Pancreatic Cancer: A Silent and Aggressive Disease

Pancreatic cancer develops when cells of the pancreas, an organ that lies behind the stomach, begin to grow out of control and form a tumour. This is a very aggressive type of disease that is hard to diagnose in its early stage and resistant to most standard treatments against cancer. Despite active research in seeking ways of improving early detection, pancreatic cancer remains a challenge to oncology.

What is Pancreatic Cancer?

Cancer of the pancreas results from alterations in the DNA of the cells lining the pancreas, which allow uncontrollable growth and tumour formation. The pancreas is a vital portion of digestion and metabolism, performing two major functions that have far-reaching consequences on the body. Most pancreatic cancers begin in the ducts, through which the digestive enzymes travel into the small intestine.

The pancreas's deep location in the body and the lack of specific early symptoms make this malignancy difficult to diagnose at a relatively early stage. By the time it is diagnosed, the malignancy has already spread to the surrounding organs in most cases, complicating the treatment options.

Types of Pancreatic Cancer

There are two major types of pancreatic cancer, broadly classified based on the type of cell from which the tumour originates:

Exocrine Tumors: These are the most common types of tumours, accounting for over 90% of pancreatic cancers. The most common form is pancreatic adenocarcinoma, which arises from the lining of the pancreatic ducts. These tumours grow fairly quickly and are generally diagnosed at a rather late stage.

Neuroendocrine Tumors (NETs): Less than 10% of pancreatic cancers fall under this category. Neuroendocrine tumors arise from hormone-producing cells and are generally slower-growing. One such type of NET that affects the pancreas is called Islet cell carcinoma.

Prevalence of Pancreatic Cancer

Pancreatic cancer accounts for approximately 3% of all cancers within the United States. Although less common compared with other types of cancer, the rate of deaths resulting from it is relatively high. Pancreatic cancer currently ranks as the 10th most frequent cancer in men and 8th in women, with trends indicating it is likely to move to the second position of the leading causes of cancer-related deaths in the country.

Symptoms of Pancreatic Cancer

Unfortunately, symptoms of the disease are rather vague and usually only arise when the tumour starts affecting other organs. Common symptoms include:

• Jaundice-so the skin and eyes take on a yellow colour
• Urine is dark and stools light-coloured
• Pains in the abdomen and middle back
• Unintended weight loss
• Feeling tired and weak
• Nausea and vomiting
• Loss of appetite
• New diabetes
• For neuroendocrine tumours, symptoms are varied and can include diarrhoea, anaemia, and skin flushing.

Risk Factors of Pancreatic Cancer

Although there is no exact cause for pancreatic cancer, there are some risk factors. These include:

• Smoking: It greatly increases the risk of pancreatic cancer.
• Obesity: Being overweight, or carrying excess weight around the waist, raises the risk.
• Diabetes: Sudden onset of type 2 diabetes
• Chronic Pancreatitis: Inflammation of the pancreas for a long time increases the risk for cancer.
• Family History: Genetic syndromes and genetic mutations have been linked with an increased propensity, including BRCA1 and BRCA2.

Diagnosis of Pancreatic Cancer

The pancreas is deep in the abdomen; hence, tumours in the pancreas are difficult to observe during a routine physical exam. If pancreatic cancer is suspected, doctors may perform the following:

• Imaging Tests: CT scans, MRI and PET scans show the pancreas and surrounding structures.
• EUS: Specialized ultrasound, which gives a more detailed view of the pancreas.
• Blood Tests: Tumor markers, which include proteins that are secreted by the cancerous tumour, such as CA 19-9, to determine whether a tumour exists within the pancreas. 
• Laparoscopy: A surgical procedure that uses small-sized cuts through which the extent of spread of the cancer is evaluated and tissue taken for biopsy.
• Genetic Testing: Those diagnosed with pancreatic cancer, especially in a case when they may have some genetic history of the same, will be subjected to genetic testing to identify hereditary factors responsible for certain cancers.

Stages of Pancreatic Cancer

The various stages of pancreatic cancer are:

• Resectable: Cancer is entirely confined within the pancreas and can be fully removed by surgery.
• Borderline Resectable: Cancer involves neighbouring blood vessels and may or may not be removable by surgery.
• Locally Advanced: Cancer has extended onto adjacent tissues, and surgery may not be an easy approach.
• Metastatic: Cancer has spread to other organs far away from the pancreas, such as the liver or lungs, and cannot undergo surgery.

Treatment Options for Pancreatic Cancer

Treatment options for pancreatic cancer depend on the position, size, stage of the tumour, and the general health of the patient. Treatment options may include:

Surgery is the only curative approach to pancreatic cancer, but this is possible only in the early stages of the disease when the tumour is still confined within the pancreas. The standard surgical intervention for pancreatic cancer is the Whipple procedure, involving the resection of the head of the pancreas and portions of adjacent organs.

• Chemotherapy: These are drugs that kill the rapidly growing cells of cancer. Such treatments can be provided before surgery to shrink tumours or afterwards to clear the cancerous cells that might be left.
• Radiation Therapy: High-energy radiation is conducted to target and destroy cancer cells. Often, such treatment is combined with chemotherapy in what is called chemoradiation.
• Targeted Therapy: Newer treatments target specific proteins that help the growth of cancerous cells. Erlotinib and olaparib can be given with other treatments for more serious forms of this disease.
• Pain Management: The growth of a tumour in the pancreas causes pain due to its impingement on nerves surrounding the pancreas. Pain can be relieved by doctors through medication or nerve blocks.

Prevention of Pancreatic Cancer

Although it is impossible to completely prevent pancreatic cancer, lifestyle habits that reduce the risk of developing it include:

Not smoking or drinking much alcohol

Healthy diet: emphasizing fruits, vegetables, and whole grains; limiting foods high in fats and cholesterol, such as processed meats and red meats
Regular exercise, maintaining ideal body weight
Reducing exposure to poisons, such as pesticides and petrochemicals

Conclusion

Pancreatic cancer is an aggressive tumour with an overall poor prognosis due to its late diagnosis and resistance to most kinds of treatments. Early detection, genetic testing, and new therapeutic approaches do continue to raise hopes for better outcomes in this setting. Understanding the risk factors and maintaining a healthy lifestyle may lower the chance of developing this challenging disease.

If you or someone important to you is concerned about the possibility of pancreatic cancer, early consultation with a healthcare professional will ensure that you receive an accurate diagnosis and have options for treatment.