Overview:
- it is abnormal cells that multiply in an uncontrollable way, as these cells destroy normal cells, which leads to disorder in pancreatic functions
- may occur disorder in secretion of digestive enzymes and may occur disorder in secretion of pancreatic hormones.
- Unfortunately, pancreatic cancer does not give symptoms in its early stages, symptoms begin to appear when the tumor becomes large and spreads to abdominal organs
- Types:
- pancreatic adenocarcinoma:
- most common
- neuroendocrine cancer
Etiology:
- Cancer cells are normal cells in origin, but have undergone changes or mutations in their DNA
- The changes caused an imbalance in how they grow and divide and a disorder in their functions
- When cancer arises from pancreatic cells secreting digestive enzymes, it forms adenocarcinoma
- When cancer arises from hormone-secreting pancreatic cells, it forms endocrine cancer
Symptoms:
- Severe abdominal pain radiating to the back
- Nausea and vomiting
- Jaundice
- Light colored stools
- Dark urine
- Skin itching
- Blood clotting disorder
- general systemic symptoms of cancer (weakness, fatigue, pallor, fever and night sweating )
- Pancreatic cancer may lead to bowel obstruction
Causes:
risk factors of pancreatic cancer include:
- Chronic pancreatitis
- Diabetes mellitus
- Obesity
- Smoking
- Excessive drinking alcohol
- Family history
- Age: pancreatic cancer is most common at older ages (over 65)
- Genetic mutations:
- Lynch syndrome
- BRCA2 mutation which responsible for breast cancer
- Familial atypical multiple mole melanoma (FAMMM) syndrome
Diagnosis:
- clinical examination with detailed diseases history
- Laboratory tests to assess pancreatic function, bilirubin elevation, and screening for tumor markers1 19-9
- Upper gastrointestinal endoscopy
- Endoscopic ultrasound to assess the degree of tumor invasion
- CT, MRI and PET scan to determine stage of the tumor
- Biopsies and samples are taken through the skin under ultrasound guidance or during diagnostic laparoscopy
Treatment:
Pancreatic cancer treatment varies according to cancer stage and location:
- In pancreatic head cancer, Whipple surgery is performed: excision of pancreatic head, duodenum, gallbladder, part of bile duct and adjacent lymph nodes
- In cancer of the body and tail of pancreas, distal pancreatectomy is done (with or without splenectomy)
- Total pancreatectomy in overall injuries
- If surgery is not possible (extensive tumor spread, vascular invasion), some palliative treatments can be performed (nerve blockade to relieve pain, stent insertion in bile duct to treat jaundice)
- Chemotherapy:
- Pre surgery: to decrease tumor size
- post-surgery: as a supportive adjuvant therapy to kill any remaining cancer cells
- Radiotherapy:
- Pre surgery: to decrease tumor size
- post-surgery: as a supportive adjuvant therapy to kill any remaining cancer cells
- Radiotherapy and chemotherapy are often both involved in pancreatic cancer.
