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Pancreatic cancer begins in the tissues of the pancreas, an organ in the abdomen located behind the lower part of the stomach. Your pancreas produces enzymes that aid digestion and hormones that aid in blood sugar management.
The pancreas can develop a variety of tumors, including cancerous and noncancerous tumours.The most common type of pancreatic cancer begins in the cells that line the ducts that transport pancreatic digestive enzymes (pancreatic ductal adenocarcinoma).Pancreatic cancer is rarely detected early, when it is most treatable. This is due to the fact that it frequently does not cause symptoms until it has spread to other organs.
Treatment options for pancreatic cancer are determined by the extent of the cancer. Surgery, chemotherapy, radiation therapy, or a combination of these may be options.
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Pancreatic Cancer
Pancreatic cancer is a disease in which healthy cells in the pancreas stop working as required and start growing out of control. These cancerous cells can build up and form a mass called a tumour. A cancerous tumour is malignant, meaning it can grow and spread to other parts of the body. As it grows, a pancreatic tumour can affect the function of the pancreas, grow into nearby blood vessels and organs, and eventually spread to other parts of the body through a process called metastasis.
There are several types of pancreatic cancer, mainly depending on what part of the pancreas the cancer began. So, to understand the types of pancreatic cancer, it is important to know about the two primary parts of the pancreas: Exocrine and Endocrine.
Exocrine: This part has little tubes and small sacs called acini at the end of these tubes, which make special proteins called enzymes. These enzymes are extremely important as they go into the small intestine and help the body break down and digest food, especially fats.
Endocrine: This part consists of groups of cells called “islets of Langerhans. These cells produce important hormones. The most important one is insulin, which helps control the amount of sugar in the blood. The cells also produce other important hormones like glucagon, somatostatin, pancreatic polypeptide (PP), and vasoactive intestinal peptide (VIP).
Symptoms of Pancreatic Cancer
Pancreatic cancer can cause a variety of symptoms. However, at an early stage, it may not show any symptoms. By the time symptoms occur, the cancer may have already spread to other parts of the body. The most common early signs of pancreatic cancer include:
Jaundice: This is a yellowing of the skin and eyes. Jaundice is caused by a blockage of the bile duct, which carries bile from the liver to the small intestine.
Pain in the Upper Abdomen: This pain may be constant or intermittent, and it may radiate to the back.
Weight Loss: Unexplained weight loss of 10 pounds or more can be a sign of pancreatic cancer.
Loss of Appetite: People with pancreatic cancer often lose their appetite and find it difficult to eat.
Nausea and Vomiting: These symptoms can be caused by the tumour or by blockage of the bile duct.
Fatigue: People with pancreatic cancer often feel tired and weak.
Abdominal Bloating: This is caused by a buildup of fluids in the abdomen.
Changes in Bowel Habits: These changes can include diarrhoea, constipation, or a change in the consistency of the stool.
Dark Coloured Urine: This is caused by bilirubin, a waste product that is normally removed from the body by the liver.
Itchy Skin: This can be caused by a buildup of bile in the bloodstream.
Anyone who experiences any of these symptoms, must see a doctor right away. Early diagnosis and treatment are important for improving the chances of survival for pancreatic cancer.
It is also important to note that these symptoms can also be caused by other conditions such as gallstones, pancreatitis, or ulcer. However, it is always best to see a doctor if any of the symptoms persist.
Diagnosis of Pancreatic Cancer
Pancreatic cancer can be difficult to diagnose as the symptoms are often vague and can be mistaken for other conditions. However, there are a number of tests that can be used to diagnose pancreatic cancer. These include:
Imaging Tests: These tests can create images of the pancreas and surrounding organs to help doctors look for a tumour. Commonly used imaging tests for diagnosing pancreatic cancer include:
Computerised Tomography (CT): This test uses X-rays to create detailed images of the inside of the body.
Magnetic Resonance Imaging (MRI): MRI test uses a strong magnetic field and radio waves to create detailed images of the body.
PET CT: This imaging technique combines nuclear medicine and CT scans, providing comprehensive insights into the metabolic activity and structure of tissues, aiding in the diagnosis and staging of pancreatic conditions.
