Pancreas cancer is the malignancy of the pancreas. Pancreas cancer has been called a “silent” disease because early pancreas cancer usually does not cause symptoms.
If the tumor blocks the common bile duct and bile cannot pass into the digestive system, the skin and whites of the eyes may become yellow (jaundiced), and the urine darker as a result of accumulated bile pigment called bilirubin.
Cause of Pancreas Cancer
The actual cause of this disease is unknown but various factors are considered to be increasing the chances of probability of kidney cancer occurrence.
The presence of a risk factor does not necessarily mean that an individual will develop cancer, nor does the absence of risk factors mean that an individual will not develop cancer.
Some of the risk factors are listed below:
- Age may also be a factor increasing the chances of this disease. The incidence of pancreas cancer is relatively low in individuals up to age 50, after which it increases significantly.
The age group 65 – 79 has the highest incidence of pancreas cancer.
- Smoking increases the chances of developing pancreas cancer. Study reveals that smokers develop pancreas cancer more than twice as often as nonsmokers.
- Non vegetarians have a high risk of getting pancreas cancer, if the intakes of meat & fat are high.
- Medical factors such as cirrhosis (a chronic liver disease), chronic pancreatitis, diabetes and a history of surgery to the upper digestive tract also contribute to the risk
- Environmental factors such as long-term exposure to certain chemicals, like gasoline and related compounds, as well as certain insecticides, may increase the risk of developing pancreas cancer.
- Genetic predisposition should also be considered as the possible reason to increase the risk. Possibly 3% of cases of pancreas cancer are related to genetic disorders.
Symptoms of Pancreas Cancer or Sign of Pancreas Cancer
The diagnosis of pancreas cancer is usually delayed because symptoms are nonspecific. Jaundice, which causes yellowing of the skin, is present in approximately 50% of patients at the time of diagnosis and may be associated with less-advanced disease.
Other pancreas cancersymptoms or sign of pancreas cancerinclude:
- weight loss
- discomfort in the abdomen
- loss of appetite
- glucose intolerance
In addition, the patient may experience pain in the abdomen and back. The pancreas may produce too much insulin, causing such symptoms as dizziness, weakness, diarrhea, chills, or muscle spasms.
The patient may not even notice the gradual onset of these relatively nonspecific symptoms. The doctor may interpret them as being caused by something else. So one should be very careful if any of the above symptoms are experienced.
Pancreas Cancer Treatment
The choice of pancreas cancer treatment depends largely on the stage the patient is in.
Possible treatments include surgery, chemotherapy, radiation, and biological therapy (also known as immunotherapy).
There are various treatment options available for pancreas cancer. The most common are listed below:
At the time of diagnosis, only about 20% of pancreatic tumors can be removed by surgery. This option is usually reserved for Stage 1 patients whose cancer is resectable. The surgeon may perform a resection, which is the removal of a small part of the pancreas.
The standard procedure is called a pancreatic oduodenectomy (Whipple procedure).This surgery for pancreas cancer should be done at centers that perform the procedure frequently. It is the more extensive surgery which is the removal of the pancreas head and nearby structures such as the duodenum.
It might be necessary to remove the entire pancreas as well as the spleen, gallbladder, and bile duct. Sometimes the tumor cannot be completely removed. Most specialists believe that a partial removal does not help the patient.
Sometimes a combination of therapies, such as radiation and chemotherapy given before or after surgery, can increase a patient’s chances of survival.
Any form of surgery has potential side effects. In many cases, the surgery for pancreas cancer will involve a large incision in the abdomen. The healing process for such major surgery can be very involved.
When the tumor is confined to the pancreas but cannot be removed, a combination of radiation therapy and chemotherapy may be recommended.
Certain substances emit invisible, high-energy rays, or radiation. These substances are called radioactive. The energy of the rays can kill cells. Special machines aim the rays at the parts of the body with cancerous tumors, so as to kill the cancer cells while minimizing damage to healthy tissue.
Unlike chemotherapy, radiation is not necessarily carried throughout the body. As such, it is known as a local therapy, rather than as a systemic therapy. However, there are still potential side effects of radiation including fatigue, localized hair loss, changes to appearance of skin, and digestive problems. Medicines and other treatments can reduce the intensity of the side effects.
As with other cancer treatments, the incidence of side effects varies with patient health and the exact nature of the treatment.
Biological or Immunotherapy
This form of therapy involves using drugs to boost the body’s natural immune response (its ability to fight disease). Examples of these drugs are interferon and monoclonal antibodies. They work with the body’s immune system to block the growth of cancer cells. Biological therapy can be used on its own or in conjunction with other therapies.
When the tumor has spread to other organs (metastasized) such as the liver, chemotherapy alone is usually used.
The standard chemotherapy agent is gemcitabine, but other drugs may be used. Gemcitabine provides clinical improvement in approximately 25% of patients.
For patients who have biliary obstruction (blockage of the vessels that transport bile) and the tumor cannot be totally removed, the obstruction must be relieved.
There are generally two approaches to this, surgery and placement of a biliary stent (similar to stents placed in the arteries of the heart to relieve blockages) during ERCP.
Management of pain and other symptoms is an important part of the treatment of advanced pancreas cancer. Hospice can be very helpful to patients for both pain and symptom management and psychological support for the patient and the family during the course of the illness.
Immunotherapy can result in side effects that are reminiscent of the flu: fever, aches, weakness, fatigue, and chills. Patients may also experience skin problems such as easy bruising or rashes, as well as diarrhea and nausea.
Pancreas Cancer Prognosis
Pancreas cancer prognosis varies between patients, as some patients are resectable (can be surgically removed), some patients are cured. However, cure rates are significantly less than 50%.
Most commonly chemotherapy and radiation are often given after surgery to attempt to increase the cure rate. Patients with pancreas cancer that can be removed successfully with surgery should consider enrollment in a clinical trial (a medical research study to determine the best treatment).
For patients with pancreas cancer that cannot be removed completely with surgery or cancer that has spread beyond the pancreas, cure is not currently possible. The average (median) survival is generally less than 1 year.
Pancreas Cancer Survival Rate
Pancreas cancer is rarely curable. The overall pancreas cancer survival rate is less than 4%. The cure rates are highest (although still usually under 25%) if the tumor is small (less than 2 cm in diameter) and is truly localized to the pancreas but, unfortunately, such cases account for fewer than 20% of all cases of pancreas cancer. For patients with advanced cancers, the overall survival rate of all stages is less than 1% at 5 years with most patients dying within 1 year.