All organs in the body are susceptible to cancer, however the chances of treatment and survival vary depending on which organ is affected. One particular organ is known to have a very poor prognosis when affected with cancer and this is the pancreas. Many people may have first heard of Pancreatic cancer following the death of Steve Jobs (who was the CEO of Apple).
The pancreas is an unassuming organ that many of us do not give much thought to. This organ is about six inches long and is located in the abdomen, behind the stomach. Just like other cancers, pancreatic cancer occurs when cells go haywire and have uncontrolled growth. In the United States, pancreatic cancer accounts for only about 3% of cancers diagnosed. WHile this may sound like a small number, remember that when a large population is being considered, 3% of any number of humans is a lot of lives to be considered.
Unfortunately, due to multiple factors including lack of necessary diagnostic tests, late presentation of patients and poor data collection, we as a country do not have such data.
As with all other illnesses, prevention and early diagnosis are key to survival, so here are some facts you should know about pancreatic cancer.
The Pancreas has two main types of cells: exocrine cells and endocrine cells. Exocrine cells make up most of the cells in the pancreas. These cells create the pancreatic enzymes that help in food digestion. A smaller number of cells in the pancreas are the endocrine cells, which are involved in forming hormones such as insulin and glucagon. Exocrine cancers are the most common types of pancreatic cancers. Adenocarcinomas that start in the pancreatic ducts account for the majority of pancreatic cancers. Endocrine pancreatic cancers, often called islet cell tumors or NETs, are far less common.
Symptoms of pancreatic cancer can be difficult to distinguish from symptoms of other diseases.This is one of the reasons why pancreatic cancers are not often caught in the early stages. Signs of pancreatic cancer include jaundice or yellowing of the skin, urine that is dark in color, pale and greasy stools, weight loss, and abdominal pain. Painful blood clots called deep vein thromboses may form in a leg. If the bile duct is blocked, the gall bladder may become enlarged and cause pain
Certain diseases such as pancreatitis, diabetes, liver cirrhosis, and stomach ulcers may increase the likelihood of an individual developing pancreatic cancer. Pancreatic cancer may also be linked to genetics. Pancreatic cancer risk is higher for smokers, overweight individuals, and those who are exposed to certain industrial chemicals. While many of these risk factors are uncontrollable, others can be avoided with some lifestyle modifications.
If any of the above symptoms are present and pancreatic cancer is suspected, a proper history and physical exam will have to be conducted. Diagnostic imaging tests such as a computed tomography (CT) scan, magnetic resonance imaging (MRI), or ultrasound will also be required. These tests allow visualization of the pancreas, blood vessels, and bile ducts. There may also be need for an endoscopy. This is done by passing a camera through a tube into the abdomen to look more closely at the bile ducts and other organs. If jaundice is present, liver function tests may be done to determine the origin of the jaundice. Blood tests for the tumor marker CA 19-9 are helpful in the diagnosis of pancreatic cancer. If all of these tests point to pancreatic cancer, a biopsy may be necessary. This requires removing a small portion of pancreatic tissue for testing.
Treatment for pancreatic surgery consists of surgery, chemotherapy, radiation, or any combination of the three. When considering surgery, a staging laparoscopy will help determine which type of surgery is needed.
In most cases, Pancreatic cancer has often spread to other parts of the body by the time it is diagnosed. Therefore, it is often too late to completely remove the cancer through surgery.
The Whipple procedure is a surgery to remove the head of the pancreas and is the most common operation for exocrine pancreatic cancer. Less common surgeries are to remove only the tail of the pancreas or the entire pancreas. If the cancer is too widespread to be completely eradicated, palliative surgery is an option. In this case, the cancer is not completely removed, but enough is removed to decrease pain.
The survival rates for those diagnosed with pancreatic cancer are sadly discouraging. This is due to the fact that it is often detected only after spreading to other parts of the body. The one-year survival rate is 20%, and the five-year survival rate is a disappointing 7%. In general, the smaller the tumors, the greater the chance of survival.
While pancreatic cancer is not entirely preventable, there are certain risk factors that you can avoid.
- Give yourself the best chance for a long and healthy life by not smoking.
- Keep yourself at a healthy weight.
- Give your body plenty of exercise.
- Fuel your body with nutritious whole foods including leafy greens, lean proteins, fruits, vegetables, and whole grains.
- Avoid excessive use of alcohol, as alcohol may contribute to cancer risk or to disease resulting in cancer.
- Avoid exposure to cancer-causing chemicals (pesticides, heavy metals such as cadmium) in your workplace.
