PANCREATIC

The pancreas is a large gland that’s part of the digestive system. It is an organ in your abdomen that lies behind the lower part of your stomach. The Pancreas makes digestive juices/enzymes and insulin.

Pancreatic cancer is caused by the abnormal and uncontrolled growth of cells in the pancreas. It is uncommon among people below the age of 40.

Types of Pancreatic cancer

The pancreas is divided into the head, body and tail. Cancer can start in any of these three places, though about 70% of pancreatic cancers start in the head.

Exocrine pancreatic cancer

Theses are the most common types of pancreatic cancer. They start in the exocrine cells of the pancreas that make digestive enzymes. Types of exocrine pancreatic cancers include

  • Adenocarcinomas : which start in the cell lining of the ducts of the pancreas),
  • Cystic tumours: cyst filled sac in the pancreas which may be benign or cancerous,
  • Acinar cell carcinomas :  they start from the cells at the end of the ducts that make the digestive juices
  • Intraductal papillary mucinous neoplasms: They start in the duct of the pancreas and produce mucus
Endocrine pancreatic cancer

They develop in the endocrine cells where hormones and insulin are made. They are also called pancreatic neuroendocrine tumours (PNETS) or islet cell tumours. They are usually grouped into functioning and non functioning NETs.

Pancreatoblastoma

This is a type of cancer that mainly affects children. They may be linked with rare genetic conditions like Beckwith-Wiedemann syndrome.

Sarcoma of the pancreas

This cancer starts in the connective tissues in the pancreas

Lymphoma

This is a cancer of the lymphatic tissue of the pancreas.

Symptoms of pancreatic cancer

Pancreatic cancer does not show symptoms in early stages. In most cases, the symptoms start occurring after the cancer has spread to other organs.

  • Abdominal pain that radiates to your back (the pain gets worse when lying down or after eating)
  • New diagnosis of diabetes 
  • Fatigue
  • Loss of appetite or unexplained weight loss
  • Blood clots
  • Yellowing of your skin and the whites of your eyes (jaundice)
  • Light-coloured stools
  • Dark-coloured urine
  • Itchy skin

Causes/risk factors of pancreatic cancer

Factors that increase the risk of pancreatic cancer include:

Age

The risk increases as you grow older. Most people are diagnosed after age 60 and is very rare in people under 40 years old.

Smoking

About 1 in 5 cases of pancreatic cancers are linked to smoking. Smoking cigarettes, pipes and chewing tobacco can significantly increase pancreatic cancer risk

Obesity

This is another significant factor that can cause pancreatic cancer, This may be due to the production of excess insulin in obese people.

Diet and alcohol

Having a diet high in fat and sugar, eating lots of processed foods and drinking a lot of alcohol may increase the risk of getting pancreatic cancer.

Family history

There is an increased risk if a family member has had colon cancer. If more than one family member has/had colon cancer, the risk is even greater.

Other conditions

Medical conditions like Diabetes, chronic pancreatitis and infections like Helicobacter pylori infection can increase the risk of getting pancreatic cancer.

Diagnosis

Your doctor may carry out the following tests if pancreatic cancer is suspected.

Imaging tests

Tests like ultrasound, CT, MRI and PET scans can be used to get a clearer view of your organs, including your pancreas.

Endoscopic ultrasound

This ultrasound device is passed through a thin, flexible tube (endoscope) down your throat and into your stomach in order to obtain the images.

Laparoscopy

The doctor may put a  thin tube called a laparoscope through a small cut they make in your abdomen.

Biopsy

A sample of cells may  be collected during an endoscopic ultrasound to test for cancer cells or check how far a cancer has spread.

Staging

Stage 1

The cancer is still contained within the pancreas and there is no spread anywhere else. The cancer may be smaller than 2cm (stage 1A) or bigger than 2cm (stage 1B).

Stage 2

This means the cancer may have started to spread from the pancreas to the nearby lymph nodes not blood vessels. It may be bigger than 4cm but not spread anywhere else ( stage 2A)  or the tumour is any size but has spread to no more than 3 lymph nodes (stage 2B)

Stage 3

This is called locally advanced cancer. the cancer has spread to blood vessels near the pancreas and maybe nearby lymph nodes.

Stage 4

Usually called metastatic cancer, this means the cancer has spread to other organs such as the liver and lungs.

Treatment

Pancreatic cancer might be treated using surgery, chemotherapy, radiation therapy or a combination of these.

Surgery

You may have surgery to remove cancer if it located in the head of pancreas (Whipple  procedure or pancreaticoduodenectomy ), in the pancreatic body and tail ( distal pancreatectomy) or to remove the entire pancreas (total pancreatectomy ).

Chemotherapy

This uses cytotoxic drugs to kill cancer cells. they can be taken as a tablet or injected into a vein. This can be used with radiation to treat cancer that hasn’t spread to other organs. it can be used to shrink the cancer before surgery or used after surgery to reduce the risk of pancreatic cancer coming back. It can be used to control cancer growth and relieve symptoms.

Radiotherapy

It uses high-energy x-rays to kill cancer cells. It can be used with chemotherapy  to shrink cancer before surgery and also to manage pain.

 

REFERENCES

https://www.macmillan.org.uk/cancer-information-and-support/pancreatic-cancer#causes_of_pancreatic_cancer

https://www.cancerresearchuk.org/about-cancer/pancreatic-cancer

https://www.mayoclinic.org/diseases-conditions/pancreatic-cancer/symptoms-causes/syc-20355421

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