Pancreatic Cancer: Causes, Risk Factor, Symptoms, Types, Stages

 A 30-year-old Japanese male patient came to the doctor with a complaint of epigastric pain. It was revealed after that he was having a family history of pancreatic cancer. When a CT scan was conducted it was revealed that he was having a tumour in the pancreatic body. Apart from that an endoscopic ultrasound resulted in a low echoed tumour growing next to the splenic vein. After conducting some more tests the patient was diagnosed with pancreatic cancer and underwent surgery. He was lucky that it was stage-1 cancer saving his life.

Alarmed? Read on to know more about Pancreatic Cancer.

A pancreas is a glandular organ located behind the stomach in the upper left abdomen. It mainly produces enzymes and hormones. These enzymes break down fats, carbohydrates, protein, and acids in the duodenum. The pancreas also releases bicarbonate to neutralise stomach acid. But this simple organ can make anyone a cancer patient if not taken care of.  

In the blog below we will learn about pancreatic Cancer. Apart from that, we will also know its causes, symptoms, types, treatment, and stages. 

What is Pancreatic Cancer?

Pancreatic cancer is a type of cancer that happens when some malicious cells grow in the pancreas. This cancer cannot be diagnosed in the early stage. It affects the endocrine and exocrine parts of the pancreas. They can grow in any part of the pancreas. There are many types of pancreatic cancer but the most common one is pancreatic ductal adenocarcinoma. This cancer initiates itself by lining cells in the pancreatic duct. Pancreatic Neuroendocrine Tumours (NETs) are less common but have a better prognosis. 

Avoiding any type of cancer is a challenge as it is difficult to diagnose in the early stage. By the time the symptoms grew, the cancer had grown larger and is spread outside the pancreas. 

Pancreatic Cancer Causes and Risk Factors

The causes of pancreatic Cancer include: 

• Obesity 
• Diabetes 
• Age 
• Use of tobacco 
• Chronic pancreatitis 

Risk factors that you can change 

Here are some risk factors that you can change: 

•  Weight 

Obese people who have a BMI of more than 30 are 20% more likely to get pancreatic Cancer. 

• Diabetes 

If you have diabetes, then you are more prone to pancreatic Cancer. There are two types of diabetes: type 1 and type 2. Among these, type 2 diabetes is more likely to develop pancreatic Cancer. 

• No use of tobacco 

Smoking and alcohol are the primary reasons why people get pancreatic Cancer. The chances increase if you smoke more than twice a day. 

• Chronic Pancreatitis 

Consuming alcohol can cause alcohol-related chronic pancreatitis, and it is the most common cause for the condition. It increases the risk of developing pancreatic Cancer.

Risk factors that you cannot change 

Here are some risk factors that are not in the hands of a person. 

• Age 

The risk of developing this Cancer increases with age. Most of the patients are older than 45, while two-thirds of them are older than 65. Though the average age is 70 years. 

• Gender 

Men are more likely to develop pancreatic Cancer in comparison to women. This may be because of higher tobacco use in men. 

• Family History 

If this Cancer was there in any family history, then you may develop it due to a syndrome called inherited syndrome. 

Pancreatic Cancer Symptoms 

It is revealed that pancreatic Cancer does not show any kind of symptoms until it has reached an advanced stage. After reaching that stage, it shows symptoms like: 

• Getting tired easily 
• Dark colour of urine. 
• Belly pain on the side or back 
• A lot of itching 
• Diabetes is getting out of control 
• Floating or light-coloured stools 
• Continues pain or swelling on arm or leg (blood clot may be the reason) 
• Weight loss 
• Itching all over the body 
• Yellowing of skin or whitening of eyes 
• Not feeling hungry anymore 

Also Read : Top 6 Warning Signs of Colon Cancer & Its Preventions

Pancreatic Cancer Types 

There are two major types of pancreatic Cancer: Exocrine Pancreatic Cancer and Endocrine Pancreatic Cancer. 

Exocrine Pancreatic Cancer 

This type of pancreatic Cancer creates up to 95 per cent of Cancer. These include Adenocarcinoma, Squamous Cell Carcinoma, Adenosquamous Carcinoma, and Colloid Carcinoma. 

Neuroendocrine Pancreatic Cancer 

This type of Cancer makes up less than 5 per cent of Cancer. Making a reason for being rare among all the types. This Cancer includes Benign Precancerous Lesions. 

Pancreatic Cancer Stages

The pancreatic cancer stages are staged using the TNM system. There are five stages of pancreatic Cancer. The stages include 0. 1. 2. 3, and 4.  

Pancreatic Cancer Diagnosis

Pancreatic cancer is diagnosed using tests and procedures that create pictures of pancreas and the areas around it. This helps to find whether the cancer is confined within the pancreas or has spread beyond it. This process is known as Staging.

In case of Pancreatic Cancer, detection, diagnosis, and staging tests are typically performed simultaneously. In order to plan a treatment course, the doctor needs to know the cancer stage and whether it can be surgically removed. 

