About the disease
Pancreatic cancer develops in the pancreas, which is located behind the stomach. The pancreas is responsible for the production and secretion of endocrine and exocrine substances and for regulating digestion. Adenocarcinoma is the most common type of pancreatic cancer, accounting approximately for 85% of all pancreatic cancers. Adenocarcinomas usually form within the pancreas and can spread to other organs if not diagnosed early on.
Although the exact cause has not been identified, such factors as alcoholism, smoking and excessive consumption of grilled and red meat are thought to increase the likelihood of developing pancreatic cancer. It should be noted that more than 94% of pancreatic cancer patients have been found to have a gene abnormality that has not been noticed in any other form of cancer. It is highly likely that genetic research will play a vital role in creating new measures for diagnosing pancreatic cancer earlier and thereby improving the survival rate. Until then, people with a mutation of gene p53 are required to be examined regularly in order to avoid any risk of developing pancreatic cancer.
Symptoms
- Abdominal pain
- Frequent urination
- Weight loss
- Nausea
- Yellow skin
- Diarrhea
- Dark-colored urine
- Loss of appetite
Diagnosis
Diagnosis of pancreatic cancer usually presents some difficulty, as this type of cancer has similar symptoms to jaundice and diabetes mellitus. Doctors mostly use instrumental studies to determine whether their diagnosis is correct.
- An ultrasound examination of the pancreas can determine whether it has become enlarged or has developed any abnormalities in its anatomical structure.
- An X-ray examination can determine whether the cancer has spread from the pancreas to any other organs.
- An endoscopy, whereby the pancreas is examined through an endoscope, creates a more precise image of the organ than the ultrasound does.
- A biopsy of malignant tissue can determine the type of the cancer and the dynamics of its progression.
Treatment
- Chemotherapy and radiation therapy are used in combination to kill as many malignant cells as possible. Radiotherapy is usually efficient in shrinking the cancer, while chemotherapy can reduce the amount of malignant cells and prevent them from metastasizing further. Chemotherapy and radiation therapy are commonly used before surgery so that less tissue needs to be resected.
- ERCP (endoscopic retrograde cholangiopancreatography) and bougienage are techniques that are used if a patient has stenosis in the passages of the pancreas. The surgeon will insert a bougie – a special cylinder – into the passageway to widen it. This procedure is mostly used to improve the patient’s ability to digest food.
- Whipple procedure (pancreaticoduodenectomy) is a complex surgical technique whereby the surgeon resects the head of the pancreas and part of the small intestine, stomach and nearby lymph nodes. After this the surgeon connects the remaining section of the pancreas with the stomach and intestines, thereby restoring the patient’s digestive function and enabling the pancreas to resume its hormone secretion function. This procedure can be used if cancer has not spread to any other organs and has not ruined the pancreas beyond repair.
- Segmental pancreas resection is performed if the exact location of the cancer has been determined and if it can be segmentally resected while preserving the remaining parts of the pancreas.
Author: Dr. Nadezhda Ivanisova
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