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VERIFIED CONTENTAuthor: lek. Maciej Grymuza, a graduate of the Faculty of Medicine at the Medical University of K. Marcinkowski in Poznań.

Pancreatic cancer is an extremely difficult cancer to treat. This type of cancer is asymptomatic for a long time, and when these appear it is too late for effective treatment. What are the causes, symptoms, and types of pancreatic cancer? Is it possible to treat it effectively and when?

Pancreatic canceris a very dangerous cancer, not only because it is characterized by rapid growth and early metastasis, but also because it does not cause any symptoms for a long time, and above all there is no effective screening for this cancer.

Find out who is at risk of this cancer and what the symptoms of pancreatic cancer are . .

Pancreatic cancer - types

Among the npancreatic tumorswe distinguish not only cancer, but also malignant proliferation of cells that secrete pancreatic hormones, the so-called neuroendocrine tumors, are rare diseases. These include:

  • insulinoma
  • gastrinoma.

These tumors cause symptoms corresponding to the hormones they produce, and these are respectively: a drop in blood glucose levels and the formation of numerous gastric and duodenal ulcers.

In contrast to thempancreatic canceroriginates from the exocrine part (cells of the pancreatic ducts responsible for the production of digestive enzymes), due to its origin it is called adenocarcinoma and has no hormonal function .

Unfortunatelypancreatic canceris one of the most common in terms of incidence (10th place in women and 9th in men among all cancers) and mortality (5th place in women and 6. in men in terms of the number of deaths from cancer).

Pancreatic cancer - symptoms

Symptoms are affected by the size and location of the tumor.Pancreatic cancerdevelops asymptomatically for a very long time or causes very discreet and uncharacteristic ailments, especially if it is located in the body or tail of the pancreas.

At a fairly early stage of cancer development, the following appear:

  • abdominal discomfort
  • flatulence
  • anorexic
  • lossbody weight
  • diarrhea
  • nausea.

Symptoms of many other diseases much more common thanpancreatic cancer , such as food poisoning or irritable bowel syndrome. This makes its diagnosis extremely difficult.

If cancer affects the head of the pancreas, jaundice without colic may occur early, as the spreading tumor blocks the bile ducts, namely the common bile duct. This is one of the few opportunities to detect this cancer at a relatively early stage.

Latepancreatic cancer symptomsare much more characteristic: she mentions jaundice can also be a symptom of cancer metastasis to the surrounding lymph nodes, which, like the cancer itself, can oppress the bile ducts, causing yellowing of the skin stool discoloration and darkening of the urine, as well as itchy skin caused by bilirubin deposits.

Other ailments include back pain, caused by the tumor pressing against nerve trunks or pancreatitis, is severe and girdling.

Symptoms of latepancreatic canceralso include abdominal pain, anorexia, rapid satiety and cachexia.

Gastrointestinal complaints in the advanced stage of the disease are in the form of nausea and vomiting, disturbed bowel movements or gastrointestinal bleeding are the result of duodenal infiltration and portal vein thrombosis.

Pancreatic cancercan also cause:

  • glucose intolerance and diabetes
  • acute pancreatitis
  • venous thrombosis
  • traveling thrombophlebitis (called Trousseau syndrome)
  • gastrointestinal bleeding
  • ascites

Pancreatic cancer - risk factors

Pancreatic canceris more common in smokers, it is believed that up to 25% of pancreatic cancer is related to smoking.

In addition, this cancer is more common in people suffering from obesity, diabetes and chronic pancreatitis.

The latter is a chronic inflammatory disease, leading to pancreatic insufficiency, resulting in abdominal pain, diarrhea, malnutrition and diabetes. Alcohol is the most common cause of chronic pancreatitis.

Not without significance in the originpancreatic cancerthere is a genetic predisposition, the presence of this neoplasm in relatives and congenital neoplastic syndromes, such as :

  • Peutz and Jeghers team
  • Lynch syndrome (HNPCC gene)
  • familial polyposis of the large intestine (APC gene).

Pancreatic canceris also more common in patientscarriers of the BRCA2 gene responsible for the familial occurrence of breast and ovarian cancer.

Pancreatic cancer - prophylaxis

The most important method of prevention is fighting the risk factorspancreatic cancer , first of all stopping smoking, but also treating diabetes and obesity.

  • How to stop smoking successfully?

In the case of people who have a family history of people suffering frompancreatic cancer , imaging tests are used prophylactically.

