Pancreatic cancer is a serious, often deadly, disease, as symptoms don’t often show up until an advanced stage. If you or someone you love is showing signs of the disease, contact your doctor before starting a search to learn more about this type of cancer.
The pancreas is located behind the lower part of the stomach and aids in digestion and managing your blood sugar. When a symptom does show up, it’s often jaundice — the yellowing of the skin and whites of the eyes.
Screening and Prevention
Currently, no medical society or other group recommends routine screening for pancreatic cancer. This is mostly attributable to the fact that there are no approved screening tests for the early diagnosis of pancreatic cancer.
Measuring levels of carbohydrate antigen 19-9 may be useful in monitoring disease activity and response to treatment. Unfortunately, it is not a suitable screening test for pancreatic cancer, as it has high rates of falsely positive tests.
Most clinicians agree that there is no way to prevent pancreatic cancer. However, low-dose aspirin has been the most promising preventative agent. It has shown to significantly reduce the risk of pancreatic cancer in a dose-dependent manner.
Additional measures include:
- Quitting smoking;
- Minimization or abstinence from alcohol;
- Regular exercise, and;
- Maintaining a healthy weight.
These measures may reduce your risk of developing pancreatic cancer but not necessarily prevent it.
If you develop symptoms associated with pancreatic cancer, your doctor will start by taking a medical history. This delves into your symptoms by pinpointing location, onset, duration, and exacerbating/relieving factors. After this process, a physical examination looking for any signs of pancreatic cancer will be carried out. Lastly, your blood may be drawn for testing to reveal any abnormalities.
Based on these variables, your doctor may choose one or more imaging studies to verify the presence of a tumor in your pancreas. They may choose an ultrasound, computed tomography scan, magnetic resonance imaging, and/or positron emission tomography scan.
If there is indeed a tumor in your pancreas, a biopsy will be needed to obtain a definitive diagnosis of pancreatic cancer. Biopsies may be completed using different techniques, which are determined on a case-by-case basis. The most used method for biopsy is fine-needle aspiration. This is where your doctor inserts a needle through the skin, into the abdomen, and ending up in the diseased portion of the pancreas. Other methods that allow for the completion of biopsies include endoscopic retrograde cholangiopancreatography, endoscopic ultrasound, and laparoscopy.
As pancreatic cancer progresses, it can lead to complications through several mechanisms. This includes:
- Pressure on adjacent organs/structures;
- Deficiency of hormones/substances produced by normal pancreatic cells;
- High metabolic demands of the cancer, or;
- The spread of the cancer.
The following may be complications of pancreatic cancer:
- Pancreatic Insufficiency: This occurs in 80 to 90 percent of patients with pancreatic cancer. It requires pancreatic enzyme replacement therapy for treatment.
- Bile Duct Obstruction: A very common complication of pancreatic cancer. It can lead to jaundice.
- Cachexia: Characterized by extreme weight loss, muscle wasting, and loss of appetite.
- Bowel Obstruction: Resulting from the growth of cancer cells pressing into the first portion of the small bowel.
- Diabetes: 85 percent of patients with pancreatic cancer will develop insulin resistance or full-blown diabetes.
Other potential complications of pancreatic cancer are:
- Weight loss;
- Nausea and vomiting;
- Chronic pain, and;
- Blood clots, which could dislodge and travel to the lungs causing a potentially life-threatening pulmonary embolism.
Even though pancreatic cancer is usually diagnosed at an advanced stage, it is a treatable disease. The treatment of pancreatic cancer is highly influenced by the stage of cancer, but not totally dependent. Despite the absence of screening recommendations, early detection is key to provide the best chances of survival.
As with most cancers, the goals of treatment for pancreatic cancer are to eradicate cancer cells and prevent their spread to other parts of the body. In general, the treatments for pancreatic cancer may include surgery, chemotherapy, radiation therapy, and targeted therapy.
If pancreatic cancer is confined to the pancreas, surgery may be an option. Depending on the location of the cancerous tumor, there are several surgical options for the removal of the diseased portion of the pancreas.
If the tumor is located in the head and/or neck of the pancreas, the Whipple procedure, or pancreaticoduodenectomy, is the surgical procedure of choice. It can be performed through open surgery, laparoscopic surgery, or robotic surgery. In this complex surgical procedure, the head of the pancreas, duodenum, gallbladder, and lower portion of the bile duct are removed. There is also a modified Whipple procedure. It removes a portion of the stomach in addition to those structures discussed previously.
If the tumor is located in the body or tail of the pancreas, a distal pancreatectomy is the surgical procedure of choice. This procedure removes the tail and/or body of the pancreas, with or without removal of the spleen.
Sometimes, the entire pancreas must be removed. This operation is referred to as a total pancreatectomy. Diabetes is assured with a total pancreatectomy as insulin is no longer produced naturally by your pancreas.
Other complications from the surgical treatment of pancreatic cancer may include
- Leaking from the surgical connections to the pancreas or bile duct, and
- Delayed emptying of the stomach.
Surgery may be unacceptable for individuals with advanced-stage pancreatic cancer. In this case, chemotherapy may be a therapeutic option to control the growth of cancer cells and prolong survival.
Chemotherapy drugs can be injected into veins or taken by mouth. They may be administered alone or in a combination of agents. These drugs may be administered before surgery to shrink a tumor or after surgery to reduce the risk of cancer recurrence.
Common side effects of chemotherapy include:
- Hair loss;
- Nausea and vomiting;
- Easy bruising and bleeding;
- Loss of appetite, and;
- Increased susceptibility to infections.
Another option for individuals with advanced-stage pancreatic cancer not amenable to surgery is radiation therapy. Radiation therapy uses high energy beams to kill cancer cells.
There are two types of radiation therapy that can be used to treat pancreatic cancer
- External beam radiation
- Intraoperative radiation
Radiation therapy is often combined with chemotherapy. It can also be administered before or after cancer surgery, often in combination with chemotherapy.
The most common early side effects of radiation therapy are fatigue and skin problems. Other side effects may include hair loss, nausea and vomiting, and diarrhea.
Targeted therapy is relatively new in the treatment of pancreatic cancer. It uses drugs or other substances to specifically target cancer cells and destroy them. These drugs are designed not to harm normal cells and work in a different manner than standard chemotherapy drugs.
One such example of targeted therapy is erlotinib (Tarceva). It has been helpful in some individuals with advanced pancreatic cancer. Erlotinib is taken by mouth as a pill and often combined with the chemotherapeutic agent gemcitabine. Common side effects of erlotinib include:
- An acne-like rash on the face and neck;
- Loss of appetite, and;
Learn More Today
Although pancreatic cancer is a relatively rare malignancy and survival rates have been improving over the years, it is still considered largely incurable. Search online to learn more about pancreatic cancer, which could lead to better outcomes if you spot warning signs via early diagnosis and treatment.