Pancreatic Cancer: A Silent Threat You Can’t Ignore!
Pancreatic cancer is one of the most aggressive and deadly forms of cancer, often diagnosed at a late stage when treatment options are limited. Known as the “silent killer,” it frequently shows no symptoms until it has spread, making early detection a critical challenge.
In this blog post, we’ll dive into the risk factors, warning signs, and advancements in treatment that could change the game for patients. Don’t miss this essential guide to understanding pancreatic cancer and how you can protect yourself or your loved ones.
What is Pancreatic Cancer?
Pancreatic cancer occurs when cells in the pancreas begin to grow uncontrollably. The pancreas is a vital organ, playing key roles in digestion and blood sugar regulation. This type of cancer often develops silently, meaning symptoms may not appear until it has reached advanced stages.
Types of Pancreatic Cancer
Pancreatic cancer primarily falls into two categories:
- Exocrine Tumors
⦿ Most common, accounting for about 95% of cases.
⦿ Arise from cells that produce digestive enzymes.
⦿ The most prevalent type is pancreatic adenocarcinoma.
- Endocrine Tumors
⦿ Develop from hormone-producing cells in the pancreas.
⦿ Classified as neuroendocrine tumors.
⦿ Often grow slower and may not present symptoms right away.
Causes of Pancreatic Cancer
The causes of pancreatic cancer are complex and not fully understood. However, certain risk factors have been identified:
Family history of pancreatic or related cancers, and specific genetic syndromes such as BRCA mutations, Lynch syndrome, and familial atypical multiple mole melanoma (FAMMM) syndrome.
Smoking, heavy alcohol consumption, and obesity.
Long-term diabetes, chronic pancreatitis, and non-alcoholic fatty liver disease.
Exposure to certain toxins in workplaces, such as chemicals used in dry cleaning and metalworking.
The risk increases significantly after the age of 60.
High consumption of red and processed meats, and low intake of fruits and vegetables.
Chronic infections like Helicobacter pylori (H. pylori) may slightly increase the risk.
Symptoms of Pancreatic Cancer
⦿ Unexplained weight loss: A sudden drop in weight without changes in diet or exercise.
⦿ Jaundice: Yellowing of the skin and eyes due to blocked bile ducts.
⦿ Digestive issues: Nausea, vomiting, diarrhea, or changes in appetite.
⦿ Abdominal pain: Pain that radiates to the back, often worse after eating or lying down.
⦿ Fatigue and weakness: Persistent tiredness that doesn’t improve with rest.
⦿ Dark urine: Caused by bilirubin buildup in the blood.
⦿ Light-colored stools: Due to lack of bile reaching the intestines.
⦿ New-onset diabetes: Especially in individuals over 50 with no prior history of diabetes.
⦿ Blood clots: Unexplained blood clots in the legs (deep vein thrombosis) or lungs (pulmonary embolism).
⦿ Itchy skin: Often associated with jaundice.
Screening for Pancreatic Cancer
Screening for pancreatic cancer is not routine but is recommended for high-risk individuals. Here’s a concise overview:
- Who Should Screen?
⦿ Family history: Two or more first-degree relatives with pancreatic cancer.
⦿ Genetic syndromes: BRCA mutations, Lynch syndrome, FAMMM syndrome, Peutz-Jeghers syndrome, or hereditary pancreatitis.
⦿ Chronic conditions: Long-standing diabetes or chronic pancreatitis.
⦿ Age: Over 50 with unexplained weight loss or new-onset diabetes.
- Screening Methods
⦿ Endoscopic Ultrasound (EUS): Examines the pancreas and allows biopsies.
⦿ MRI/MRCP: Detailed imaging of the pancreas and bile ducts.
⦿ CT Scans: Detects tumors using cross-sectional images.
⦿ Blood Tests: CA19-9 and CEA biomarkers (not specific but helpful).
⦿ Genetic Testing: Identifies inherited risk factors.
- Challenges
⦿ Lack of specific biomarkers.
⦿ Cost and accessibility of advanced tests.
⦿ Risk of false positives.
| Reason | Description | Impact |
|---|---|---|
| Early Detection | Identifies cancer before symptoms appear, increasing the chance for successful treatment. | Improves survival rates and allows for more treatment options. |
| High-Risk Identification | Screening helps detect pancreatic cancer in individuals with a family history or genetic mutations. | Enables early intervention and personalized care for high-risk individuals. |
| Increased Treatment Options | Detecting pancreatic cancer early increases the possibility of surgery and other effective treatments. | Offers a better chance of curing or controlling the disease. |
| Prevention of Advanced Disease | Screening can identify pre-cancerous conditions, allowing for early treatment to prevent progression. | Reduces the likelihood of cancer spreading or becoming inoperable. |
| Improved Prognosis | Early-stage pancreatic cancer is more likely to respond to treatment. | Enhances the overall prognosis and quality of life. |
Diagnosis of Pancreatic Cancer
✅ Imaging tests:
⦿ CT scans: Provide detailed cross-sectional images of the pancreas.
⦿ MRIs: Use magnetic fields to create detailed images of the pancreas and surrounding tissues.
⦿ Ultrasounds: Help visualize the pancreas and detect abnormalities.
⦿ Positron Emission Tomography (PET) scans: Used to detect cancer spread.
✅ Blood tests:
⦿ CA19-9: A biomarker often elevated in pancreatic cancer patients.
