A brief about Pancreatic Cancer
When cells in our body degenerate or become old, they are replaced by new cells. These new cells are supposed to be exact replicas of the cells they are replacing. However, sometimes the new cells turn out to be different. If the intricate and elite systems in our body are not able to correct this mistake, these cells grow to become cancer cells.
Pancreatic cancer occurs in the pancreatic tissues and is difficult to identify in the early stages. There are many crucial organs located right next to the Pancreas, such as bile ducts, intestine, major blood vessels, etc. Unfortunately, Pancreatic Cancer is extremely metastatic and spread directly to these vital organs.
In cases like these, removing the malignant 4 pancreatic tumor isn’t enough; the surgeon may have to remove the Pancreas in entirety.
No wonder Pancreatic cancer is extremely ruthless and dangerous. It has a high-risk rate and a low relative survival rate. But the fight isn’t over till we say it is. Today innumerable ongoing clinical trials are striving for better treatment and survival rate when it comes to Pancreatic Cancer.
What are the types of Pancreatic Cancer ?
Let’s understand the two types of Pancreatic tumor in detail:
- Exocrine– This is the most common form of Pancreatic cancer as the exocrine makes up for 95% of the Pancreas. Exocrine Pancreatic cancer spreads from the exocrine cells of the Pancreas. The most prevalent kind of Exocrine Pancreatic Cancer is Pancreatic Carcinoma or Pancreatic Adenocarcinoma. When cancer originates in the mucus-secreting gland in the Pancreas, it is called Pancreatic Adenocarcinoma. Pancreatic Ductal Adenocarcinoma is the most common form. Intraductal Papillary Mucinous Neoplasm(IPMN) is another common inter-ductal form of Pancreatic Cancer. It isn’t dangerous in the beginning, but risk increases as it grows and spreads. Mucinous cystic neoplasm with an invasive adenocarcinoma is a rare Pancreatic tumor that occurs in the tail. It is a dangerous cyst that is comparable to IPMN.
- Endocrine– The endocrine pancreatic system generates hormones which are directly released in the bloodstream. These tumors are also called Pancreatic neuroendocrine tumors (PNETs), or islet tumors. These PNETs can be functional or non-functional; the functional ones release hormones, and the non-functional ones don’t. These Pancreatic endocrine tumors react differently as compared to exocrine tumors. Their symptoms also vary from the exocrine Pancreatic tumor.
There are a variety of hormones involved in endocrine pancreatic cancer, and depending on the hormone, the symptoms of pancreatic cancer may vary:-
- Insulinomas– decreases sugar levels, causes fatigue and may result in coma
- Glucagonomas– increases sugar levels, increase in urination, may cause rash and skin changes, diabetic symptoms
- Gastrinomas– inexplicable stomach ulcers, shooting pain in the stomach, explosive acidity, black-colored stool
- Somatostatinomas– can cause a variety of problems ranging from symptoms of Diabetes to Jaundice
- P Pomas– explosive and watery diarrhea, liver pain, abdominal pain, enlarged liver
- VIPomas– increased blood sugar levels and symptoms of Diabetes
- Carcinoid tumors- affects the functioning of the heart causes wheezing and heart palpitations, may cause heart murmurs
- Recurrent Pancreatic Cancer
Only at a later stage do we usually discover the signs of Pancreatic Cancer. It diminishes the chances of surviving the 5-year mark of a healthy life. Most people witness recurrent symptoms and are diagnosed with Recurrent Pancreatic Cancer. Apart from taking proper medication, and leading a medically supervised life, regular checkups and CT Scans can help catch the signs of Pancreatic Cancer in advance.
Understanding the difference between the various types of Pancreatic cancer is crucial in the determination of treatment and medication.
What are the symptoms and signs of Pancreatic Cancer?
While there are very few cases of Pancreatic cancer each year, it is safer to remember these symptoms and keep them in mind, just in case. Not only will it help in a quicker Pancreatic Cancer diagnosis, but it also helps control the metastatic nature of the Pancreatic tumor.
- Abdominal pain– Pain in the abdominal region; often, sharp/shooting pains in the abdomen may be caused because of the tumor pushing against abdominal walls.
- Abdominal bloating– Ascites or abdominal bloating refers to an increase in the number of fluids in the abdominal region, swollen or bloated abdomen
- Lower back pain– Abdominal pain is often accompanied by lower back-pain due to the same reasons; the tumor may be blocking the digestive pathways.
