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Dr.Anti-Cancer
Roberto García

Pancreatic Cancer

Pancreatic cancer is rarely detected early, but it can still be treated based on its stage. applying a combination of techniques ranging from radiotherapy to surgery.

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What is Pancreatic Cancer?

The pancreas is an organ located behind the stomach that is part of the digestive system. This is responsible for releasing enzymes that promote digestion.

Pancreatic cancer occurs when there is an uncontrolled growth of the cells that make up your exocrine glands. The most common type of cancer that occurs in this organ is adenocarcinoma of the pancreas.

Their endocrine cells can also develop a much less common type of tumor (pancreatic neuroendocrine tumor), which also has a better prognosis. This differentiation is important, as all diagnostic and treatment protocols vary from one type of tumour to another.

Pancreatic cancer is considered very aggressive and unpredictable, as symptoms usually do not occur during the early stages of the disease until it has spread to other tissues. This makes it difficult to identify and treat them early.

Benign tumors (which do not pose major risks) may develop in the pancreas, as well as so-called precancerous tumors. Those who make up this second group should be observed and treated in a timely manner if they are detected in imaging tests.

Common Symptoms of Pancreatic Cancer

Pancreatic cancer is a complex disease with varied and subtle symptoms in the early stages. Signs and symptoms of pancreatic cancer may include:

Jaundice

Signs and Effects Jaundice is a condition that causes a yellowing of the skin and eyes due to the buildup of bilirubin in the blood. In the case of pancreatic cancer, it can occur when a tumor blocks the bile duct preventing the normal removal of bilirubin.

Abdominal and Back Pain

Abdominal and back pain is caused by the tumor pressing on nearby organs and nerves. This pain is usually constant, worsening when lying down or eating.

Unexplained Weight Loss

Unexplained weight loss is usually the result of poor absorption of nutrients due to disruption of the normal functions of the pancreas, including the production of enzymes that aid digestion.

Associated gastrointestinal symptoms

In addition to the symptoms mentioned above, pancreatic cancer can also present with other gastrointestinal symptoms. Among them:

Changes in Digestion and Appetite

Pancreatic tumors can interfere with the production of enzymes and hormones that aid in digestion, causing alterations in appetite and digestion.

Nausea and Vomiting

Nausea and vomiting can occur as a result of the growth of a tumor pressing on the stomach or blocking the flow of food through the digestive system.

Changes in Stool and Urine

Changes in stool and urine are often the result of bilirubin accumulated in the blood being excreted through the kidneys, which can result in dark urine. Stool may become light in color or fatty due to a lack of digestive enzymes.

Less Common but Important Symptoms

There are also symptoms that, although less common, are equally important in identifying pancreatic cancer.

  • Fatigue and Generalized Weakness Fatigue and generalized weakness can be caused by a lack of nutrients in the body due to malabsorption or the energy the body invests in fighting disease.
  • Abdominal Bloating and Distention These symptoms are usually caused by fluid buildup in the abdomen (ascites) that stems from tumor pressure on nearby organs and blood vessels.
Síntomas Menos Comunes pero Importantes

Diagnosis

When the specialist suspects the presence of pancreatic cancer, the questions during the initial interview will be aimed at confirming symptoms, knowledge of the patient’s family history and habits.

Among the habits that can predispose to the appearance of pancreatic cancer are chronic inflammation of the pancreas (pancreatitis), diabetes, smoking, being overweight and a sedentary lifestyle.

This type of cancer is difficult to detect and diagnose in its early stages, because:

  • It shows no noticeable symptoms.
  • When it manifests any sign, it can easily be confused with any other disease.
  • Its location is also not of much help, because it is behind the stomach, large intestine, liver, gallbladder, and spleen.

Likewise, several tests are performed for its detection and staging, among which the following stand out:

Blood studies

These tests identify some substances and their concentration (including bilirubin), which is released into the blood by organs and tissues. Its increase or decrease is a sign of disease.

Tumor markers

This procedure involves testing a sample of blood, urine, or tissue to measure the cancer antigen and carcinoembryonic antigen; developed by tissues, organs, and tumor cells in the body.

CT scan

Detailed images of the inside of the body are obtained at various angles after administering a dye orally or intravenously; so that organs and tissues can be seen more clearly.

MRI

Similar to a CT scan, it captures a series of images of the inside of the body using a magnet and strong radio waves.

Proton emission tomography

It allows you to find malignant tumor cells. To do this, a radioactive glucose is injected that travels through the organs and tissues, creating contrast in the areas where there is a higher concentration of cancer cells.

Abdominal ultrasound

It uses an ultrasound transducer against the abdomen to emit sound waves that bounce off organs and tissues creating echoes.

Endoscopy

A device containing a beam of light and a lens is inserted through the mouth or rectum to observe the entire path.

Endoscopic retrograde cholangiopancreatography

This procedure is used to take x-rays of the tubes that carry bile from the liver to the gallbladder and from the gallbladder to the small intestine.

Endoscopic retrograde cholangiopancreatography

This procedure is used to take x-rays of the tubes that carry bile from the liver to the gallbladder and from the gallbladder to the small intestine.

Percutaneous transhepatic cholangiography

A dye is injected into the liver or bile ducts through the skin, under the rib in the direction of the liver, for imaging.

