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What are the early warning signs of Pancreatic Cancer?

Do you know what are the early warning signs of pancreatic cancer? Pancreatic cancer is a dangerous form of cancer, although not so common.

In this article, there’ll be an explanation of the common symptoms of pancreatic cancer and how to diagnose it. There’ll also be a description of different treatments available for this terrible disease.

For further information directly from a doctor, continue reading this article.

What is the pancreas?

The pancreas is a gland with the shape of a pear that locates in the abdomen. It has a head (close to the small intestines), a body, and a tail (which is close to the stomach). This organ functions as an exocrine gland and as an endocrine gland simultaneously. 

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Pancreas Anatomy
Source

An exocrine gland secretes its content throughout a duct to other parts of the body. An example of this is salivary glands, mammary glands, lacrimal glands, and others.

An endocrine gland secretes its products, which are usually hormones, through the bloodstream. Some of them are the ovaries, the hypothalamus, the thyroid, and many others. These don’t have an especial duct to release hormones as they release them through the blood vessels.

The pancreas’ exocrine function is to secrete pancreatic juices, containing digestive enzymes (or pancreatic enzymes), into the intestines. This is through the pancreatic duct. It has a stretch anatomic relation with the first part of the intestine, the liver, and the gall bladder. The pancreas secretes the pancreatic juices through the same hole that the gallbladder releases bile (which helps the absorption of fats). The bile comes out of the gallbladder through the common bile duct, reaching the pancreas’ head and then the duodenum. Pancreatic enzymes are in charge of absorbing protein, carbohydrates and breaking down fats.

The pancreas’ endocrine function is to secrete two hormones: insulin and glucagon. These two hormones are in charge of regulating blood sugar levels. Insulin controls and reduces the levels of blood sugar after a person eats. This happens by various methods and also has other effects on the body. Glucagon increases sugar in the blood when a person has not eaten, so that way, they maintain their energy. 

What is pancreatic cancer?

Pancreatic cancer is the abnormal growth of cells in the organ’s tissue. There are two main types of pancreatic cancer, depending on which type of cell is affected. 

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Diagram showing stage T2 cancer of the pancreas
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First, there is exocrine pancreatic cancer, which affects the pancreas’ exocrine cells (the one that produces digestive enzymes). This type of pancreatic tumor is the commonest as it represents around 90% of them. Within exocrine pancreatic tumors, there are several types, but the predominant is pancreatic adenocarcinoma. It’s important to know which type of cancer has the pancreatic cancer patient as each type can have different medical approaches. 

Then there is neuroendocrine pancreatic cancer (or endocrine pancreatic cancer), which affects the pancreas’ endocrine cells. A neuroendocrine tumor is less common, and they grow way slower than exocrine tumors.

Sadly, this is a very fatal disease, as the 5-year survival rate is 9%. Meaning only 9 percent of patients stay alive 5 years after the diagnosis. The type of pancreatic cancer will influence the symptoms that the patient presents. If we remember that adenocarcinoma is the most common, patients with this cancer would mostly present its symptoms.

What are the early warning signs of pancreatic cancer?

Pancreatic cancer is difficult to identify early on. The pancreas is in a deep area of the body. Thus, doctors cannot see or feel tumors in their early stages during regular physical examinations. Pancreatic cancer symptoms typically don’t occur until cancer has spread to other organs or has become very large.

Jaundice is a skin and eye yellowing phenomenon, something followed by skin itchiness. Many people with pancreatic cancer experience jaundice as one of their first symptoms. The accumulation of bilirubin, a substance produced by the liver, induces this symptom. As pancreatic cancer spreads, it usually goes to the liver first and can trigger jaundice, too.

Dark urine is another indicator of high bilirubin, more specifically direct bilirubin. As bilirubin levels increase in the blood, the color of the urine becomes brown. In the same way, bilirubin typically helps to give the stool its brown color. The stool may be gray or light in color if tumors block the bile duct. If bile and pancreatic enzymes cannot penetrate the intestines to break down fat, the stool may become fatty and float.

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Choluria (Black or Brown urine)
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Cancers that begin in the body or the pancreas’ tail may develop dramatically, compressing other nearby organs and cause pain. It’s also very normal for people with pancreatic cancer to have unexplained weight loss. Other symptoms such as nausea, vomiting, and abdominal pain get worse after eating. 

Pancreatic cancer may often affect endocrine cells, resulting in diabetes. Feeling thirsty and hungry, as well as needing to urinate, are common symptoms.

 A blood clot in a large vein, usually in the leg, can be the first sign of pancreatic cancer. Pressure, swelling, redness, and warmth in the affected leg are all potential symptoms. 

What are the risk factors for developing pancreatic cancer?

A risk factor raises the probability of developing cancer. Still, it is not enough or essential for the disease to occur. Some people with any of these risk factors never experience pancreatic cancer, while others who have none develop the disease.

The development of pancreatic cancer is due to the interaction of various factors, including lack of physical activity, being overweight or obese, and consuming alcohol or tobacco. However, specialists recognize other elements with a higher incidence of this disease; age is one of them. Most people who develop pancreatic cancer are over 65 years old. In the same way, Black people are more likely than Asians, Hispanics, or whites to develop pancreatic cancer,

Pancreatic adenocarcinoma is more likely to occur if chronic pancreatitis has been present for many decades. When smoking and genetic factors enter into the equation, the risk skyrockets. Patients who have had diabetes for a long time are also at a greater risk of developing it. Diabetes can be an early symptom of pancreatic cancer rather than a predisposing factor in some instances.

