Pancreatic Cancer

General and more comprehensive text about cancer diseases, their behavior, causes and treatment can be found here.

 

Pancreatic cancer is one of the worst types of cancer diseases with a very low survival rate. It is assumed that only 5% patients survive one year after the diagnosis and only 1% of patients survive five years.

Causes

The risk factors include age, sex (it is more typical in men) and chronic inflammation of he pancreas, i.e. chronic pancreatitis. Increased risk of the disease is in heavy smokers and chronic alcoholics.

Symptoms

The symptoms depend on the exact location of the tumor. If they grow from the head of the pancreas, they may manifest early by compression of nearby located biliary tract resulting in painless jaundice due to disruption of bile flow. In addition, missing bile in stool causes its pale color and malabsorption of nutrients, especially fats and some fat-soluble vitamins. Tumors growing in other parts of the pancreas (pancreatic body and tail) are for longer time asymptomatic. Later, they may manifest with similar symptoms as the mentioned tumors of the pancreatic head, with abdominal pain, loss of appetite, weight loss, nausea, vomiting, fatigue and many other symptoms.

 

Pancreatic cancer

 

Scheme - close relationship of the cancer within the head of the pancreas to bile duct and pancreatic duct

 

Prevention

The risk may be lowered by avoidance of smoking and only reasonable alcohol consumption.

Diagnosis

The diagnosis should be suspected in any case of painless jaundice, especially in a patient above the age of 50. The tumor mass may be visualized by abdominal ultrasound or computed tomography. Direct visualization of local biliary tree is possible by ERCP examination, which also allows taking samples for cytological examination (brush cytology). Local extent of a suspected tumor including affection of nearby lymph nodes may be examined by endosonography. In addition, there is a tumor marker known as CA19-9 dedicated for diagnosis of pancreatic cancer.

Treatment

If the tumor is found in its early stage, it is possible to treat it surgically. The operation is usually extensive with removal of a significant par of the pancreas and nearby tissues and organs including a part of duodenum. Chemotherapy may be used in combination with surgery or alone. However, the pancreatic cancer is not very responsive to chemotherapeutics. Very often, the only possible approach is palliative symptomatic treatment with administration of painkillers and ensuring the bile flow by inserting a tube-shaped stent into the biliary tree (by ERCP).