- Weight loss– Aversion from food, change in food palate, inexplicable weight-loss, feelings of anorexia, recent and enormous changes in body weight.
- Digestive problems– This occurs when the pancreatic tumor presses against the walls of the stomach, causing food to remain inside the stomach for long durations, which results in nausea, fatigue, irritability, and frequent vomiting.
- Changes in stool– Digestive problems cause changes in stool, black(tarry) stool or faded(light-colored)stool, irregular bowel movement, difficulty in passing stool, the patient may suffer from constipation or diarrhea, stool may be watery or fluid.
- Changes in blood density– Cancer often causes changes in blood density, which may result in blood-clot formation, which may go unnoticed for a long period.
- Skin problems– Itchy skin, the occurrence of recurring rashes, inexplicable changes in skin problems.
- Enlarged gallbladder– Pancreatic Cancer can directly affect the gallbladder due to its proximity with the pancreas.
- Diabetes– Irregular amount of insulin or glucose levels, severe increase or decrease in glucose levels, frequent urination, diabetic symptoms, may cause fatigue or coma.
- Jaundice– This is caused due to an increase in the levels of bile content in blood. Symptoms include eyes and skin becoming yellowish, change in the color of urine, itchiness or rashes, change in the color of nails
There are two types of Pancreatic tumors- Malignant Pancreatic tumors and Benign Pancreatic tumors. Any Pancreatic cancer survivor will tell you that catching the symptoms at an early stage can help reduce the chances of the tumors becoming malignant.
What are the causes of Pancreatic Cancer?
Not even the best pancreatic cancer hospital will be able to explain why some cells are damaged, and some aren’t. Doctors haven’t been able to understand what causes the mutation of these cells, or why their genetic roadmap isn’t regular.
Causes of Pancreatic cancer include the following two types of mutations:
- Inherited Gene Mutations: You can inherit mutations in your genes from your parents. Parents who have pancreatic cancer are likely to pass it on their children. Six such genes can cause mutations to be passed down from parent to offspring. These genes are- BRCA1, BRCA2, CDKN2A, ATM, TP53, and MLH1. Mutation of any of these genes can cause the person to be at a higher risk of Pancreatic Cancer, but it’s not a necessity. Passing down genes that cause other types of cancer(colorectal cancer) may also cause inherited mutations.
- Acquired Gene Mutations: While some gene mutations are inherited, most happen after the child is born. These mutations may occur due to external causes like frequent exposure to tobacco smoke, or there may be no external cause whatsoever. It is a tedious task to determine what caused these gene mutations if no external factor had any role to play. There is an interesting fact that must be brought to notice- some of the acquired gene mutations are similar to those that are inherited(ex- TP53), while others are starkly different. Acquired gene mutation is the more common cause of pancreatic cancer.
Risk factors involved in Pancreatic Cancer
- Age– Chances of acquiring Pancreatic cancer increase with the advent of older age. Pancreatic cancer treatment is arduous when it comes to patients aged 60 and above. The treatment is less effective and causes severe side effects. Most people who show signs of pancreatic cancer are older people. Out of these, 90% are older than 55, and 70% are older than 65.
- Genetics– People with a family history of Pancreatic Cancer are more likely to acquire it. This is due to the inherited gene mutations.
- Gender- There is a minor difference in the percentage of men who have Pancreatic cancer, as compared to women. Men are more likely to acquire this type of cancer than women.
- Race– Race or ethnicity makes a massive difference to the chances of having Pancreatic Cancer. This could be because of the external factors attached to a race. Black people have a higher risk of getting Pancreatic cancer as compared to Asians, Hispanics, or Mexican people. Jewish people also have a high risk of acquiring pancreatic cancer.
- Diabetes– If you have Diabetes, especially Type 2 diabetes, you are at a higher risk of Pancreatic Cancer. This is why it is important to keep Diabetes in check.
- Chronic pancreatitis – Having an inflamed pancreas can increase the risk of acquiring pancreatic cancer. Chronic pancreatitis can occur due to excessive smoking or drinking.
- Smoking– Exposure to excessive tobacco smoke can shoot up the chances of acquiring an inflamed pancreas, and in turn, increase your chances of having Pancreatic Cancer.
- Cirrhosis– Cirrhosis is usually caused due to alcohol abuse. Your liver cells face the brunt of it, but it also increases the risk of developing Pancreatic Cancer. Another reason for having Cirrhosis might be a specific type of Hepatitis.
