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Pancreatic cancer – Early signs and management

Pancreatic cancer – Early signs and management

The pancreas is a vital organ that controls blood sugar levels and aids digestion. When cells in the pancreas begin to mutate and multiply, they form a tumor. Generally, these growths generate in the ducts of the pancreas, and the cancerous growth that begins in the pancreas is termed pancreatic cancer. Early stages of pancreatic cancer may be undetectable in imaging tests. This form of cancer is also known for being resistant to several treatments.

What are the types of pancreatic cancer?
There are two major types of pancreatic cancer:

Exocrine tumors
Over 90% of pancreatic tumors are exocrine tumors, which develop from the exocrine cells in the pancreas. These include adenocarcinoma, squamous cell carcinoma, adenosquamous cell carcinoma, and colloid carcinoma.

Neuroendocrine tumors (NETs)
Also known as Islet Cell Carcinoma, these tumors are less common and develop in the endocrine gland of the pancreas. The endocrine gland secures insulin and glucagon to regulate blood sugar levels.

What are the signs and symptoms of pancreatic cancer?
Pancreatic cancer often goes undiagnosed until it spreads to the other organs (reaches the metastasis stage). Being vigilant and regularly checking for the following signs and symptoms of pancreatic cancer can help receive an early diagnosis and manage the condition better:

Stomach and back pain
A dull pain in the upper abdomen and the middle or upper back is a common sign of pancreatic cancer. It generally occurs because the tumor in the pancreas begins to put pressure on the stomach or the spine. For some people, this pain may worsen when lying down but alleviates when leaning forward. However, since abdominal pain can differ from person-to-person and have several underlying causes, one must discuss all their symptoms with their doctor.

Jaundice
When the amount of bilirubin in the body increases, it could lead to jaundice. With pancreatic cancer, this condition is often painless and occurs when the tumor at the head of the pancreas blocks the bile duct. Common symptoms of jaundice include yellowing of the skin and eyes, dark urine, pale, greasy stools, and itchy skin (pruritus).

Gastrointestinal problems
The growing tumor begins to press on parts of the digestive system. This could lead to gastrointestinal problems such as loss of appetite, nausea, indigestion, vomiting, bloating, or abdominal swelling.

Fatigue
Unexplained and extreme tiredness or fatigue may also be a sign of pancreatic cancer. However, it can also be associated with several other health conditions, so it is best to consult a doctor for a proper diagnosis.

New-onset diabetes
An early diagnosis of pancreatic cancer often occurs during tests for other conditions, such as diabetes. For some people, pancreatic cancer may trigger sudden onset diabetes, as it can destroy insulin-making cells, thereby increasing blood sugar levels. Those experiencing a sudden onset of diabetes must always be evaluated for pancreatic cancer.

If a healthcare provider suspects pancreatic cancer, they may prescribe imaging tests such as computed tomography (CT) scans, magnetic resonance imaging (MRI), positron emission tomography (PET), and endoscopic ultrasounds (EUS). Doctors may also prescribe a pancreas blood test, staging laparoscopy, or genetic testing.

Most healthcare providers do not perform routine screenings for pancreatic cancer. However, those with an immediate family history of pancreatic cancer must speak with their doctor regarding their risk levels and monitoring, screening, and imaging tests to detect the condition early.

What treatment options are available for pancreatic cancer?
Depending on the location of the tumor, its stage of advancement, and one’s overall health, doctors may recommend one of the following courses of action for treating or managing pancreatic cancer:

Surgery
The only ‘cure’ for pancreatic cancer is surgery. However, doctors only advise this line of treatment when they believe the entire tumor can be removed. Depending on the location and size of the tumor, surgeons may use techniques such as:

Whipple procedure (pancreaticoduodenectomy)
This technique may be used if the tumor is located at the head of the pancreas. During the Whipple procedure, the surgeon will remove the head of the pancreas, the duodenum, the gallbladder, a portion of the bile duct, and some surrounding lymph nodes. The remaining bile duct and pancreas are then reattached to the small intestine to complete the digestive tract.

Distal pancreatectomy
A distal pancreatectomy may be recommended for tumors that affect the tail of the pancreas. Here, the surgeon will remove a part of the pancreas and may also remove the spleen.

Total pancreatectomy
A total pancreatectomy may be necessary if the cancer has spread throughout the pancreas. Here, the entire pancreas is removed. While it is possible to live without a pancreas, it may cause significant side effects, such as diabetes and digestive issues.

Chemotherapy
Chemotherapy is used to kill cancer cells. It may be advised as a standalone treatment for people with advanced pancreatic cancer or recommended before surgery to reduce the tumor and kill active cancer cells.

Radiotherapy
In this treatment procedure, high-frequency X-rays are used to kill cancer cells. It is often administered in combination with chemotherapy, also known as chemoradiation. It may be recommended before or after surgery. It may also be a part of the primary treatment for those with advanced pancreatic cancer who do not qualify for surgery, as it can help ease symptoms.

Targeted Therapy
This treatment targets proteins that control the growth and spread of cancer cells. Targeted therapy may be used in combination with other treatment options.

Pain management
Pancreatic cancer can cause immense pain when it spreads to the surrounding nerves. Doctors may recommend treatment options to alleviate it and ease the symptoms.

Unfortunately, one cannot prevent pancreatic cancer. However, adopting healthy lifestyle habits can help prevent its onset and spread. Eating fresh fruits, vegetables, and whole grains, reducing the intake of red meat, sugary drinks, and processed foods, and exercising regularly can make a considerable difference. Moreover, limiting exposure to harmful chemicals such as asbestos, pesticides, and petrochemicals can also help lower the risk of pancreatic cancer.

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