different parts of the body is called a malignant tumor.
When a tumour successfully spreads to other parts of the body and grows, invading and destroying other healthy tissues, it is said to have metastasized. This process itself is called metastasis, and the result is a more serious condition that is very difficult to treat.
Pancreatic Cancer is classified into two types, based on the part of pancreas that is affected –
Pancreatic Cancer is more common in western countries as compared to developing countries like India. However, data from recent studies and surveys have revealed that there is an alarming rise in Pancreatic Cancer cases.
The one year survival rate for this rare and aggressive form of cancer is about 20% and 5 year survival rate declines to 7%. Though the 5 year survival rate is low, it can rise upto 20% – 35%, if the tumor is detected at early stage (before metasizing) and is removed completely.
Pancreatic Cancer is aggressive with few symptoms until the cancer is advanced. In the early stages, the cancer doesn’t usually show any signs or symptoms. By the time the symptoms are visible, the cancer has already spread beyond the pancreas.
These symptoms of Pancreatic Cancer have numerous other causes, making it difficult to diagnose the disease before it is in an advanced stage.
Cancer is the result of cells that grows uncontrollably and do not die naturally. Normal cells in the body follow an orderly path of growth, division, and death. Programmed cell death is called apoptosis, and when this process breaks down, it results into cancer.
Pancreatic Cancer cells do not experience programmatic death, but instead continue to grow and divide. Although scientists do not know exactly what causes these cells to behave this way, they have identified several potential risk factors. Some of the causes are discussed below:
Cancer occurs when a cell’s gene mutations results in permanent DNA damage. DNA mutations that lead to Pancreatic Cancer are mostly a resultant of factors that affected DNA after birth rather than a merely inheritance from parents.
Pancreatic Cancer can be the result of a genetic predisposition inherited from family members. About 10% of Pancreatic Cancers are caused by inherited gene mutations. Genetic syndromes that are associated with Pancreatic Cancer include hereditary breast and ovarian cancer syndrome, melanoma, pancreatitis, and non-polyposis colorectal cancer (Lynch syndrome).
Carcinogens are a class of substances that are directly responsible for damaging DNA, promoting or aiding cancer. Certain pesticides, dyes, and chemicals used in metal refining are thought to be carcinogenic, increasing the risk of developing Pancreatic Cancer.
When our bodies are exposed to carcinogens, free radicals are formed that try to steal electrons from other molecules in the body. These free radicals damage cells, affecting their ability to function normally, and the result can be cancerous growths.
The best way to lower the risk of Pancreatic Cancer is to avoid risk factors and get an early diagnosis, with regard to natural factors. Some of the lifestyle changes mentioned below do offer some shielding to the disease:
The “stage of cancer” is a term used to describe the spread and extent of the Cancer cells. During diagnosis, a stage is assigned to the cancer to facilitate planning and proper treatment of the disease. The stages of Pancreatic Cancer are categorized as follows:
Survival rate is a calculation of the probability of surviving the disease based on the earlier track records of a number of patients having the same disease at the same stage. Since, the prognosis and treatment of each individual may vary based on a number of other factors like health history, immunity, family history etc., so predicting the outcome of any particular case to precision is not possible.
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Pancreatic Cancer is hard to find early. The pancreas is located deep inside the body, so early tumors can’t be seen or felt during routine physical exams. People usually have no symptoms until the cancer has already spread to other organs. Screening tests are used to look for a disease in people with no evident symptoms.
If a person has spotted any of the signs and symptoms that might be caused by Pancreatic Cancer, certain exams and tests needs to be done at the earliest.
The signs of Pancreatic Cancer along with other health problems are examined. The examination mostly focuses on the belly. Pancreatic Cancers can sometimes cause the liver or gallbladder to swell. Skin and the whites of the eyes will also be checked for jaundice (yellowing).
Imaging tests use x-rays, magnetic fields, sound waves, or radioactive substances to create pictures of the pancreas. Imaging tests might be done for a number of reasons both before and after a diagnosis of Pancreatic Cancer, including:
The CT scan makes detailed cross-sectional images of the body. CT scans are often used to diagnose Pancreatic Cancer because they can show the pancreas clearly. They can also help show if cancer has spread to organs near the pancreas, as well as to lymph nodes and distant organs. A CT scan can help determine if surgery might be a good treatment option.
MRI is a procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
Ultrasound tests use sound waves to create images of the pancreas.
A wand-shaped probe called ultrasound transducer is moved over the skin of the abdomen. It gives off sound waves and detects the echoes as they bounce off organs. The transducer receives the echoes and sends them to a computer, which uses the echoes to make pictures called sonograms.