- Chemical exposure– Benzene, petrochemicals, pesticides etc. can be harmful to your health. Exposure to these chemicals can trigger acquired gene mutations.
- Hepatitis B– While there isn’t a lot of research on this subject, studies show people who have Hepatitis B infection are more likely to develop signs of Pancreatic Cancer later.
How to Prevent Pancreatic Cancer?
Pancreatic cancer treatment is ruthless and aggressive. To avoid ever having to go through it, we must:
- Stop smoking: Smoking is one of the major risk factors that can aggravate any chances of having Pancreatic Cancer. Even if you might not be at risk, exposure to excessive tobacco is harmful to your general health.
- Balanced diet: Having a balanced diet can reduce many problems in the body. It can make sure your body functions normally and excretes toxins. Having food at regular intervals also avoids ulcers and acidity.
- Daily exercise: Daily exercise helps keep your mind and body fit.
- Maintaining BMI: Maintaining the correct Body-Mass index is important as the loss of weight is one of the first symptoms of Pancreatic Cancer.
Diagnosis for Pancreatic Cancer
There are different methods for diagnosing Pancreatic cancer:
- Physical examination– The doctor will check for signs of jaundice in eyes, nails, and stool samples. The doctor will check for a bloated stomach or abdomen.
- Blood tests– The doctor will check for increased levels of tumor markers of Bilirubin in the blood.
Both are the signs of Pancreatic Cancer.
Imaging tests help identify the origin and location of the Pancreatic tumor. Pancreatic cancer treatment can begin only when the stage and location are identified correctly.
- CT Scan– CT Scans take snapshots of the inside of your body using X-rays. These X-rays scan your body from different angles; the pictures from all these angles are put together for a conclusive result.
- PET Scan(Positron Emission Tomography Scan)– Trace amounts of radioactive substances are injected in your body to understand the situation better. It provides a detailed visual image of the tumor. This is usually done in combination with a CAT Scan or CT Scan.
- Ultrasound– Ultrasound devices use sound waves to deliver an image of the internal organs or the affected areas. There are two types of ultrasound devices- transabdominal ultrasound device and endoscopic ultrasound device.
- PTC– Percutaneous transhepatic cholangiography is used to analyze the bile ducts and if there exists any blockage.
- Endoscopic retrograde cholangiopancreatography (ERCP): A bendable tube is inserted into the area under evaluation. This tube has an attached camera that can take pictures. It is inserted from the mouth and elongated into the small intestine, in proximity to the Pancreas.
Biopsy refers to tests on tissues removed from the Pancreas. A needle is injected (FNA-Fine Needle Aspiration) to remove cells from the Pancreas, to be tested in the lab.
Molecular testing or molecular profiling may be carried out to understand the genetic roadmap of the mutated genes, their constituent proteins, and nutrients.
Treatment for various stages of Pancreatic Cancer
There are five standard treatment options available to any patient riddled with Pancreatic cancer:
- Surgery: If the Pancreatic cancer hasn’t spread to vital organs or blood vessels, it can be taken out via surgery. This may include the Whipple Procedure, total pancreatectomy, or distal pancreatectomy. If the tumor can’t be removed without causing destruction, palliative surgery can be carried out to improve the life of the cancer patient. This may include the biliary bypass, endoscopic stent, or gastric bypass.
- Radiation Therapy: It is a common treatment method used to shrink and treat cancer. It is used to stunt the growth of Pancreatic cancer. It can be carried out externally(by sending radiation into the body through an external machine) or internally(calculated amounts of radioactive materials are sent/injected inside the body).
- Chemotherapy: It uses chemicals to stunt the growth of cancer and to kill them. These chemicals can be taken orally such that they may travel through the entire body system to reach the cancerous area, or they may directly be afflicted via injections into the affected areas.
- Chemoradiation therapy: Combines Chemotherapy and radiotherapy.
- Targeted therapy: Targeted drugs are injected into the bloodstream; these attack only the cancerous cells and leave other cells alone.
stages of pancreatic cancer
- Stage 0: This refers to the stage wherein the cancer is localized and hasn’t spread to areas other than the origin. Symptoms may not be visible and may go undetected.
- Stage I: Cancer has started to spread. Stage IA- Pancreatic cancer has spread two cms across the origin site. Stage IB- Pancreatic cancer has spread to 4 cms across the origin site. Neither IA nor IB witness cancer spreading to lymph nodes. The survival rate is 34%.
