Pancreatic Cancer

What is pancreatic cancer?

There are two types of cancer that start in the pancreas. Cancers of the pancreatic ducts (adenocarcinomas) make up more than 90% of cases; the rest are cancers of cells that produce insulin.

Cigarette smoking and chronic pancreatitis may increase the risk of getting pancreatic cancer. Because the initial symptoms are subtle, pancreatic cancer often spreads significantly before it is diagnosed. The outlook is poor.

Most pancreatic tumors affect the head of the pancreas. When they grow larger, they can block the outflow of bile from the liver and bile ducts into the intestine. This causes bilirubin, an orange-yellow pigment, to build up in the body.

Symptoms

Vague abdominal discomfort is often the only symptom of pan­cre­atic cancer as the tumor

Develops. Another symptom is gnawing pain, radiating from the abdo­men to the back, that improves when you bend forward. As it progresses, you may have the following symptoms:

• Jaundice, which is a yellowing of the skin and eyes
• Dark urine
• Pale-colored stools
• Abdominal and/or back pain
• Loss of appetite
• Unintended weight loss
• Itching

In people with tumors of hormone-producing cells, the symptoms depend on the hormone that is overproduced. Most often, excessive amounts of insulin are produced, leading to low blood sugar levels and faintness, confusion, trembling, and sweating.

Treatment

Diagnosing pancreatic cancer can be challenging, as symptoms often don't appear until the disease has progressed. When pancreatic cancer is suspected, doctors typically use a combination of tests to confirm the diagnosis. These may include imaging studies such as CT scans, MRIs, or endoscopic ultrasounds, which can help visualize the pancreas and surrounding organs. Blood tests may also be performed to check for elevated levels of certain substances, like the tumor marker CA 19-9, although these tests alone cannot definitively diagnose pancreatic cancer. In some cases, a biopsy may be necessary to obtain a tissue sample for examination under a microscope. This can be done through various methods, including fine needle aspiration or during an endoscopic procedure. Early and accurate diagnosis is crucial for determining the most appropriate treatment options and improving outcomes for patients with pancreatic cancer.

Diagnosis is made through patient history, physical examination, blood tests, abdominal imaging such as ultrasound or CT scan, and sometimes biopsy of the pancreas or other minor surgical procedure to help make the diagnosis.

Treatment involves a combination of several methods, including chemotherapy, radiation therapy, surgery to remove all or part of the pancreas. Some treatments are given to help relieve some of the symptoms and to reduce pain.