He pancreatic cancer It is one of the most aggressive cancers that exist since the neoplasia, an abnormal mass of tissue, spreads rapidly due to its proximity to various organs such as the liver and does not offer signs that can be detected early. It has been estimated that it affects eight out of every 100,000 people a year. Most cases are diagnosed after 65 years of age.
The pancreas is a gland that is part of the digestive and endocrine systems. It is formed by lobules that are grouped together creating ducts and in which groups of cells called ‘islets of Langerhans’ are distributed. They form 5% of the total cells of the gland and synthesize the hormones secreted by the gland. The pancreas participates in the digestive process, being responsible for secreting pancreatic juice into the duodenum to neutralize the acids that reach it from the stomach. It also secretes enzymes that break down carbohydrates, proteins and fats.
At the endocrine level, it secretes hormones as important as insulin, which is involved in the metabolic use of nutrients; glucagon, which stimulates glucose production by the liver; pancreatic polypeptide, which regulates the secretory functions of the pancreas; and somatostatin, which intervenes in the regulation of blood glucose by inhibiting the secretion of insulin and glucagon.
The pancreas in the upper and left posterior region of the abdomen behind the stomach and in front of the spine. It directly contacts the small intestine and the liver and communicates with a large number of blood and lymphatic vessels and nervous structures, both its own and the organs that surround it.
Causes of pancreatic cancer
No defined cause
It has not yet been possible to clearly define what causes pancreatic cancer, although risk factors that can increase the chances of developing it are pointed out:
– Chronic pancreatitis (chronic inflammation of the pancreas).
– Family history of chronic pancreatitis.
– Family history of pancreatic cancer.
– Cancerous pancreatic cysts.
– Smoking.
– Obesity or overweight.
– Diabetes
– Combination of smoking, long-term diabetes and poor diet.
BRCA2 gene mutation.
– Suffer from hereditary pathologies such as:
– Multiple neoplasia syndrome type 1 (MEN1).
– Hereditary nonpolyposis colon cancer (CCSPH; Lynch syndrome).
– von Hippel-Lindau syndrome
– Peutz-Jeghers syndrome.
– Hereditary breast and ovarian cancer syndrome.
– Familial melanoma with multiple atypical moles (FAMMM) syndrome.
There are types of cancers that can start in the pancreas, such as lymphoma and sarcoma, but types of pancreatic cancer are classified according to their component: exocrine or endocrine.
Most common exocrine tumors:
– Adenocarcinoma. If it begins to develop in the ducts of the pancreas, they are called ductal adenocarcinomas. If it begins in the acini, a grape-shaped histological structure, it is called acinar adenocarcinoma.
– Papillary mucinous neoplasia (IPMN). It grows inside the ducts of the pancreas and produces a thick fluid called mucin. It is not cancerous in origin but if not treated in time it can become cancerous.
Rare exocrine tumors:
– Acinar cell carcinoma.
– Adenosquamous carcinoma.
– Colloid carcinoma.
– Giant cell tumor.
– Hepatoid carcinoma.
– Mucinous cystic neoplasms.
– Pancreatoblastoma.
– Serous cystadenoma.
– Signet ring cell carcinoma.
– Solid and pseudopapillary tumors.
– Squamous cell carcinoma.
– Undifferentiated carcinoma.
Endocrine tumors or pancreatic neuroendocrine tumors (PNET) or islet cell tumors. They are much less common than exocrine and appear in approximately 1% of pancreatic cancer cases. A pancreatic neuroendocrine tumor may or may not be functioning. A non-functioning tumor does not produce hormones and is named after the hormone it secretes. Are:
– Insulinoma
– Glucagonoma
– Gastrinoma
– Somatostatinoma
– VIPomas
– PPomas
Symptoms of pancreatic cancer
No specific symptoms
Pancreatic cancer is a type of cancer that is rarely detected in an early stage of the disease. However, there are some measures that can provide clues such as:
– The study of pancreatic cysts if they have appeared.
– Diabetes with weight loss.
– Jaundice (yellowing of the skin and corneas, dark urine, pale or greasy stools, itchy skin).
– Pain in the upper abdomen that extends to the back.
– Loss of appetite.
– Depression.
– Blood clots.
– Intestinal obstruction.
– Nausea and vomiting after eating.
– Enlargement of the gallbladder or liver.
Diagnosis of pancreatic cancer
Pancreatic ultrasound and biopsy among other tests
If a case of pancreatic cancer is suspected, in addition to the physical examination and the listing of symptoms, the tests that the specialist can perform are:
– Blood test to detect tumor markers (specific proteins that are released from pancreatic cancer cells such as CA19-9, although it is not always decisive).
– Pancreatic ultrasound.
– Computed tomography.
– Magnetic resonance.
– Biopsy (removal of a small tissue sample.
If the diagnosis is confirmed, the next step is to determine the stage: 0, I, II, III or IV. If it is in the IV it has already spread to other parts of the body (metastasis).
Pancreatic cancer treatment and medication
Specific design
Treatment may include radiation therapy, chemotherapy, or a combination of all of these options. The choice of treatment must be adapted to each patient based on their preferences and health conditions.
Possible surgeries could be:
– Pancreaticoduodenectomy (Whipple procedure).
– Distal pancreatectomy.
– Surgery for tumors that affect nearby blood vessels.
Each of these surgeries has a risk of bleeding and infection.
Chemotherapy uses drugs taken orally or injected intravenously to help kill cancer cells.
Radiation therapy or chemoradiation is used to treat cancer that has spread to nearby organs of the pancreas to try to shrink the tumor.
Anxiety is a common emotion when faced with a diagnosis of pancreatic cancer, so strategies can also be proposed to deal with it, such as having someone to talk to about worries, manual therapies, meditation, relaxation…
Pancreatic cancer prevention
Eliminate tobacco and take care of your diet
The only generalized preventions regarding pancreatic cancer, since they fall within the risk factors, are: quitting smoking, following a healthy and balanced diet, maintaining an adequate weight, daily exercise… and if you have a family history of cancer of pancreas it could be interesting to consult with a specialist or genetic counselor.
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