Pancreatic cancer develops when uncontrolled cell growth begins in a part of the pancreas.
The pancreas is a small, hockey stick-shaped gland located behind the stomach. The main jobs of the pancreas are to aid in food digestion and regulate blood sugar levels in the body. The pancreas is involved in maintaining blood sugar levels because it makes insulin and glucagon, two hormones that control blood sugar levels.
Most people don’t experience early signs of pancreatic cancer. As the disease progresses, however, people may notice:
• Upper abdominal pain that may spread to the back.
• Yellowing of the skin and the whites of the eyes (jaundice). It is present in around 70% of people with this type of cancer.
• Loss of appetite.
• Light-colored poop.
• Dark-colored pee.
• Weight loss.
• Blood clots in the body.
• Itchy skin.
• New or worsening diabetes.
• Nausea and vomiting
• a rash due to jaundice
Pancreatic cancer is categorized into five different stages. Your diagnosis depends on the size and location of the tumor and whether or not the cancer has spread:
• Stage 0: Also known as carcinoma in situ, Stage 0 is characterized by abnormal cells in the lining of the pancreas. The cells could become cancerous and spread to nearby tissue.
• Stage 1: The cancer is in the pancreas. It is localized.
• Stage 2: The cancer has reached the bile duct and other structures but not the lymph nodes. It is regional.
• Stage 3: The cancer affects the lymph nodes but is still regional.
• Stage 4: The cancer has reached other organs and parts of the body. It is distant.
There are different types of pancreatic cancer. The main distinction is whether they affect the exocrine glands or the endocrine glands.
▪︎ Exocrine pancreatic cancer
The exocrine glands produce enzymes that enter the intestines and help digest fat, proteins, and carbohydrates. Most of the pancreas consists of exocrine glands.
Types of tumor that can affect exocrine function include:
• acinar cell carcinomas
• cystic tumors
Most pancreatic tumors affect exocrine function.
▪︎ Endocrine pancreatic cancer
The endocrine glands are small clusters of cells known as the islets of Langerhans. They release the hormones insulin and glucagon into the bloodstream. There, they help manage blood sugar levels. Problems with these glands can lead to diabetes.
The name will depend on the type of hormone-producing cell where the cancer starts.
Some examples include:
• insulinomas (insulin)
• glucagonomas (glucagon)
• gastrinomas (gastrin)
• somatostatinomas (somatostatin)
The cause of pancreatic cancer is unknown.
Pancreatic cancer occurs when abnormal cells begin to grow within the pancreas and form tumors, but it’s unclear why this happens.
Typically, healthy cells grow and die in moderate numbers. In the case of cancer, there’s an increase in the production of abnormal cells. These cells eventually take over healthy cells.
• Family history of genetic syndromes that can increase cancer risk, including a BRCA2 gene mutation, Lynch syndrome and familial atypical mole-malignant melanoma (FAMMM) syndrome
• Family history of pancreatic cancer
• Older age, as most people are diagnosed after age 65
A doctor will ask about symptoms, take a family and medical history, and carry out a physical examination. They may also recommend some tests.
Some tests that a doctor may recommend include:
• blood tests, including a liver function test
• urine and stool tests
• imaging tests, such as X-rays, ultrasound scans, or MRI scans
• a biopsy to confirm a diagnosis
Treating pancreatic cancer involves two main goals: to kill cancerous cells and prevent the cancer from spreading. The most appropriate treatment option will depend on the stage of the cancer.
The main treatment options include:
• Surgery. Surgical treatment of pancreatic cancer involves removing portions of the pancreas (more on this below). While this can eliminate the original tumor, it won’t remove cancer that’s spread to other areas. As a result, surgery usually isn’t recommended for advanced-stage pancreatic cancer.
• Radiation therapy. X-rays and other high-energy beams are used to kill cancer cells.
• Chemotherapy. Anticancer drugs are used to kill cancer cells and help prevent their future growth.
• Targeted therapy. Medications and antibodies are used to individually target cancer cells without harming other cells, which can happen with chemotherapy and radiation therapy.
• Immunotherapy. Various methods are used to trigger your immune system to target the cancer.
In some cases, a doctor might recommend combining multiple treatment options. For example, chemotherapy might be done before surgery.
For advanced-stage pancreatic cancer, treatment options might focus more on pain relief and keeping symptoms as manageable as possible.
No specific measure can prevent pancreatic cancer, but some lifestyle choices can help reduce the risk.
• quitting smoking, if applicable
• maintaining a moderate weight
• exercising often
• eating plenty of fresh fruits and vegetables
• limiting one’s intake of red meat
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