Pancreatic Cancer
Cells in the pancreas develop mutations in their DNA, leading to pancreatic cancer or pancreatic carcinoma. The
basic function of the pancreas is to produce enzymes and regulate sugars. There are two types of glands in the
pancreas exocrine and endocrine glands. Cancerous states of the pancreas are also classified into endocrine and
exocrine.
Exocrine glands The exocrine glands are responsible for the production of pancreatic juices or enzymes which are
released into the intestine and help digest the food. Non-functionality of the endocrine glands means food will
pass through the intestine without being absorbed. 95% of the cells of the pancreas make of exocrine glands. The
common type of cancer developing in this area is the adenocarcinoma which actually constitutes for most of the
cancers of the pancreas.
Endocrine glands The endocrine glands are made up of small clusters of cells called islets of Langerhans. These
are responsible for producing insulin and glucagon hormones which are released directly into the blood. Glucagon
increases blood sugars in the body whereas insulin reduces it. Cancers developing within the endocrine glands are
broadly classified as neuroendocrine tumors or NETs and since they form in the pancreas are called Pan NETs.
Pancreatic cancer has a reputation of poor prognosis and the cancer can spread rapidly. It is very difficult to
detect it in the early stages and symptoms are mostly noted in advanced stages.
- Age: usually detected in patients above the age of 65
- Gender: disease is more common in men
- Smoking
- Heredity
- Diabetes mellitus
- Periodontal disease
- Dietary factors: high consumption of red meat or processed meat and sugary drinks (colas and soft drinks)
- Alcohol abuse
- Obesity
- Pain in upper abdomen and back
- Jaundice: yellowish skin and eyes and darkened urine
- Steatorrhea or fatty stools
- Cachexia or unexplained weight loss
- Loss of appetite
- Feeling of fullness due to compression of organs by the tumor
- Heartburn or dyspepsia
- Trousseau’s syndrome
- Clinical depression
- Pulmonary embolism
- Pancreatic cancer metastases
Tumour markers like CA 19-9 and CEA are helpful in the diagnosis and treatment of this
condition.
Imaging tests A CT scan and MRI are done to visualize the internal organs and the pancreas.
EUS: The endoscopic ultrasound make images with the help of an ultrasound device which passed through a flexible tube called the endoscope to obtain images.
Biopsy: A small sample of the tissue is extracted from the pancreas with the help of a needle to be examined under the microscope. This is called fine needle aspiration aided by endoscopic ultrasound.
ERCP: Endoscopic retrograde cholangiopancreatography is done with a help of a dye that is injected into the pancreatic ducts.
MRCP: Magnetic Resonance Cholangio Pancreatography also gives good road map of the cancer as well as dilatation of the CBD and pancreatic ducts.
PET-CT: is sometimes required to rule out spread of the disease before planning treatment.