- Stage II: The pancreatic cancer is beginning to extend its reach. The cancerous area is more than four cm long and no more limited to the origin site. It is slowly covering the area around the Pancreas or to the lymph nodes in proximity. The survival rate is 12%.
Stage I and II: Surgery is followed by chemotherapy and chemoradiation. The patient is advised to subject themselves to clinical trials of targeted therapy and combination chemotherapy.
- Stage III: The pancreatic tumor is spreading rapidly to blood vessels that are close by. It is going to spread to nearby organs soon. The pancreatic tumor hasn’t become metastatic yet. The survival rate is 12%.
For Stage III, it is difficult to remove the Pancreatic tumor so palliative surgery is the best measure. The patient may be subjected to various combinations of Chemotherapy, chemoradiation, and targeted therapy. Clinical trials for internal radiotherapy are strictly advised.
- Stage IV: Pancreatic cancer has spread to distant sites and organs. The survival rate is 3%.
Again, much like Stage III, it is impossible to remove the tumor, but the pain is alleviated via Palliative surgery. This is followed by Chemotherapy, and the patient is advised to undergo clinical trials for anticancer drugs.
Side effects of surgery may include appetite loss, constipation, irritable bowel, pain at incision, pneumonia, heart problems, and pulmonary embolism.
Side effects of Chemotherapy include losing hair, feelings of nausea, dry skin/itchy skin, diarrhea, constipation, gum sores, or mouth ulcers.
Life in remission
Side effects of the treatment may include:
- Anemia– lack of red blood cells, destruction of red blood cells by the body
- Attention, memory problems– having trouble focusing, attention span reduces, memory is unreliable.
- Diarrhea– Unreliable and frequent bowel movements, the stool is watery or fluid.
- Xerostomia– dry mouth, difficulty swallowing, lack of saliva, burning sensation in the mouth
- Difficulty swallowing or chewing food– jaw muscles become stiff, pain in the tongue and mouth, difficult to pass food down the food-pipe
- Alopecia– Hair loss is a common side effect of chemotherapy, chemoradiation therapy or radiation therapy, hair may fall out slowly in sections, hair may fall out at once
- Nausea– frequent feelings of nausea, frequent vomiting, caused due to Chemotherapy, and targeted therapy.
Preventive measures during remission:
- Take proper medication for nausea
- Switch to citrus fruits to deal with nausea
- Switch to gentle hair products for your hair
- Ingest saliva stimulants(medication) or use saliva substitutes to deal with dry mouth
- Acupuncture may cause relief from body pain, joint pain or muscle pain
- Eat food at normal room temperature
- Exercise daily
- Avoid spicy food to keep your bowels away from any irritation
Pancreatic Cancer patients need to be wary of any signs of recurrence. Go for timely medical checkups and report any signs of recurrence at first notice.
How can ZenOnco.io help?
- Nourish Yourself: It is important to care for your health while combating pancreatic cancer. It can be challenging for many cancer patients to undergo several treatments that can weaken the immune system. Thus, it is imperative to make sure that you are consuming a nutritious diet which is high in proteins, vitamins, minerals, healthy fats, and carbohydrates. If it helps, eat small meals throughout the day to avoid nausea and vomiting.
- Stay fit yourself: You’ll feel weakened by the end of the treatment, and it will make you feel feeble and small. It’s time to take matters into your own hands and keep your body fit. There’s no need to engage in rigorous activities right away. Light to moderate exercises is the right way to go.
- Stay calm: Undergoing cancer treatments and therapies can demotivate and affect a cancer patient’s mental health adversely. To fight through this tough phase, mind-relaxing activities like yoga and meditation can be of great help. Staying calm and keeping a positive outlook is important for a faster recovery and emotional wellness.
- Cancer-proof your home: Sanitize your surroundings to prevent any infections. A clean home is the first step in cancer-proofing your house. Substitute your cookware with cancer-friendly cookware, use radon-items and opt for cancer-proof supplies.
- Get Community Support: Going through treatments and therapies for Ovarian cancer can undeniably be stressful. It will do you good to remind yourself that there are others like you, and we’re all in this together. Knowing that you have an entire community supporting, you can work wonders for your will-power and determination. It also offers closure and emotional support.
Visit our website ZenOnco.io to learn more about our community support and ZenOnco.io’s other wellness practices and protocol. Let us help you fight ahead through these tough times and emerge as a survivor.