Pancreatic cancer usually shows little or no symptoms until it has advanced and spread. Therefore, most cases (up to 80 per cent) are diagnosed at later, more difficult-to-treat stages.
If cancer hasn’t spread outside the pancreas (stage-1 & 2) and surgery is possible, then the survival 3 to 5 years or more. Stage 1 cancer patients have better survival than stage-2. Cancer that has spread beyond the pancreas into surrounding tissues is called locally advanced cancer or stage 3.
If cancer can’t be removed by surgery, the median survival is about 6 to 11 months. For cancer that has spread to another part of the body (stage 4), the median survival is only between 2 and 6 months.
Pancreatic cancer is curable if it’s caught early. Two types of surgery, Whipple procedure or distal pancreatectomy, can remove a portion of the pancreas. The surgery will eliminate the initial cancer tumour. After surgery, your doctor may advise you chemotherapy depending upon the stage of the disease.
Unfortunately, the majority of pancreatic cancers are not found and diagnosed until the cancer is in an advanced stage and spread beyond the original site.
It is a relatively rapid progression. The average T1 stage pancreatic cancer progresses to the T4 stage in just over one year. However, this is only an estimate; the actual progress may be rapid in some patients.
Pancreatic cancer takes at least a decade to start as per some research.
It takes many years for the first cancer-causing mutation that occurs in a cell in a pancreatic lesion to turn into a full-fledged cancer cell. Such lesion is called “high-grade” and should be removed, much like polyps are removed from the colon.
After the first cancer cell appears, it takes an average of nearly seven years for that cell to turn into the billions that make up a cancerous tumour the size of a plum, after which at least one of the cells within the tumour has the potential and ability to spread to other organs.
Pancreatic cancer has ranked 11th most common cancer in the world counting 458,918 new cases and causing 432,242 deaths (4.5% of all deaths caused by cancer) in 2018. The average age of diagnosis is 71 years for men and 75 years for women. Pancreatic cancer in India is 0.5-2.4 per 100000 men, and it is 0.2-1.8 per 100000 women.
One of the biggest concerns when it comes to pancreatic cancer is that patients often don’t exhibit any symptoms during the early, treatable stage of the tumour, which is what makes it so deadly.
The pancreas lies deep inside the abdominal cavity, behind the stomach, in an area called retroperitoneum. A small tumour within pancreas does not produce any symptoms as it will not affect digestion or any other function. But it spreads very fast to lymph glands & liver (via blood), even when it is tiny. So, when it produces symptoms, the cancer is far more advanced in most of the patients.
The pancreas is a gland of the digestive system. It is joined to the small bowel by a duct. Pancreatic cancer starts in the cells lining this duct. It then spreads into the body of the pancreas, before invading nearby nerves and blood vessels. If left untreated, it will spread to all the organs in the abdomen. Pancreatic cancer may also enter the lymphatic system and spread to other parts of the body.
The patient will experience pain & jaundice. There is significant weight loss secondary to indigestion, vomiting & cancer progression. Cancer spreads to other organs via blood, making it incurable.
- Pancreatic cancer can spread to other organs in the body.
- It most often spreads to the abdomen and liver first. The other organs that can be involved are lungs, bones & adrenals.
- The time interval required for pancreas cancer to spread to these organs varies in different patients. But on an average the cancer spreads within 1 month to 6 months, if left untreated.
In the early stages, pancreatic cancer is extremely difficult to detect because often there are no symptoms. But, as the cancer grows, symptoms may include:
- Pain in the upper abdomen or upper back
- Yellow skin and eyes, and dark urine from jaundice
- Loss of appetite
- Nausea and vomiting
- Weight loss
- Recent onset diabetes after the age of 50 years
These symptoms are not sure signs of pancreatic cancer. An infection or other problem could also cause these symptoms. Only a doctor can diagnose the cause of a person’s symptoms. Anyone with these symptoms should see a doctor.
Pancreatic cancer occurs when cells begin to grow uncontrollably and form a tumor within the pancreas. The exact cause of pancreatic cancer is unknown. However, doctors have identified some risk factors that increase your chances of developing pancreatic cancer. These include:
- Age >45 years
- Male gender
- Alcohol abuse Cigarette smoking (responsible for about 25% of pancreatic cancers)
- Regular consumption of high dietary fats
- Obesity (obese people are about 20% more likely to develop pancreatic cancer than non-obese people)
- Type 2 diabetes
- Chronic pancreatitis (often seen with heavy alcohol use and smoking)
- Family history of pancreatic cancer
- Heavy exposure to certain chemicals used in the dry cleaning and metalworking industries.
A blood test may help doctors detect the most common form of pancreatic cancer in its early stages.
Ca 19-9 is the blood test used to detect the most common type of pancreatic cancer called ‘Adenocarcinoma’. Higher the value, higher the chances that the cancer is advanced.
Chromogranin is the blood test used to detect another type of pancreatic cancer called ‘Neuroendocrine tumours’.
However, the order & interpretation of these tests should be done by a qualified practitioner only.