Pancreatic Cancer Awareness Month: All you need to know about pancreatic cancer  |  Photo Credit: Getty Images
- Pancreatic cancer is the third-most common cancer leading to cancer-related deaths
- Early signs of pancreatic cancer are sometimes missed as they are vague symptoms like abdominal pain (mostly at the back), weight loss, jaundice, loss of appetite to name a few
- Depending on certain factors, your doctor will stage your cancer and then decide on the treatment
New Delhi: Pancreatic cancer is the third-most common cancer leading to cancer-related deaths. The pancreas is an organ in your body located in the abdominal region behind the stomach. It has primarily two functions – endocrine, regulating the blood sugar and exocrine, helping in digestion of the food.
Early signs of pancreatic cancer are sometimes missed as they are vague symptoms like abdominal pain (mostly at the back), weight loss, jaundice, loss of appetite to name a few. There is abnormal growth of cells in the pancreas leading to cancer. The tumour can develop either in the head, neck, body or tail of the pancreas. The five-year survival rate even after treatment is around two-nine per cent. If the tumour has invaded the blood vessels called the celiac artery and the hepatic artery, pancreatic cancer in the body and tail of the pancreas is unresectable, as per Johns Hopkins Medicine.
Risk factors for pancreatic cancer
There are certain risk factors associated with pancreatic cancer.
- Men are diagnosed with pancreatic cancer more than females
- Increasing age is associated with increased risk of pancreatic cancer
- People who smoke are twice more likely to develop this kind of cancer than non-smokers
- Chronic or recurrent pancreatitis can lead to pancreatic cancer
- Obesity and diet rich in fat are also independently associate with increased risk
- Long-standing diabetes
- Rare inherited disorders like hereditary pancreatitis (HP), Peutz-Jeghers syndrome (PJS), hereditary breast and ovarian cancer (HBOC) syndrome
Signs and symptoms of pancreatic cancer
Generally, the symptoms of pancreatic cancer appear very late and for this reason, it is called the “silent disease”. Some of these symptoms that indicate any other pancreatic disease are:
- Painless obstructive jaundice, resulting in yellow skin and eyes
- Clay-colored stool and darkening of the urine
- Generalised itching
- Pain in the abdomen or upper back with radiation of the pain to the midback or lower-back
- Loss of appetite, nausea and vomiting
- Significant weight loss
- The onset of diabetes in the previous year
- Palpable metastatic cervical nodes in a few cases of metastatic disease
Pancreatic Cancer is detected by doing a series of tests, including a blood test, imaging studies and biopsy to diagnose and stage the cancer, if present. Apart from the routine tests, the following are also recommended:
- Tumour markers: 75-85 per cent have increased CA 19-9 levels; about 40-45 per cent have elevated CEA levels
- Abdominal ultrasound: Both transabdominal and endoscopic ultrasound are done
- CT and PET CT scans: While CT scan is done to primarily understand the tumour size and position, PET CT is done to stage the cancer. Many centres use pancreatic protocol CT scan, in which pictures are taken at specific time intervals after using a contrast intravenous dye
Some other tests such as endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangiography (PTC) are done to look for a place of obstruction of bile ducts.
Depending on certain factors, your doctor will stage your cancer and then decide on the treatment. The staging is based on three key factors – the tumour extent, spread to nearby lymph nodes and spread (metastasis) to distant sites (in this case peritoneum, liver, lungs and bones). The treatment of pancreatic cancer mostly depends on the type and stage of cancer, possible side effects of treatment and patient’s overall health status. Common treatment options for pancreatic cancer include:
Surgery: Surgery is the primary mode of treatment for early pancreatic cancer. Your doctor will aim to resect the tumour tissue along with the healthy tissue surrounding it. This is called a negative margin or a clear margin. Surgery is also planned along with radiotherapy or chemotherapy which is either given after surgery in most cases or sometimes before taking the patient for surgery. To name a few surgeries, your doctor may perform either of the following:
- Pancreaticoduodenectomy (Whipple procedure)
- Distal pancreatectomy
- Total pancreatectomy
Chemotherapy: Various types of chemotherapeutic agents are present and your doctor will choose the one which is most suited to kill the cancer cells in your body. Sometimes a combination of chemotherapeutic agents is used and is almost tailor-made to target the cancer cells.
Radiotherapy: High energy rays like X-rays and proton rays are used to destroy the cancer cells. Often, the treating team will decide to give chemotherapy at the same time as radiation therapy because it can enhance the effects of radiation therapy, which is called radio-sensitisation.
Some other treatment options are also available like immunotherapy and targeted therapy which your doctor will suggest to you specific to your type and stage of cancer.
Most pancreatic cancer, unfortunately, cannot be prevented. However, you can take certain measures that will lower the risk. For example:
- Stop smoking – It is considered to be the most important risk factor associated with pancreatic cancer.
- Maintaining ideal weight – Do enough exercise and eat a balanced diet to keep a healthy weight of your body. Avoid junk foods and have more vegetables.
Scientists say that limiting your alcohol use can also lower your risk for pancreatic cancer.
(Disclaimer: The author, Dr Mantosh Kumar, Consultant Psychiatrist, medECUBE Healthcare, is a guest contributor and a part of our medical expert panel. Views expressed are personal)