The Diagnosis and Treatment of Pancreatic Cancer

The pancreas is a tiny, hockey stick-shaped gland located behind the stomach. It helps in food digestion and regulates blood sugar levels in your body. The pancreas plays a role in blood sugar regulation because it produces the chemicals glucagon and insulin, which regulate blood sugar levels.

What is pancreatic cancer?

Pancreatic cancer develops when the pancreas' cells undergo changes (mutations) that cause them to multiply uncontrollably. This tumour may occasionally be benign (not cancerous). However, the mass in pancreatic cancer is malignant (cancerous). Due to its difficulty in detection, pancreatic cancer is typically not discovered until it is far advanced. Weight loss and jaundice are indications of pancreatic cancer. Diabetes and exposure to specific chemicals are risk factors. The type of treatment needed will depend on the tumour's size, location, and whether it has spread to other body parts.

Also Read: Stages of pancreatic cancer

What are the types of pancreatic cancer?

Exocrine tumours and neuroendocrine tumours are the two forms of cancers that develop in the pancreas. Exocrine tumours make up roughly 93% of all pancreatic tumours, and adenocarcinoma is the most typical form of pancreatic cancer. When someone says they have pancreatic cancer, they typically mean pancreatic adenocarcinoma. Ductal adenocarcinoma is the kind that most frequently starts in the pancreatic ducts.

Approximately 7% of all pancreatic cancers are neuroendocrine tumours (NETs), also known as pancreatic NETs (PNETs), islet cell tumours, or islet cell carcinoma. Some NETs overproduce hormones. Depending on the type of hormone the cell produces, they may go by other names; for example, an insulinoma would be a tumour in an insulin-producing cell.

Causes and Symptoms of Pancreatic Cancer

Most people don't notice pancreatic cancer's early symptoms. However, when the illness worsens, people could observe:

• Upper abdominal pain that may spread to the back
• Jaundice
• Loss of appetite
• Tiredness
• Weight loss
• Light-coloured poop
• Dark-colored pee
• Blood clots in the body
• Itchy skin
• New or worsening diabetes
• Nausea and vomiting

Your doctor might suspect pancreatic cancer if you have some symptoms and you recently had diabetes or pancreatitis a painful condition due to the inflammation of the pancreas.

Symptoms of pancreatic neuroendocrine cancer may differ from conventional pancreatic cancer symptoms, such as jaundice or weight loss. This is because some PNETs overproduce hormones.

Also Read: What are the causes of Pancreatic Cancer?

Diagnosis and Tests for Pancreatic Cancer

It's challenging to detect pancreatic cancer early because doctors do not consider the pancreas in a routine exam. If your doctor suspects that you may have pancreatic cancer, he may order imaging tests to take pictures of the internal organs. It is also possible to perform endoscopic ultrasonography.

A small tube with a camera at the tip is inserted via the mouth and into the stomach to perform endoscopic ultrasonography (EUS). The pancreas can be imaged via the stomach wall using the endoscope's ultrasonic probe. During the process, a pancreatic ultrasound-guided biopsy (tissue sample) may be taken, if necessary.

A tumour marker is a chemical that a blood test can find. High carbohydrate antigen (CA) concentrations 19-9, a type of protein secreted by pancreatic cancer cells, may signify a tumour in cases of pancreatic cancer.

Treatment of Pancreatic Cancer

Treatment for pancreatic cancer is based on several factors, including the location of the tumour, its stage, your overall health, and if the disease has progressed outside of the pancreas. Options for treatment include:

Surgical removal: Resection refers to the removal of malignant pancreatic tissue. You might also have the pancreatic lymph nodes removed. A pancreatectomy is a medical procedure to remove all or parts of the pancreas. Your doctor might advise the Whipple procedure if your tumour is in the pancreas head, which is its broadest region and is closest to the small intestine. The pancreatic head, the duodenum (the first section of the small intestine), the gallbladder, a section of the bile duct, and adjacent lymph nodes are all removed during this surgical procedure.

Radiation therapy: High-speed energy is employed to destroy cancer cells.

Chemotherapy: This process employs medicines that destroy cancer cells.

Immunotherapy: A form of cancer treatment that supports the immune system. About 1% of persons with pancreatic cancer with a specific genetic mutation may benefit from immunotherapy, even though it has been mainly ineffective against pancreatic cancer.

Targeted therapy: It aims at targeting specific genes or proteins that support cancer growth. Usually, genetic testing is how we decide if targeted therapy is the best option for you.

A pancreatic cancer diagnosis can be shocking and life-changing. You might consider joining a support group for people with pancreatic cancer. Spending time with others who are going through the same things can be empowering and beneficial for your mental and emotional health. You can also talk with a counsellor, therapist or social worker about how youre feeling. Knowledge is power, and there are several helpful resources available for you and your family.

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Reference:

1. McGuigan A, Kelly P, Turkington RC, Jones C, Coleman HG, McCain RS. Pancreatic cancer: A review of clinical diagnosis, epidemiology, treatment and outcomes. World J Gastroenterol. 2018 Nov 21;24(43):4846-4861. doi: 10.3748/wjg.v24.i43.4846. PMID: 30487695; PMCID: PMC6250924.
2. Kanji ZS, Gallinger S. Diagnosis and management of pancreatic cancer. CMAJ. 2013 Oct 1;185(14):1219-26. doi: 10.1503/cmaj.121368. Epub 2013 Apr 22. PMID: 23610017; PMCID: PMC3787168.