Inherited genetic mutations play a significant role in the development of pancreatic cancer. The DNA repair genes BRCA2, PALB2, and ATM, are all altered in most of these patients.

The term inherited refers to genetic traits passed down through a family from generation to generation. Having pancreatic cancer in first-degree relatives, parents, or siblings, or seven in second-degree uncles or cousins raises the risk of developing it.

Some hereditary syndromes are hereditary pancreatitis, Peutz-Jeghers syndrome, Familial atypical multiple mole melanoma syndromes, hereditary breast and ovarian cancer, and Lynch syndrome.

How is pancreatic cancer diagnosed?

Whenever doctors suspect pancreatic cancer, various tests allow them to diagnose the disease. They also conduct tests to determine whether cancer has spread to other areas of the body from where it originated.

Imaging tests are key to the diagnosis since they enable the visualization of internal organs, including the pancreas. Techniques used to detect pancreatic cancer include ultrasound, computed tomography (CT scan), magnetic resonance imaging (MRI), and positron emission tomography (PET).

The use of an endoscope to capture ultrasound images of the pancreas is also often valuable. Endoscopic ultrasound (EUS) employs an ultrasound system to take images of the pancreas from the inside of the abdomen. The device moves through a small, flexible tube, the endoscope, down the mouth and esophagus for then going into the stomach to retrieve the images.

For certain cancers, a biopsy is the surest option for a doctor to establish whether the body’s region has cancer. A biopsy is a procedure for removing a tiny sample of tissue for further analysis under a microscope. Generally, doctors get the tissue during an endoscopic ultrasound, using special instruments guided through the endoscope. Less frequently, they collect pancreatic tissue samples inserting a needle through the skin and into the pancreas.

Doctors can test blood in patients for particular proteins or tumor markers secreted by cancer cells in the pancreas. The tumor marker CA19-9 is the assay used for pancreatic cancer. It could be important to see how cancer reacts to the medication. But the test is not necessarily accurate since certain patients with pancreatic cancer don’t have an elevated CA19-9 dose, making the test less effective.

Can pancreatic cancer be treated?

Pancreatic cancer can be treated. It will depend on the stage and location of the cancer, the patient’s wellbeing, and personal preferences. The first aim of pancreatic cancer therapy is to eradicate cancer if possible. Sometimes this is not possible; thereby, priority could be on increasing patients’ quality of life and limiting cancer from growing further (palliative care).

Treatment may involve surgery, radiation, chemotherapy, or a mixture of these. In pancreatic cancer surgery, doctors remove all or part of the pancreas. This decision depending on the tumor location and size within the pancreas. A healthy tissue zone around the tumor is also often removed. It’s called a margin, which ensures that no cancer cells are present at the healthy tissue’s edge. But, doctors often use chemotherapy and/or radiation therapy to reduce the tumor before surgery. 

Which are the treatment options available for pancreatic cancer?

The Whipple procedure is the most common surgery for removing pancreatic tumors. The head of the pancreas, the gallbladder, the duodenum, a small part of the stomach, as well as surrounding lymph nodes are all removed in normal surgery. If doctors find a tumor in the pancreas’ body or tail, they will perform a distal pancreatectomy. But on other occasions, the whole pancreas must be removed through a complete pancreatectomy. If the surgeons remove the entire pancreas, the patient will require medication to maintain blood sugar control.

Physicians use chemotherapy in people with advanced pancreatic cancer, and cancer spread to other parts of the body. Chemotherapy does use drugs to destroy cancer cells. Patients may receive these medications into a vein or take them by mouth. Oncologists also pair chemotherapy with radiation therapy. They use this combination to treat cancer that has not spread to other organs outside the pancreas. It is often used after surgery to reduce the risk that pancreatic cancer can return.

Radiotherapy uses high-energy radiation, such as x-rays, to destroy cancer cells. Radiation therapy comes from a machine that moves through the body, directing the radiation to different areas. Patients may receive radiation treatment before, during, or after surgery, often in combination with chemotherapy. There are different types of radiation. In several more advanced medical facilities, they may use protons. This proton therapy can have fewer side effects compared to traditional radiation therapy.

Palliative care is any treatment that focuses on minimizing symptoms, enhancing the quality of life, and offering support to patients and their families. These treatments vary and can include medications, dietary changes, relaxing techniques, and social support. However, patients can also undergo palliative interventions such as those used to remove cancer, such as chemotherapy, surgery, or radiation.

Do you have symptoms of this disease or think you are at risk of it?

This tool is a Pancreatic Cancer Symptoms Checker. The tool gathers the most important signs, symptoms, and risk factors for it. Therefore, it would tell anybody who uses it the likelihood of their symptoms because of Pancreatic Cancer. Using the tool is free and would only take a few minutes.

What do you think?

Written by Dr. Esteban Kosak

Doctor of Medicine - MD Recently Graduated from Medical School and inspired to aid the global population during this situation. I think that we shall no longer be waiting to see a doctor when we feel sick. Several times we feel disease searches in Google drive us to a rabbit hole and come out thinking that we may die of cancer or something very serious, given that symptoms may seem to fit a wide variety of illnesses. Since I recently graduated from medical school. I have all the medical information fresh in my mind. My thorough experience as an expert researcher allows me to very-well known the different diseases and conditions that affect human bodies. Empowered by the United Nations 17 Sustainable Development Goals (SGDs). I think that we all can provide a grain of sand to help humanity. That's why we created Symptoms.Care a place where you can come and screen your symptoms and find what different illnesses can be related to them. Armed with the right information you can instantly, discretely, secure and from the comfort of your home talk with a Doctor that can Evaluate your Symptoms and help you seek the right treatment.

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