⦿ CEA (Carcinoembryonic Antigen): Another marker that may indicate cancer.
⦿ Liver function tests: To check for bile duct obstruction.
✅ Biopsy:
⦿ Fine-needle aspiration (FNA): A small tissue sample is taken using a thin needle.
⦿ Core needle biopsy: A larger tissue sample is collected for analysis.
✅ Endoscopic Retrograde Cholangiopancreatography (ERCP):
⦿ Combines endoscopy and X-rays to examine the bile and pancreatic ducts.
⦿ Helps diagnose and treat bile duct obstructions.
⦿ Can be used to remove gallstones or place stents.
✅ Laparoscopy:
⦿ A minimally invasive procedure to examine the pancreas and surrounding organs.
⦿ Involves small incisions and a camera for visualization.
⦿ Aids in staging cancers and assessing operability.
Treatment Options for Pancreatic Cancer
👉 Surgery:
⦿ Whipple procedure (pancreatoduodenectomy): Removes the head of the pancreas, part of the small intestine, gallbladder, and bile duct.
⦿ Distal pancreatectomy: Removes the tail and sometimes part of the body of the pancreas.
⦿ Total pancreatectomy: Removes the entire pancreas, spleen, gallbladder, and part of the stomach and small intestine.
👉 Chemotherapy:
⦿ Gemcitabine: A common chemotherapy drug for pancreatic cancer.
⦿ FOLFIRINOX: A combination of drugs (5-FU, leucovorin, irinotecan, and oxaliplatin) used for advanced cases.
⦿ Nab-paclitaxel (Abraxane): Often used in combination with gemcitabine.
👉 Radiation therapy:
⦿ External beam radiation: Targets the tumor with high-energy beams.
⦿ Stereotactic body radiotherapy (SBRT): Delivers precise, high-dose radiation to the tumor.
👉 Immunotherapy:
⦿ Checkpoint inhibitors: Drugs like pembrolizumab (Keytruda) that help the immune system recognize and attack cancer cells.
⦿ CAR-T cell therapy: A personalized treatment that modifies the patient’s immune cells to target cancer.
👉 Targeted drug therapies:
⦿ Erlotinib (Tarceva): Targets the EGFR protein on cancer cells.
⦿ Olaparib (Lynparza): Used for patients with BRCA mutations.
⦿ Larotrectinib (Vitrakvi): For cancers with specific genetic changes (NTRK gene fusion).
👉 Palliative care:
⦿ Focuses on relieving symptoms and improving quality of life.
⦿ Includes pain management, nutritional support, and psychological counseling.
Prevention for Pancreatic Cancer
⦿ Healthy diet: Rich in fruits, vegetables, whole grains, and lean proteins.
⦿ Regular exercise: Helps manage weight and boosts the immune system.
⦿ Avoid tobacco products: Smoking is a leading cause of pancreatic cancer.
⦿ Moderate alcohol consumption: Excessive intake may increase risks.
⦿ Maintain a healthy body weight: Reduces the likelihood of many cancers.
⦿ Manage existing health conditions: Diabetes or pancreatitis.
⦿ Genetic predispositions: Discuss screening options with a healthcare provider if you have a family history.
Frequently asked questions
Frequently asked questions
What is pancreatic cancer?
Pancreatic cancer occurs when cells in the pancreas grow uncontrollably, forming tumors. It is often called a “silent killer” because symptoms usually appear only in advanced stages.
What are the early signs of pancreatic cancer?
Early signs include unexplained weight loss, jaundice (yellowing of skin/eyes), abdominal pain radiating to the back, and digestive issues like nausea or loss of appetite.
Who is at risk of pancreatic cancer?
High-risk individuals include those with a family history of pancreatic cancer, smokers, people with diabetes, obese individuals, and those with chronic pancreatitis or genetic syndromes.
Is pancreatic cancer curable?
Pancreatic cancer is curable only if detected early and treated with surgery. However, most cases are diagnosed at advanced stages, making treatment challenging and reducing survival rates.
What tests are used to diagnose pancreatic cancer?
Doctors use CT scans, MRIs, endoscopic ultrasound (EUS), blood tests (CA19-9), and biopsies to diagnose pancreatic cancer.
Can pancreatic cancer be prevented?
While not entirely preventable, risks can be reduced by quitting smoking, maintaining a healthy weight, eating a balanced diet, and managing diabetes or chronic pancreatitis.
What are the treatment options for pancreatic cancer?
Treatment includes surgery (Whipple procedure), chemotherapy, radiation therapy, targeted drug therapy, and immunotherapy, depending on the stage and type of cancer.
Is pancreatic cancer hereditary?
Why is pancreatic cancer called a silent killer?
It is called a silent killer because symptoms often appear only in advanced stages, making early detection difficult and leading to poor survival rates.
Can lifestyle changes reduce the risk of pancreatic cancer?
Yes, lifestyle changes like quitting smoking, limiting alcohol, eating a diet rich in fruits and vegetables, and exercising regularly can help lower the risk.
Meet
Dr. Harsh Shah
MS, FMAS, FALS, DNB, MCh Pancreas, Liver, Gastro & Cancer Surgeon
Dr Harsh Shah is a well known GI & HPB Robotic Cancer Surgeon in Ahmedabad. He treats cancers of Esophagus, stomach, liver, pancreas, colon, rectum & small intestines. He is available at Apollo Hospital.
