Symptoms, Diagnosis & Treatment for Pancreatic Cancer

WHAT IS THE PANCREAS?

The pancreas is part of the digestive system. It lies in the upper half of the abdomen, well above the navel, on a level with the V where the ribs meet at the front. It is deep inside the abdomen, lying just in front of the spine. It is about 15cm (6 inches) long.

The large rounded section on the right-hand side of the body is called the head of the pancreas, the middle part is known as the body of the pancreas and the narrow part on the left-hand side of the body is called the tail of the pancreas. The head of the pancreas lies next to the first part of the small intestine, which is called the duodenum.

The pancreas produces pancreatic juice (a fluid which helps to digest food) and insulin (a hormone which enables the body to use sugars and store fats). The digestive juices produced by the pancreas flow down a tube (the pancreatic duct) into the duodenum.

WHAT IS CANCER?

The organs and tissues of a body are composing of micro small building blocks called cells. Cells in various areas of a body might inspect and work differently but most of them replicate themselves in the same manner. Cells regularly become old and dying, and in their place new cells are developed to function.

Naturally, the division and growth of cells is well organised and be in control, whereas sometimes this process of replication gets unorganised and out of control for some reason, the cells will divide and redevelop in fast pace and form into a lump which is called a tumour. Tumours are of two kinds- benign or malignant, where malignant tumour is the cancer.

Benign tumour is where cells do not expand to other parts of a body and therefore are not cancer cell.  But, if it continues to replicate at the original site, it might cause a trouble by pressing on the adjoining organs of body.

It is essential to be inform about cancer is not a single disease with a single type of treatment.

CAUSES OF PANCREATIC CANCER

Cause of pancreatic cancer are poorly known. Although some of the rarer forms (such as neuroendocrine and papillary cancer) can affect adults in their 20s and 30s, it is most common in persons between the ages of 60 and 80.

• Habit of smoking cigarettes then you are more at risk of developing cancer of the pancreas.
• Person who have chronic pancreatitis which causes the pancreas to become inflated are also more prone to develop it.
• Drinking a lot of alcohol over a long period of time is one of the key causes of chronic pancreatitis.
• Because most pancreatic tumours are not caused by an inherited defective gene, members of your family are unlikely to be at an increased risk of developing it as a result of your diagnosis. Some families, however, are at a higher risk of having pancreatic cancer if they have inherited the defective breast cancer genes BRCA1 or BRCA2, or if they have a bowel disorder called FAP.
• Members of families with a proclivity for huge numbers of atypical moles have a higher risk of pancreatic cancer.
• However, the genetic mutations that cause these cases of pancreatic cancer have yet to be discovered, and as a result, there is currently no cure.

Types Of Pancreas Cancer

Pancreatic cancers are classified into groups based on their location inside the pancreas and the type of cell from which they originated.

The head of the pancreas (70–80 percent) is more likely to develop cancer than the body or tail (see pancreas diagram). Almost all pancreatic tumours begin in the cells that line the pancreatic ducts’ inner lining. The fluids produced by the pancreas move out through these channels into the small bowel. Adenocarcinoma is the name for this type of cancer.

The pancreas can also be affected by other extremely rare tumours.

• a set of disorders known as neuroendocrine tumours, which are hormone-producing tumours
• a form of lymphoma – a cancer that develops in the pancreas’ lymphatic tissue
• a form of pancreatic sarcoma- that develops in pancreas’s tissue which stick together the cells.

Symptoms of Pancreatic Cancer​

Cancer can sometimes go unnoticed for a long period before causing symptoms, and the signs can be unclear at first. The most prevalent signs and symptoms of pancreatic cancer are listed here. Only one of these symptoms may be present in some persons.

 

• Pain: It usually starts with discomfort or pain in the upper abdomen, then it might extend to the back. The discomfort may come and go at first, but it can become more persistent later. Some people’s discomfort is worse when they’re lying down, but it goes away when they sit up or bend forward.
• Weight loss and loss of appetite: A sudden weight loss and also feel heavy after eating less food are frequent in persons with pancreatic cancer.
• Yellowing of the skin and whites of the eyes, dark yellow urine, pale bowel motions and itchy skin: Jaundice is characterised by yellowing of the skin and whites of the eyes, dark yellow urine, pale bowel movements, and itchy skin. It can be caused by a variety of conditions, including pancreatic cancer. If cancer develops in the head of the pancreas, it might block the bile duct, which transports bile from the liver to the gut, resulting in jaundice. The symptoms listed above are caused by a build-up of bile in the body.
• Other symptoms such as indigestion, bloating after meals, and excessive exhaustion are possible.

Remember that while you can make an appointment with your doctor if you are concerned, most abdominal pain is not caused by pancreatic cancer.

How Pancreatic Cancer Is Diagnosed

When people have symptoms, they usually go to their primary doctor first. Pancreatic cancer can be difficult to identify because the symptoms are sometimes nonspecific and might be caused by other illnesses. However, your doctor will usually check your eyes and skin colour for jaundice, test your urine for bile, and take a blood sample if necessary. 

Your doctor may also feel around your belly for any enlargement around the liver. Following that, more tests or x-rays may be scheduled. For these tests, as well as specialised advice and treatment, your GP will recommend you to the hospital.

Before performing a physical examination in the hospital, the doctor will take your medical history.

