What is pancreatic cancer?
Pancreatic cancer occurs when malignant cells form in the pancreatic tissue. The term "pancreatic cancer" corresponds generically to pancreatic adenocarcinoma, which is the most common malignant tumor of the pancreas, and which forms from exocrine cells (which produce digestive enzymes).
Can there be more than one type of pancreatic cancer?
yes. Several types of malignant tumors can develop in the pancreas.
What is the pancreas?
The pancreas is a gland of the digestive tract, it is about 15 centimeters long and is located in the upper abdomen, behind the stomach. The pancreas is divided into three parts:
- Head (right side)
- Body (center section)
- Tail (left side)
What is the function of the pancreas?
The pancreas has two main functions:
- It is responsible for the production of digestive enzymes, which are essential for the digestion of food (exocrine function)
- production of several hormones released into the blood, the best known being insulin, which is essential for regulating sugar levels (endocrine function)
What are the risk factors for pancreatic cancer?
The causes of pancreatic cancer are not known, but some risk factors are known. The main ones are:
- Chronic smoking: it is the main risk factor identified, increasing the risk of cancer about two to three times
- obesity: obese individuals have a slightly higher risk of developing pancreatic cancer
- diabetes mellitus with onset from the age of 50, especially in the first 3 years after diagnosis
- Chronic pancreatitis, usually associated with alcohol and tobacco use, is an additional risk factor
- patients with a certain type of cyst (mucinous) of the pancreas
- Familial predisposition: the risk of developing pancreatic cancer is higher in 1st degree relatives (parents, siblings or children) who have or have had the disease (particularly when it appears before the age of 50)
What are the symptoms of pancreatic cancer?
Pancreatic cancer is usually silent until an advanced stage of the disease and the symptoms vary with the location of the tumour in the pancreatic itself.
Symptoms are relatively nonspecific, such as:
- abdominal pain
- loss of appetite
- slimming
- tiredness
Yellowish discoloration of the eyes and skin (jaundice) may also appear if the tumor involves the head of the pancreas and causes obstruction of biliary drainage (by invasion of the bile duct, which carries bile from the liver to the intestine).
How is pancreatic cancer diagnosed?
The diagnosis of pancreatic cancer is usually made through physical examination and ancillary tests, such as:
- Abdominal ultrasound: it is often the initial option because it is a simple, non-invasive and innocuous exam
- computed tomography (CT) with intravenous contrast and magnetic resonance imaging (MRI): imaging exams with excellent detail in the evaluation of the pancreas and very important in the diagnosis and staging (to characterize the location and stage of the disease)
- Echoendoscopy, also known as transendoscopic ultrasound: a technique performed by a gastroenterologist, under sedation, and which allows the visualization, through a high-resolution ultrasound probe, of the entire pancreas through the stomach and duodenum (initial portion of the intestine). It is an extremely useful test in the diagnosis and staging of pancreatic cancer, with the unique advantage of allowing biopsies to be performed (the only way to obtain a definitive diagnosis)
Is it possible to screen for pancreatic cancer?
There is no defined screening program for the general population. There are, however, tests that are easy to perform, readily available, free of complications and with high accuracy that enable the diagnosis of pancreatic cancer.
In several European centres, screening is carried out for specific subgroups at high risk of pancreatic cancer (either by family history or by identifying certain hereditary syndromes).
What is the treatment for pancreatic cancer?
The treatment of pancreatic cancer will depend first and foremost on:
- your staging
- Your Location
Thus, the therapeutic approach should be individualized, taking into account the characteristics of the patient and the tumor itself.
Therapeutic options may include:
- A surgery: the most appropriate approach, especially when cancer is detected at an early stage. The surgical technique performed depends essentially on the location and relationship of the tumor with neighboring structures
- a radiotherapy
- a chemotherapy
- the previous ones in combination
However, the only treatment that can effectively cure cancer is radical surgery, in which the affected pancreas and regional nodes are removed. This is a complex surgery that should only be performed in referral centers with experience in pancreatic surgery.