Endoscopic Ultrasound (EUS): This test uses an ultrasound probe that is inserted through the mouth and into the stomach to create images of the pancreas.
Blood Tests: These tests can measure the levels of certain proteins and enzymes that can be elevated in people with pancreatic cancer. Blood tests that may be used to diagnose pancreatic cancer include:
CA19-9: This is a tumour marker that is often elevated in people with pancreatic cancer. However, it can also be elevated in people with other conditions, so it is not a definitive test for pancreatic cancer.
Amylase and Lipase: These are enzymes that are produced by the pancreas. Elevated levels of these enzymes can be a sign of pancreatitis, but they can also be elevated in people with pancreatic cancer.
Biopsy: A biopsy is the removal of a small piece of tissue from the tumour for examination under a microscope. This is the only way to definitively diagnose pancreatic cancer.
If someone experiences symptoms that could be caused by pancreatic cancer, it is important to see a doctor right away. Early diagnosis and treatment are important for improving the chances of survival for pancreatic cancer.
Treatment of Pancreatic Cancer in Ahmedabad
Pancreatic cancer treatment depends on the stage and location of cancer as well as on your overall health and personal preferences. For most people, the first goal of pancreatic cancer treatment is to eliminate cancer, when possible. When that isn’t an option, the focus may be on improving your quality of life and preventing the cancer from growing or causing more harm.
Treatment may include surgery, radiation, chemotherapy or a combination of these. When pancreatic cancer is advanced and these treatments aren’t likely to offer a benefit, your doctor will offer symptom relief (palliative care) that makes you as comfortable as possible.
Surgery of Pancreatic Cancer in Ahmedabad
Operations used in people with pancreatic cancer include:
Surgery for tumors in the pancreatic head. If your cancer is located in the head of the pancreas, you may consider an operation called a Whipple procedure (pancreaticoduodenectomy).
The Whipple procedure is technically difficult operation to remove the head of the pancreas, the first part of the small intestine (duodenum), the gallbladder and part of the bile duct. In some situations, part of the stomach and nearby lymph nodes may be removed as well. Your surgeon reconnects the remaining parts of your pancreas, stomach and intestines to allow you to digest food.
Surgery for tumors in the pancreatic body and tail.Surgery to remove the left side (body and tail) of the pancreas is called distal pancreatectomy. Your surgeon may also remove your spleen.
Surgery to remove the entire pancreas. In some people, the entire pancreas may need to be removed. This is called total pancreatectomy. You can live relatively normally without a pancreas but do need lifelong insulin and enzyme replacement.
Surgery for tumors affecting nearby blood vessels. Many people with advanced pancreatic cancer are not considered eligible for the Whipple procedure or other pancreatic surgeries if their tumors involve nearby blood vessels. At a very few medical centers in the United States, highly specialized and experienced surgeons will safely perform these operations with removal and reconstruction of parts of blood vessels in select patients.
Each of these surgeries carries the risk of bleeding and infection. After surgery some people experience nausea and vomiting if the stomach has difficulty emptying (delayed gastric emptying). Expect a long recovery after any of these procedures. You’ll spend several days in the hospital and then recover for several weeks at home.
Chemotherapy
Chemotherapy uses drugs to help kill cancer cells. These drugs can be injected into a vein or taken orally. You may receive one chemotherapy drug or a combination of them.
Chemotherapy can also be combined with radiation therapy (chemoradiation). Chemoradiation is typically used to treat cancer that has spread beyond the pancreas, but only to nearby organs and not to distant regions of the body. At specialized medical centers, this combination may be used before surgery to help shrink the tumor. Sometimes it is used after surgery to reduce the risk that pancreatic cancer may recur.
In people with advanced pancreatic cancer, chemotherapy is often used to control cancer growth and prolong survival.
Supportive (Palliative) Care
Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. Palliative care can be used while undergoing aggressive treatments, such as surgery, chemotherapy and radiation therapy.
When palliative care is used along with other appropriate treatments — even soon after the diagnosis — people with cancer may feel better and live longer.
Palliative care is provided by teams of doctors, nurses and other specially trained professionals. These teams aim to improve the quality of life for people with cancer and their families. Palliative care is not the same as hospice care or end-of-life care.