What Is Staging Pancreatic Cancer?

Cancer’s stage refers the extend of cancer related to its size and whether it has spread beyond its source location on the body. Knowing the degree of cancer aids doctors in determining the best course of treatment.

The stage of a cancer is a term used to describe its size and whether it has spread beyond its original area of the body. Knowing the extent of Cancer helps the doctors to decide on the most appropriate treatment.

Pancreatic cancer is classified into four phases: small and localised (stage one); spread into nearby structures (stages two and three); and spread to other areas of the body (stages four and five) (stage four). Secondary cancer occurs when cancer has spread to other places of the body (or metastatic cancer).

The following is a description of a regularly used staging system.

Stage 1:  The first level is the most basic. Cancer can only be seen within the pancreas only, although it may be fairly large. Cancer in the lymph nodes close to the pancreas cannot be spread and nor it will have any sign that it has spread to anywhere else in the body.

Stage 2:  Cancer has spread to the duodenum or bile duct, as well as other tissues and organs near the pancreas. The lymph nodes in the area are cancer-free.

Stage 3: The cancer has spread to the tissues around the pancreas and might be of any size.

Cancer has also been discovered in adjacent lymph nodes. Cancer is likely to have spread to other body organs via the lymph system in this case.

Stage 4 malignancies are classified into two groups: 4A and 4B.

4A indicates that cancer has spread to surrounding organs such as the stomach, spleen, big bowel, or neighbouring significant blood arteries. The lymph nodes may or may not include cancer.

4B indicates that cancer has spread to other parts of the body like liver or lungs.

What Is the Treatment for Pancreatic Cancer?

The sort of treatment you receive is determined by the type of pancreatic cancer you have, the stage of the cancer, its size, and your overall health.

• Pancreatic cancer is particularly tough to treat. Early-stage tumours can occasionally be cured with surgery, but many pancreatic cancers are not discovered until they have progressed to the point where they are no longer curable.
• Surgery to remove part or all of the pancreas is the most effective treatment for early-stage pancreas cancer. This is a big procedure that should only be undertaken by those who have cancer that is tiny and has not spread, as well as those who are physically fit. This type of surgery is not viable if the cancer is too large or has already progressed outside the pancreas when it is discovered. It’s difficult to deal with the news that your cancer has spread and that certain treatments are no longer appropriate for you. Your doctor will recommend treatments that are most likely to help you in your condition.

If cancer has spread and a blockage of the bile duct or bowel has developed, surgery can be done to clear the obstruction and relieve symptoms.

• Chemotherapy can be applied in a variety of ways. It could be administered following surgery for early-stage pancreatic cancer to help lower the risk of the cancer returning. It can also be used to treat malignancies that have migrated to other parts of the body, such as the liver, or to shrink tumours that have spread to the area around the pancreas (locally advanced). Chemotherapy and radiotherapy may be given separately or jointly for tumours that have not progressed beyond the pancreas and which cannot be removed by surgery. You may be requested to participate in a clinical study of a new drug or treatment on occasion.

Chemotherapy may also be used to alleviate some cancer symptoms. Radiotherapy can aid with pain management.

If the pain produced by pancreatic cancer cannot be adequately controlled with painkillers, your doctor may recommend a nerve block.

• By blocking the nerves, themselves, a nerve block prevents pain messages from reaching the brain. This can be accomplished in a variety of ways, including injecting an anaesthetic such as alcohol into the nerve or, in rare cases, severing the nerve. The tumour pressing on the coeliac plexus can cause persistent pain in the belly and back in persons with pancreatic cancer (a complicated web of nerves at the back of the abdomen). Treatment for pancreatic discomfort with a celiac plexus nerve block is usually highly successful

Your blood pressure may drop for a day or two thereafter, making you feel light-headed and dizzy, especially when you get up. The nerve can sometimes be severed rather than injected, however this requires a general anaesthetic. As a result, when a person is having additional surgery, such as bypass surgery, a block involving severing the nerve is frequently performed.

What are the Benefits and disadvantages related to above treatments?

Pancreatic cancer is notoriously difficult to treat and control. It’s common to be advised that the risks or side effects of some treatments outweigh the advantages, which can be difficult to comprehend and accept. Uncomfortable symptoms, on the other hand, can almost always be addressed to make you feel better.

Many people are apprehensive about receiving cancer treatments because of the potential adverse effects. Some people wonder what would happen if they were not treated.

Although many of the therapies can have negative side effects, these can usually be managed with medication.

Treatment can be offered for a variety of reasons, and the possible advantages will range based on the individual’s circumstances. Surgery is frequently performed on persons with early-stage pancreatic cancer in the hopes of curing the disease. Additional therapies, such as chemotherapy, may be used to lower the chances of recurrence.

If Cancer is at a more advanced stage, the treatment may only be able to control it, leading to an improvement in symptoms and a better quality of life.

However, for other patients, the treatment will have no effect on their cancer, and they will suffer the negative effects while receiving no benefit.

It may not be difficult to decide whether to accept treatment aimed at treating your cancer if you have been offered it. It may be more difficult to decide whether to continue with treatment if a cure is not achievable and the treatment is given to control Cancer for a period of time.

Making treatment selections in these situations is often difficult, and you may need to explore your treatment options with your cancer specialist in depth. You can still be offered supportive (palliative) care with drugs if you don’t want to.