What you need to know about pancreatic cancer

The pancreas is an organ in your abdomen that lies horizontally behind the lower part of your stomach.

It works to release enzymes that aid digestion and hormones that help manage your blood sugar. It is about 15cm long and looks like a pear lying on its side.

Pancreatic cancer occurs when cells in your pancreas develop mutations and grow uncontrollably, and continue living after normal cells would die. These accumulating cells can form a tumour.

Pancreatic cancer spreads rapidly to nearby organs. It is seldom detected in its early stages. But for people with pancreatic cysts or a family history of pancreatic cancer, some screening steps might help detect a problem early.

One sign of pancreatic cancer is diabetes, especially when it occurs with weight loss, jaundice or pain in the upper abdomen that spreads to the back. Treatment may include surgery, chemotherapy, radiation therapy or a combination of these.

See your doctor if you experience unexplained weight loss or if you have persistent fatigue, abdominal pain, jaundice, or other signs and symptoms that bother you. Many conditions can cause these symptoms, so your doctor may check for these conditions as well as for pancreatic cancer.

It is not clear what causes pancreatic cancer in most cases. Doctors have identified factors, such as smoking and drinking as factors that may increase your risk of developing the disease.

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Symptoms 

Signs and symptoms of pancreatic cancer often don’t occur until the disease is advanced. They may include:

• Pain in the upper abdomen that radiates to your back.
• Loss of appetite or unintended weight loss.
• Depression.
• New-onset diabetes.
• Blood clots.
• Fatigue.
• Yellowing of your skin and the whites of your eyes (jaundice).

Risk factors

Factors that may increase your risk of pancreatic cancer include:

• A combination of smoking, long-standing diabetes and a poor diet increases the risk of pancreatic cancer beyond the risk of any one of these factors alone.
• Chronic inflammation of the pancreas (pancreatitis).
• Diabetes.
• Family history of pancreatic or any other cancer.
• Smoking.
• Alcoholism.
• Obesity.
• Older age, as most people are diagnosed after age 65.

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Complications

Complications include:

Weight loss.This can be caused by the cancer itself. Nausea and vomiting caused by treatments or a tumour pressing on your stomach may make it difficult to eat. Or your body may have difficulty processing nutrients from food because your pancreas isn’t making enough digestive juices.

Jaundice. Pancreatic cancer that blocks the liver’s bile duct can cause jaundice. Signs include yellow skin and eyes, dark-coloured urine, and pale-coloured stools. Jaundice usually occurs without abdominal pain.

Pain. A growing tumour may press on nerves in your abdomen, causing pain that can become severe. Pain medications can help you feel more comfortable. Radiation therapy might help stop tumour growth temporarily.

Bowel obstruction. Pancreatic cancer that grows into or presses on the first part of the small intestine (duodenum) can block the flow of digested food from your stomach into your intestines.

Prevention

You may reduce your risk of pancreatic cancer if you:

• Stop smoking
• Maintain a healthy weight
• Choose a healthy diet
• Limit your alcohol intake

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Diagnosis

If your doctor suspects pancreatic cancer, he or she may have you undergo one or more of the following tests:

• Imaging tests create pictures of your internal organs. They include ultrasound, computerised tomography scans, magnetic resonance imaging and, sometimes, positron emission tomography scans.

• Using a scope to create ultrasound pictures of your pancreas. An endoscopic ultrasound uses an ultrasound device to make images of your pancreas from inside your abdomen.

• Removing a tissue sample for testing (biopsy). A biopsy is a procedure to remove a small sample of tissue for examination under a microscope.

• Blood test. Your doctor may test your blood for specific proteins (tumour markers) shed by pancreatic cancer cells. One tumour marker test used in pancreatic cancer is called CA19-9.

Picture: iStock

Treatment

Treatment depends on the stage and location of the cancer, as well as on your overall health and personal preferences.

For most people, the first goal of pancreatic cancer treatment is to eliminate the cancer, when possible. When that isn’t an option, the focus may be on improving your quality of life and preventing the cancer from growing.

Treatment may include surgery, radiation, chemotherapy or a combination of these.

When pancreatic cancer is advanced and these treatments aren’t likely to offer a benefit, your doctor will offer symptom relief.

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