This group includes:

  • people with at least 2 relatives of pancreatic cancer patients
  • BRCA2 mutation carriers
  • patients with Peutz-Jeghers syndrome
  • patients with Lynch syndrome.

Pancreatic cancer - research

In laboratory tests, the results are initially normal, with the appearance of jaundice, the amount of bilirubin, alkaline phosphatase and GGTP increases, which indicate damage to the bile ducts. As the disease develops, the following are added:

  • anemia
  • hypoalbuminemia

Markerpancreatic cancerthe so-called CA 19-9 is not helpful in the diagnosis of this cancer because its clinically significant growth does not appear until the cancer is very advanced.

Moreover, the increase in CA 19-9 can also be observed in other diseases associated with jaundice, such as cholelithiasis.

Therefore, CA19-9 is used rather to monitor the course of the disease and detect possible recurrencespancreatic cancer .

  • CA 19-9 tumor antigen - standard and test results

In terms of imaging examinations, ultrasound is extremely important, apart from the tumor itself, you can visualize:

  • enlarged lymph nodes
  • widening of the bile ducts
  • metastases in the liver.

Unfortunately, the correct result does not exclude the early stagepancreatic cancer .

The most important test is abdominal computed tomography with contrast, which is used not only to diagnose the neoplasm, but also to assess its advancement and the possibility of surgery.

For a similar purpose, but less commonly, magnetic resonance imaging is performed.

The less frequently performed tests are EUS, i.e. ultrasound performed through the duodenum, which allows not only the assessment of small tumors, lymph nodes and vessels, but also the performance of a biopsy of the lesion.

In order to treat jaundice, ERCP is performed, during this examination, contrast is administered to the bile ducts, and then x-rays are taken tovisualizing the obstacle in the flow and then removing it.

This test also allows you to biopsy or collect material for cytological examination.

  • Endoscopic retrograde cholangiopancreatography (ERCP) - examination of the bile ducts and pancreas

Pancreatic cancer is one of the few neoplasms that can be diagnosed on the basis of imaging only, without histopathological confirmation.It is possible, however, only in very advanced stages, when surgery cancer removal is technically not possible.

If, on the other hand, the advancement of the neoplasm allows for treatment, then it is necessary to confirm the diagnosis, and the biopsy of the lesion is usually performed through the skin or during endoscopic ultrasonography.

Pancreatic cancer - treatment

Unfortunatelypancreatic canceris a very malignant neoplasm, it grows quickly, it also infiltrates neighboring organs quickly. Similarly, metastasis occurs early, first in the peritoneum, then in the lymph nodes, the liver, and finally in the distant organs.

Treatment results depend primarily on the possibility of complete surgical removal of the neoplasm, unfortunately it is rarely possible, so the prognosis for complete recovery and survival is poor.

Pancreatic cancer prognosisdepends on the stage of the disease. The patient can undertake two therapies: radical treatment and palliative treatment. It is estimated that radical treatment can be undertaken only in about 20% of patients.

The aim of the first one is to completely cure pancreatic cancer, but unfortunately it is rarely possible due to the infiltration of the surrounding organs and metastases.

The surgical procedure is very difficult and carries the risk of many complications, because the pancreas lies close to the aorta, inferior vena cava, duodenum and mesenteric artery, i.e. vital organs.

Despite this, surgery is the main method of radical treatment, the so-called pancreatoduodenectomy using the Kausch and Whipple method is used, i.e. removal of part of the pancreas, gallbladder, duodenum and part of the stomach.

Treatment with chemotherapy or radiotherapy is continued after surgery.

Palliative treatment is to extend the patient's life and reduce pain. This management strategy is chosen for very advanced cancers, when there is no chance of completely removing the cancer.

This treatment includes:

  • chemotherapy
  • analgesic treatment (pharmacological and surgical)
  • jaundice treatment - endoscopic or surgical
  • treatment of pancreatic insufficiency - supplementation of digestive enzymes produced by this organ
  • thrombosis prophylaxis.

Pancreatic cancer is a very dangerous neoplasm, mainly because symptoms often do not occur at all, and complaints appear only at a very advanced stage.Remember that smoking is over It doubles the risk of neoplasms, which is why their elimination is the basis of prophylaxis. Unfortunately, pancreatic cancer treatment is difficult and rarely successful.

Bow. Maciej GrymuzaA graduate of the Faculty of Medicine at the Medical University of K. Marcinkowski in Poznań. He graduated from university with an over good result. Currently, he is a doctor in the field of cardiology and a doctoral student. He is particularly interested in invasive cardiology and implantable devices (stimulators).

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Category:

Oncology