Primarily the doctor will ask questions about personal and family health history and perform physical examinations. But apart from these, other evaluation methods include:

– Blood chemistry study to check for abnormal levels of substances like bilirubin

– Tumor marker test to analyze specific substance levels associated with cancer

– MRI to create detailed images using magnets, radio waves, and computers

– CT scan for 3-D views of tissues and organs, potentially with dye injection

– PET scan to detect cancer cells based on high glucose levels

– Abdominal ultrasound to visualize internal organs via high-energy sound waves

– Endoscopic ultrasound (EUS) to image tissues and organs

– Endoscopic retrograde cholangiopancreatography (ERCP) to x-ray bile ducts

– Percutaneous transhepatic cholangiography (PTC) to x-ray liver and bile ducts

Additional procedures:

– Laparoscopy to observe abdominal organs for disease signs

– Biopsy to remove tissues for microscopic examination by pathologists

Biopsy for pancreatic cancer can be done using either fine needles or core needles that can be inserted into the pancreas during imaging tests, laparoscopy, or tumor removal surgery.

These tests and procedures help identify cancer cells and find the best course of treatment based on the cancer’s stage and its location in the pancreas.

Also Read : Keto Diet May Help You To Fight Against Some Cancers

Pancreatic Cancer Treatment

The actual treatment for pancreatic cancer depends on the location and staging of the tumor, your general health, and if the cancer cells have spread.

Following are the various approaches of Pancreatic Cancer Treatment : 

• Surgery
• Chemotherapy
• Radiation therapy
• Targeted therapy
• Pain management

Surgery

Surgery is the primary method to treat pancreatic cancer. But doctors recommend it only when there is a possibility to remove the entire tumour. Depending on the size of the tumour and its location, different types of surgery are suggested : 

Whipple Procedure – when cancer is present in the head of the pancreas

Distal Pancreatectomy – when cancer is present in the tail of the pancreas

Total Pancreatectomy –  when cancer is present in the entire pancreas but its removal is still possible.

Chemotherapy

Chemotherapy is a procedure in which drugs that induce cell death for cancer cells are used either alone or at times used with other treatments.

Radiation Therapy

Radiation Therapy uses high-energy X-rays to destroy the cancer cells. Usually, Radiation Therapy is given along with Chemotherapy.

Targeted Therapy

In targeted therapy, some drugs are used to target certain proteins that control the growth and spread of cancer cells. Targeted therapy is often used with radiation therapy. Some of the common drugs used for targeted therapy in pancreatic cancer are Erlotinib, Olaparib, Larotrectinib, and Entrectinib.

Pain management

Pancreatic cancer patients also require pain management since the disease can be highly painful due to the involvement of nerves. In this respect, healthcare professionals can control the pain through medication, anesthesia, or steroid injection.

Should significant and persistent pain arise, a consultation with your healthcare provider is necessary to adjust the treatment course.

The treatment of pancreatic cancer is more or less designed on an individual-to-individual basis depending on a myriad of factors most of which individually, or collectively, help to bring forth the best method of fighting the disease given the specific patient’s situation.

How do you detect Pancreatic Cancer early?

Pancreatic cancer is difficult to diagnose early, as no standard tool or method is currently available for the general population. However, imaging and blood tests may detect it in high-risk individuals. Early-stage pancreatic cancer cases are typically detected when symptoms arise, which is usually at later stages or during unrelated medical tests. But most pancreatic cancer diagnoses occur at stage IV. 

Researchers worldwide are striving to create early detection methods for pancreatic cancer. High-risk individuals may want to participate in surveillance programs or research studies that regularly monitor for the disease, aiming to detect it sooner if it does occur.

Latest news in the world of Pancreatic Cancer detection is that Scientists have developed a blood test that can accurately detect early-stage pancreatic cancer, using a liquid biopsy to analyze small bits of RNA released by tumors. This innovative test could significantly improve early detection rates for pancreatic cancer, as the disease often goes unnoticed until it has already spread to other organs. Early detection increases the chances of survival, with a 44% 5-year survival rate for early-stage disease compared to just 3% for late-stage disease. Combining this blood test with another test for a protein called CA19-9 resulted in accurate identification of 97% of people with early-stage pancreatic cancer.

Pancreatic Cancer : When to see a doctor?

Early-stage pancreatic cancer doesn’t have specific symptoms, but if you experience unintentional weight loss, jaundice (yellowing of the skin), or stomach pain, it’s advisable you immediately consult a doctor. 

References:

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2. Can Pancreatic Cancer Be Found Early?. American Cancer Society [Internet]. https://www.cancer.org/cancer/types/pancreatic-cancer/detection-diagnosis-staging/detection.html. Accessed Oct. 07, 2024.
3. What is pancreatic cancer?. Pancreatic Cancer UK [Internet]. https://www.pancreaticcancer.org.uk/information/just-diagnosed-with-pancreatic-cancer/what-is-pancreatic-cancer/. Accessed Oct. 06, 2024.
4. Pancreatic cancer. Cancer Research UK [Internet]. https://www.cancerresearchuk.org/about-cancer/pancreatic-cancer. Accessed Oct. 06, 2024.

5. Blood Test Accurately Detects Early-Stage Pancreatic Cancer. NIH – National Cancer Institute[Internet]. https://www.cancer.gov/news-events/cancer-currents-blog/2024/liquid-biopsy-detects-pancreatic-cancer. Accessed Oct. 05, 2024

6. Pancreatic Cancer Early Detection. Pancreatic Cancer Action Network. https://pancan.org/facing-pancreatic-cancer/diagnosis/early-detection/ . Accessed Oct. 08, 2024