Overview
Pancreatic cancer is a type of cancer that originates in the cells of the pancreas, a gland located behind the lower part of the stomach. The pancreas plays a dual role, producing enzymes that aid in digestion and hormones that help regulate blood sugar levels. The most common type of pancreatic cancer is pancreatic ductal adenocarcinoma, which begins in the cells lining the ducts that carry digestive enzymes out of the pancreas. Pancreatic cancer is often difficult to detect at an early stage because it usually doesn't cause symptoms until it has spread to other organs. Treatment options may include surgery, chemotherapy, radiation therapy, or a combination of these, and the choice of treatment depends on the extent of the cancer. The development of pancreatic cancer occurs when the cells in the pancreas acquire changes in their DNA. These changes alter the instructions that cells follow, causing them to grow and multiply uncontrollably, resulting in the formation of tumors. The tumor can grow and invade healthy tissue, eventually spreading to other parts of the body.
Understanding the disease
Symptoms
Symptoms of pancreatic cancer may include belly pain that spreads to the sides or back, loss of appetite, weight loss, yellowing of the skin and the whites of the eyes (jaundice), light-colored or floating stools, dark-colored urine, itching, new diagnosis of diabetes or diabetes that's getting harder to control, pain and swelling in an arm or leg, tiredness or weakness. If you experience any of these symptoms, it is important to make an appointment with a health care professional for further evaluation.
Risk Factors
Risk factors for developing pancreatic cancer include smoking, type 2 diabetes, chronic pancreatitis, family history of DNA changes that increase cancer risk (such as BRCA2 gene changes, Lynch syndrome, or FAMMM syndrome), family history of pancreatic cancer, and obesity. For pancreatic neuroendocrine tumors, additional risk factors include a family history of pancreatic neuroendocrine tumors, certain inherited syndromes like MEN1, VHL disease, NF1, and tuberous sclerosis, and DNA changes in hormone-producing islet cells.
Development
Pancreatic cancer develops when cells in the pancreas acquire changes in their DNA, resulting in uncontrolled growth and multiplication. The most common type of pancreatic cancer is pancreatic ductal adenocarcinoma, which originates in the cells that line the ducts that carry digestive enzymes out of the pancreas. Less frequently, cancer can form in the hormone-producing cells or the neuroendocrine cells of the pancreas, known as pancreatic neuroendocrine tumors. These changes in the DNA instruct the cells to continue living when healthy cells would normally die, causing an excessive growth of cells. Over time, these cancer cells can form tumors that can invade and destroy healthy tissue, and may even spread to other parts of the body.
Assessment and Diagnosis
Triage
If you suspect pancreatic cancer, it is important to consult a healthcare professional. They can help determine if further investigation is necessary and guide you through the appropriate steps for diagnosis and treatment. It is advisable to seek medical attention if you experience symptoms such as abdominal pain, unexplained weight loss, jaundice, or new onset of diabetes. It is best to consult a healthcare professional if you have concerns or notice any potential signs and symptoms of pancreatic cancer.
Diagnosis
To diagnose pancreatic cancer, a combination of diagnostic tests and procedures are used, including:
- Imaging tests: Ultrasound, CT scans, MRI scans, and sometimes PET scans provide images of the inside of the body to help identify any abnormalities in the pancreas.
- Endoscopic ultrasound (EUS): This test involves using a long, thin tube with a camera (endoscope) to make images of the digestive tract, nearby organs, and tissues. An ultrasound device attached to the endoscope creates images of the pancreas.
- Blood tests: Tumor markers like CA19-9 can be used to detect the presence of pancreatic cancer. However, not all pancreatic cancers produce these markers, so the test may not be helpful for everyone.
- Genetic testing: Analyzing blood or saliva samples to identify inherited DNA changes that may increase the risk of cancer can provide useful information for guiding treatment and assessing the risk for family members. A healthcare professional will help determine the most appropriate diagnostic approach based on individual circumstances.
Management and Treatment
Complications
Potential complications of pancreatic cancer may include weight loss, nausea and vomiting, difficulty in eating, jaundice, and dark-colored urine. As the cancer progresses, it can cause weight loss as the body's energy is consumed by the cancer. Nausea and vomiting may result from cancer treatments or a cancer pressing on the stomach. Sometimes, the body may have trouble getting nutrients from food due to insufficient digestive juices produced by the pancreas. Pancreatic cancer that blocks the liver's bile duct can cause jaundice, which may include yellowing of the skin and the whites of the eyes, dark-colored urine, and pale-colored stools.
Home Remedies
It is important to consult a healthcare professional for proper diagnosis, treatment, and management of pancreatic cancer. Treatment options may include surgery, chemotherapy, radiation therapy, or a combination of these approaches. Home remedies are generally not recommended for managing pancreatic cancer due to the complexity and severity of the condition.
Treatment
Treatment options for pancreatic cancer may include surgery, chemotherapy, radiation therapy, or a combination of these. The choice of treatment depends on the extent and location of the cancer, as well as the patient's overall health and personal preferences. Surgery is typically the first treatment option for pancreatic cancer, but it may not be possible for some patients due to the extent of the cancer or other health issues. Chemotherapy and radiation therapy may be used before or after surgery to help destroy cancer cells and reduce the risk of recurrence. Additionally, targeted therapy and immunotherapy may be used in certain cases. It is important to discuss treatment options with a healthcare professional.
Preparing for medical consultation
To prepare for an appointment for pancreatic cancer, you should make an appointment with a doctor who specializes in digestive problems (gastroenterologist) or a doctor who treats cancer (oncologist). Before the appointment, be aware of any pre-appointment restrictions and ask if there's anything you need to do in advance, such as restricting your diet. Write down all symptoms you're experiencing, including any that may seem unrelated to pancreatic cancer. Make a list of key personal information, including recent changes or stressors and family history of cancer. List all medications, vitamins, and supplements you're taking. Bring a relative or friend to the appointment to help remember information, and bring copies of your medical records if you're seeing a new doctor for the first time. Prepare a list of questions to ask your doctor, such as "Do I have pancreatic cancer?" and "What are my treatment options?"