In this procedure, an endoscope is inserted into the body, usually through the mouth or rectum. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. A probe at the end of the endoscope is used to bounce high-energy sound waves off internal tissues or organs and make echoes to produce the sonogram. This procedure is also called endosonography.
An endoscope is passed down the throat, through the esophagus and stomach, and into the first part of the small intestine.
A small amount of dye is then injected into the common bile duct, and x-rays are taken. This dye outlines the bile and pancreatic ducts. The x-rays can show narrowing or blockage in these ducts that might be due to Pancreatic Cancer. Sometimes, a small brush is put through the tube to remove cells for a biopsy.
In this procedure, a thin, hollow needle is put through the skin of the belly and into a bile duct within the liver. A contrast dye is then injected through the needle, and x-rays are taken as it passes through the bile and pancreatic ducts. As with ERCP, this approach can also be used to take fluid or tissue samples. Because it is more invasive, PTC is not usually used unless ERCP has already been tried or can’t be done for some reason.
It can be very helpful in finding pancreatic neuroendocrine tumors (NETs). A hormone-like substance called octreotide that is bound to a radioactive substance is injected into a vein. Octreotide travels through the blood and attaches to the tumor cells of many types of NETs. A special camera is then used to trace the radioactivity in the body.
For a PET scan, a slightly radioactive form of sugar is injected. A special camera is then used to create a picture of areas of radioactivity in the body.
This test is sometimes used to look for spread from exocrine Pancreatic Cancers, but because NETs grow slowly, they do not show up well on PET scans.
This is an x-ray test that looks at blood vessels. A small amount of contrast dye is injected into an artery to outline the blood vessels, and then x-rays are taken.
An angiogram can show if blood flow in a particular area is blocked or compressed by a tumor. It can also show abnormal blood vessels in the area. This test can be useful in finding out if a Pancreatic Cancer has grown through the walls of certain blood vessels. Mainly, it helps surgeons decide if the cancer can be removed completely without damaging vital blood vessels, and it can also help them plan the operation.
A procedure in which a blood sample is checked to measure the amounts of certain substances, such as bilirubin, released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.
Jaundice (yellowing of the skin and eyes) is often one of the first signs of Pancreatic Cancer, but it can have many causes other than cancer.
Tumor markers: In this procedure a sample of blood, urine , or tissue is checked to measure the amounts of certain substances, such as CA 19-9, and carcinoembryonic antigen (CEA). Certain substances are linked to specific types of cancer when found in increased levels in the body. These are called tumor markers.
A small sample of tumor is removed and observed closely under the microscope. This procedure is called a biopsy. Biopsies can be done in different ways.
Once the cancer is diagnosed and its stage is determined then the treatment is planned based on the type of tumor and patients’ overall health condition. The treatment plan may indulge multiple phases involving more than one type of treatment.
Before rooting for a specific treatment plan, the doctor conducts multiple tests of the genes, tumor and other factors. Based on the results of these tests the most acute treatment strategy is formulated. Some of the advanced treatment options are discussed below:
Surgery is the most preffered treatment when the tumor is restricted to the pancreas only and has not spread beyond it. Surgery includes removing all or part of the tumour depending on its location, size and extent of spread. It is highly efficient for treating cancers of early stages. However, the later stages of Pancreatic Cancer is difficult to treat and may involve more complex treatment plan
Neoadjuvant treatments are the preliminary treatment that aids in shrinking the tumor before proceeding for surgerical treatments. Some of the most commonly used neoadjuvant therapies are chemotherapy, radiation therapy and hormone therapy.
Adjuvant therapy refers to the after surgery treatments that helps to decrease the risk of recurring cancer incidences. Adjuvant therapy may begin within 8 weeks after surgery, based on the recovery rate and the overall health condition of the patient. Adjuvent therapy may include chemotherapy, radiation therapy, targeted therapy and palliative treatment.
Pancreatic Cancer is a very rare and aggressive type of Cancer. It grows very fast and does not show any sign and symptom at the earlier stages and hence finding a cure for the same becomes a bit difficult. There are several options for treatment but the outcome of the treatment may not be favourable.
If you encounter any of the symptoms then consulting a doctor is the smartest move though the symptom might not necessarily indicate the presence of the fatal disease. Also having any prior history or familial history of the disease calls for a regular examination alteast once a year. If one is suffering from diabetes or jaundice it is better to test for Pancreatic Cancer to be on the safer side.
Considering the location of the pancreas and the nature of Pancreatic Cancer it is very difficult to detect it at an early stage. However, being alert and going for regular examinations can definitely help one in diagnosing the disease.