Pancreatic Cancer

What is Pancreatic Cancer?

Listed as 24th most common cancer in India and 18th in terms of mortality, Pancreatic cancer is a malignancy that originates from the tissues of your pancreas, about 6-inch-long gland located in the abdominal cavity, which is responsible for the secretion of important digestive enzymes and hormones that help to keep your blood sugar under check. Pancreatic cancer can be of various different types, the most common of which is the one that develops in the cells that line the ducts which are responsible for carrying the digestive enzymes. This is commonly referred to as pancreatic ductal adenocarcinoma.

What are the symptoms that you need to look out for?

Pain in the abdomen that radiates towards the back
Unintentional weight loss
Pale stools
Yellowing of eyes and skin
Fatigue
Itchy skin

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What causes pancreatic cancer?

Pancreatic cancer is the result of unhealthy mutations in the DNA of the pancreatic cells that makes them grow and multiply uncontrollably. In most cases, the cancer originates in the cells lining the pancreatic ducts. This is commonly referred to as adenocarcinoma or pancreatic exocrine cancer. In rare cases, these might also develop in the neuroendocrine pancreatic cells and result in the formation of pancreatic neuroendocrine tumours.

What are the various risk factors associated with pancreatic cancer?

Smoking

Advanced age, usually above 65

Diabetes

Pancreatitis, which refers to the severe inflammation of the pancreas

Having a family history of genetic syndromes like BRCA2, which is likely to elevate the risks of cancer

Having a family history of the malignancy

Being overweight or obese

Screening and diagnosis

Various modalities available for the screening and diagnosis of pancreatic cancer are listed below:

Imaging tests – These include procedures like CT (computerized tomography) scans, MRI (magnetic resonance imaging) and PET (positron emission tomography) scan, all of which help to generate detailed images of the pancreas and associated structures for better visualization
Endoscopic ultrasound – This involves the use of a long and flexible tube with an ultrasound probe, which is introduced into the abdomen via the mouth and through the oesophagus, to take images of your pancreas.
Biopsy – This involves the collection of a small sample of tissue to be examined thoroughly for any signs of abnormality. The sample can be easily retrieved using endoscopic ultrasound technique or fine-needle aspiration
Blood investigation – The patient’s blood sample is assessed for specific cancer markers that are produced by the pancreatic cancer cells.

Treatment:

Various treatment options available for addressing pancreatic cancer include:

Surgery – The goal of the surgery is to extract the tumour and remove the affected part of the pancreas to bring down the risks of remission. Depending upon the location of the tumour, the surgery can be categorized into the following:

Pancreaticoduodenectomy or Whipple procedures, that is carried out to remove tumours that develop in the pancreatic head.
Distal pancreatectomy, which involves the removal of the body and tail of the pancreas
Total pancreatectomy, in which the entire pancreas is extracted. In such cases, the patient will need lifelong insulin replacement.

Chemotherapy – It uses special drugs, that are given orally or intravenously, to target rapidly-growing cancerous cells. Chemotherapy may also be used in combination with radiation therapy to treat cancers that have not yet metastasized. This is referred to as chemoradiation.

Radiation therapy – It used x-ray beams of high intensity to target the cancerous cells. This may be given before the surgery, to reduce the size of the tumour, and after the surgery to destroy cancerous cells that were left behind during the surgery. These radiations may be given externally, using a special radiation machine, or from within, using certain radiation emitting substances.