Pancreatic cancer awareness | Narayana Health

Pancreatic cancer occurs when pancreatic cells begin to divide and grow uncontrollably. The mutation in cellular genetic makeup causes uncontrolled growth. Although pancreatic cancer is a rare cancer, it has a high mortality rate. As reported in the Indian Journal of Surgery in 2015, pancreatic cancer survival rates are among the lowest for any cancer, with a 98% mortality-to-incidence rate.

What is the origin of pancreatic cancer?

The pancreas sits behind the stomach with a wide tapering body, a narrow pointed tail and a wider head. This fish-shaped organ releases enzymes and hormones, which aid in digestion and regulate blood sugar levels. Cells of the exocrine and endocrine glands of the pancreas can have cancerous growths. Based on its origin, pancreatic cancer falls into two broad categories:

  • Exocrine Pancreatic Cancer:

The uncontrolled growth of exocrine cells (cells lining the exocrine gland and ducts of the pancreas) can develop various exocrine pancreatic cancers. They are the most common pancreatic cancer and include the following types:

  • Adenocarcinoma or ductal carcinoma: The origin of cancer is the lining of the ducts in the pancreas. It is the most common form of pancreatic cancer, accounting for 90% of pancreatic cancers diagnosed.
  • Squamous cell carcinoma: This tumor has the worst prognosis of all pancreatic cancers and is a rare variety.
  • Colloid carcinoma: Colloid carcinoma accounts for 1-3% of exocrine pancreatic cancers, is easier to treat and has a better prognosis.
  • Adenosquamous carcinoma: This tumor accounts for 1-4% of exocrine pancreatic cancers. Adenosquamous carcinoma is a more aggressive cancer with a poorer prognosis. It shows symptoms of both squamous cell carcinoma and adenocarcinoma.
  • Pancreatic Neuroendocrine Tumors (NETs):

NETs, ​​or islet cell tumors, or neuroendocrine cancer, make up less than 5% of pancreatic cancers. It develops from cells of the endocrine glands, which secrete insulin and glucagon hormones to regulate blood sugar levels. The following types of pancreatic NETs are:

  • gastrinoma: A tumor of gastrin-producing cells that interferes with the digestion of food.
  • glucagonoma: The tumor arises between glucagon-producing cells and shows consistently high blood glucose levels.
  • Insulinomas: This cancer involves the insulin hormone-producing cells, which affect blood glucose levels.

What Are the Signs and Symptoms of Pancreatic Cancer?

Symptoms of pancreatic tumors depend on the type of cancer you have. In the early stages, a person may not have any noticeable symptoms other than fluctuations in hormonal levels. In later stages, the patient may show severe symptoms. The following are some signs and symptoms seen in progressive stages:

  • Pain in the upper part of the abdomen that radiates to the back.
  • Decreased appetite
  • Signs of jaundice, including yellowing of the skin and sclera of the eyes
  • Color change of stool, usually light colored
  • Dark colored urine
  • Higher blood sugar levels lead to the development of new or worsening diabetes.
  • Itchy skin
  • Nausea and vomiting
  • Malaise
  • Unexpected weight loss

How to diagnose pancreatic cancer?

The early detection of pancreatic cancer is challenging because it usually shows no symptoms until it has spread to other organs or become noticeable. The health care providers may suggest the following diagnostic tests:

  • Medical history: The health care provider may ask about your medical and family history. A brief explanation of your symptoms is also crucial to diagnosing the condition.
  • Blood tests: It helps detect pancreatic tumor markers in the blood.
  • Endoscopic Ultrasound (EUS): A doctor can insert a thin, flexible tube into the digestive tract to look for pancreatic cancer. EUS is more accurate than abdominal ultrasound in diagnosing pancreatic cancer.
  • Computed tomography (CT) scan: Multiphase CT scan or pancreatic protocol CT scans are specific CT scans designed to detect pancreatic cancer. It also shows whether cancer has spread to nearby organs, lymph nodes, or distant organs.
  • Magnetic Resonance Imaging: MRI provides a detailed picture of the pancreas, bile ducts and blood vessels.
  • Cholangiopancreatography: It can detect blockage, narrowing or dilatation of the pancreas and bile ducts due to cancerous tumor.
  • Positron emission tomography (PET) scan: This radioactive imaging allows doctors to detect the metastases of exocrine pancreatic cancer.
  • Biopsy: The doctors may perform an endoscopic or surgical biopsy of abnormal pancreatic areas to confirm pancreatic cancer.

What are the treatment modalities of pancreatic cancer?

Certain factors, such as age, overall general health, size and location of the mass, metastasis, and cancer stage, play a critical role in determining the most effective treatment for pancreatic cancer. The following are the treatment options for pancreatic cancer:

  • Surgery: In pancreatectomy, the surgeon removes the cancerous part of the pancreas, the entire pancreas, and sometimes nearby lymph nodes. The surgeons may recommend a Whipple procedure if the head of the pancreas contains a cancerous tumor. The health care providers remove the head of the pancreas, the gallbladder, part of the bile duct, and the duodenum in the Whipple procedure.
  • Radiotherapy: A doctor uses a rapid dose of radiation to destroy cancer cells.
  • Chemotherapy: The health care providers administer cycles of chemotherapy drugs to kill the cancer cells.

Sometimes the doctors may administer chemotherapy and radiation before surgery to shrink the tumor mass.

  • Immunotherapy: The doctors give immune-boosting drugs to help your body fight cancer.
  • Palliative care: The health care providers can provide supportive care to reduce the side effects of cancer treatment. It includes diabetes management, pain management, jaundice treatment, opening the blocked bowel and other obvious symptoms.

If pancreatic cancer is detected and treated at an early stage, it has a better prognosis. Contact your healthcare provider if you have symptoms such as jaundice or stabbing back pain.

Dr. Neeraj Goel, Chief Clinical Officer and Senior Consultant – Gastrointestinal, Minimal Access, HPB and Bariatric Surgery, Dharamshila Narayana Superspeciality Hospital, Delhi

Leave a Comment