Biopsy

There are several ways to perform this technique, one of them is to insert a thin or thick needle into the pancreas and extract cells, the other way is to remove part of the tissue by means of a laparoscopy or surgery to remove the tumor.

Treatments for Pancreatic Cancer

Treatment of pancreatic cancer will be subject to the patient’s conditions, stage of disease, and location of the neoplasm.

Surgery

There are several surgical techniques that allow a tumor to be removed. These are: Total pancreatectomy: During the procedure, the entire pancreas, part of the stomach, part of the small intestine, gallbladder, spleen, common bile duct, and nearby lymph nodes are removed. Distal pancreatectomy: In this case, the tail and body of the pancreas are removed. Whipple technique: With this surgery, the head of the pancreas, gallbladder, part of the stomach, part of the small intestine, and the bile duct are removed. In this case, a part of the pancreas is preserved to secrete digestive juices and insulin.

Radiation therapy

This treatment applies high-energy X-rays combined with radiation to cause cancer cells to die and prevent them from reproducing.

Chemotherapy

It consists of the orally, intravenous or intramuscular administration of a set of drugs that enter the bloodstream to reach all the cancer cells in the body.

Chemo radiation therapy

This technique combines radiotherapy and chemotherapy treatments, with the aim of increasing the cancer-fighting effects. The use of medications that pass into the body through the bloodstream and radiation can favor in several stages: Neoadjuvant. Before surgery, to try to shrink the tumor. Adjuvant. After surgery, it prevents any invisible cells from remaining in the body that could cause the cancer to come back in the future. Advanced cancer. When surgery isn't an option, it's the way to attack cancer cells and prevent them from progressing.

Targeted therapy

It consists of the application of substances that manage to identify and attack specific cancer cells. These drugs block the signal that tumors need to grow.

Nutritional therapy

As soon as the pancreas is removed, the body stops receiving the enzymes it produces. Consequently, digesting food becomes a complex process and the patient tends to fall into malnutrition; therefore, medications that supplant these enzymes must be administered.

Immunotherapy.

For cancer that is already very advanced; Therapy that strengthens the immune system helps the immune system recognize and attack malignant cells more effectively.

Preparing for Surgery

The preoperative phase involves the following steps:

  • Consent: The patient receives information about the procedure to be undergone. At this point, the specialist makes the associated risks known and once aware of them, the person must indicate his approval.
  • Questions: During the previous phase, the patient should ask all the questions related to their intervention; to know how to act before, during and after the procedure.
  • Preoperative tests: They are a set of studies to which the patient is subjected before entering the operative phase. In case of permissible results, it will be possible to schedule the day of the intervention.
  • Risk factors: these are all those that are treated or eliminated before and during the preoperative phase, as they incur in changing processes in the patient.
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Causes of Pancreatic Cancer

Studies reveal that a cause that predisposes to the appearance of pancreatic cancer has not yet been determined. Despite this, doctors have identified some factors that increase the risk of suffering from it; These include:

  • Family history
  • Obesity
  • Diabetes
  • Smoking
  • Chronic inflammation of the pancreas

Stages of Pancreatic Cancer

Depending on the stage of the disease, the treatment and survival rate of pancreatic cancer varies; it becomes more complex the more advanced the case.

Stage I

In particular, it is an early stage where the tumor is about 2cm or less, and is located in the pancreas, without spread to lymph nodes or other parts of the body.

Stage II

At this stage, the tumor is seen to enlarge to 4cm or more, but there is no evidence of spread to nearby arteries or veins. It denotes 1 to 3 regional lymph nodes involved, but not in other parts of the body.

Stage III

Then there is a stage in which the tumor has spread to more than 4 regional lymph nodes. Dissemination in nearby arteries and veins is also evident; but there is still no presence in other parts of the body.

Stage IV

Finally, the so-called terminal stage occurs when the spread is general; both in arteries, veins, lymph nodes and organs. At this point we are talking about a cancer that has metastasized.

How to prevent pancreatic cancer?

If your family has a history of pancreatic cancer, you should seek counseling with a genetics specialist. In these cases, the doctor will be able to determine through a genetic analysis, what risk you run of suffering from this or other types of cancer.

Specialists recommend some daily routines to reduce the risk, including:

  • Healthy diet: Consume fruits, vegetables, and whole grains.
  • Smoking: Try nicotine replacement therapies or other alternatives to quit smoking.
  • Healthy weight: Make a slow and steady effort, combining daily exercises with a good diet.

Frequently Asked Questions

In this group of questions and answers you can clarify your doubts and complement information in relation to pancreatic cancer.

Cancer is considered terminal when it is stage IV; that is, when metastasis has already occurred and the tumour has spread to other areas of the body.

While some scientific studies are skeptical, others indicate that pancreatic cancer may be hereditary or related to genetic mutations, which add up against the patient.

For this reason, if there is a family history of pancreatic cancer or any other type of cancer, it is advisable to go to the doctor for a complete evaluation to allow you to know your risk factor.

As a result of many studies and despite being a fairly complex type of cancer, it has been possible to show that there is indeed the possibility of eliminating pancreatic cancer by surgery, as long as several factors and specific tests are met.

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