Pancreatic Cancer

What is Pancreatic Cancer?

Under the stomach, the pancreas is a structure that aids in digestion. Furthermore, it is essential for maintaining metabolic homeostasis. Multiple enzymes secreted by the pancreas aid in digestion. Additionally, it releases hormones that control blood sugar levels. Pancreatic cells are where pancreatic cancer first appears. The ducts that transport the pancreatic digestive enzymes are where cancer most frequently starts. Sadly, the majority of patients do not exhibit early signs of pancreatic cancer, which leads to an advanced stage diagnosis.

Asarfi oncology department excels at offering top-notch cancer treatment because of their combined more than 30 years of clinical excellence. Our oncologists and onco-surgeons treat all types and forms of cancer using a multidisciplinary approach. They are assisted by a team of highly skilled reconstructive surgeons who treat all of our patients, both adults and children, with extensive care, as well as by the newest cancer treatment technologies.

Types

The types of pancreatic cancer are as follows:

Pancreatic Exocrine Cancer

Another name for it is non-endocrine cancer. It arises from exocrine cells, which constitute the exocrine gland and pancreatic ducts. Enzymes secreted by these cells aid in the digestion of proteins, acids, fats, and carbohydrates in the duodenum. Approximately 95% of pancreatic cancer cases are exocrine cancers. Adenocarcinoma, squamous cell carcinoma, adenosquamous cell carcinoma, colloid carcinoma, and other exocrine pancreatic cancers are examples.

Endocrine Pancreatic Cancer

It is also called pancreatic neuroendocrine tumors (PNETs) or islet cell tumors. They are less common than exocrine tumors, making up around 7% of all pancreatic cancers. A pancreatic neuroendocrine tumor can be functioning or non-functioning. A functioning tumor makes hormones. A non-functioning tumor no longer makes hormones. The types of pancreatic neuroendocrine tumors are insulinoma, gastrinoma, and glucagonoma.

Symptoms

Early in the course of the disease, pancreatic cancer signs and symptoms rarely appear. Among them could be:

• Back and stomach aches
• eyes and skin that are yellowish
• urine with a dark hue
• Stools with light colours
• urticaria (itchy skin)
• Reduce your weight
• GI Issues: nausea, vomiting, indigestion, and loss of appetite
• Diabetes
• Liver or gallbladder swelling

Causes

It is thought that damage (or "modification") to the pancreatic cells' DNA is what causes pancreatic cancer. There are various possible causes for these DNA mutations. They may be inherited, the result of actions like smoking, or they may happen by accident. What specifically causes pancreatic cancer is unknown, though.

Additional Dangers

The risk of pancreatic cancer is increased by several factors. Among them are:

• Alcohol Consumption Too Much
• Smoking: Up to 30% of cases of pancreatic cancer are related to smoking.
• Being overweight
• Diabetes
• Family history: A family history of pancreatic cancer accounts for up to 10% of cases of the disease.
• Infections: A stomach tract H. Pylori infection may increase the risk of developing pancreatic cancer.
• HPV: Certain viral infections, including the human papillomavirus (HPV)
• Radiation: Being exposed to radiation, particularly ultraviolet light.

Stages

• Stage I: At this point, the cancer is limited to the outer layers of the pancreatic duct cells and has not yet spread to the inside tissues of the pancreas. These tumours are referred to as carcinoma in situ.
  Two substages comprise Stage I:
  • Stage I-A: At this point, the tumour has a maximum diameter of 2 cm and is solely located in the pancreas.
  • Stage I-B: At this point, the tumour size is between 2 and 4 cm, and the cancer has not spread to other areas of the body.
• Stage II:Additionally, Stage II is split into two subgroups:
  • Stage II-A: The tumour is more than 4 cm in diameter and the pancreatic cancer has not spread to this location.
  • Stage II-B: Tumours of varying sizes have spread to lymph nodes one to three in the pancreatic cancer progression.
• Stage III: At this point, the disease has progressed to one or more lymph nodes, and the tumours may be as small as 1 cm or as large as 4 cm.
• Stage IV: At this stage, the cancer cells in the pancreas have spread to other parts of the body. The tumour has a diameter of more than 4 cm, and additional malignant lymph nodes could be present.

Diagnosis

The physician diagnoses pancreatic cancer using a number of diagnostic methods. Among them are:

• A Physical Examination: Based on the patient's symptoms, the physician conducts the initial screening for pancreatic cancer. Abdominal swelling, abrupt weight loss, back and stomach pain, and chronic fatigue are all possible referrals from the doctor.
• Blood Tests: In order to ascertain whether a tumour marker is present, the doctor recommends that the patient have a blood test. CA19-9 is a tumour marker that is elevated in pancreatic cancer. However, since many pancreatic cancer patients do not have high levels of CA19-9, this test is not the confirmatory test for the disease.
• CT scan: To ascertain the existence and severity of pancreatic cancer, the physician might suggest a CT scan.
• MRI: The scanner uses magnetic resonance imaging (MRI) to produce images of the abdomen, particularly the area surrounding the liver, gallbladder, and pancreas.
• Ultrasound: An ultrasound can also reveal whether a pancreatic tumour is present.
• Biopsy: To obtain a sample of tissue for molecular or genetic testing of the tumour, a core needle biopsy is performed. However, compared to a fine needle aspiration (FNA), a core needle biopsy carries greater risks, including bleeding and pancreatitis.
• ERCP: The physician places a tube in the mouth that has a camera at the end to reach the small intestine. Through the gastrointestinal tract, the pancreas can be seen by the doctor to check for tumours.
• Laparoscopy: This is a process that requires multiple tiny incisions. A doctor can use laparoscopy to see inside the stomach and obtain tissue for biopsy in order to determine whether pancreatic cancer has spread.

Treatment

The following therapies may be used by the physician to treat pancreatic cancer

• Surgery: Depending on the location and stage of the cancer, the patient may require surgery for pancreatic cancer. In the event that a pancreatic head tumour is present, the physician may choose to carry out a Whipple procedure (pancreaticoduodenectomy).
• If the pancreas has cancer in that area, the surgeon may remove the organ's body and tail. Distal pancreatectomy is the name given to the procedure. The pancreas must be removed in its entirety if the cancer has spread throughout it. The term "pancreatectomy" refers to the procedure.
• The surgeon will perform a highly specialised procedure to remove the pancreas and blood vessels if the cancer has progressed to an advanced stage and is affecting the nearby blood vessels. Rebuilding the blood vessels that were removed is another aspect of it.
• Chemotherapy: A doctor will give cancer-killing medications during this treatment. The injectable or oral medications used in the chemotherapy regimen are prescribed by the doctor. To increase the efficacy of the treatment, the physician may also combine chemotherapy with radiation therapy or surgery.
• Radiation therapy: In radiation therapy, cancer cells are killed by high-energy radiation. This option is used by the surgeon during surgery. Additionally, this treatment works well in cases where surgery is not a practical cancer treatment option.