Pancreatic Cancer: Symptoms and Treatment

According to the American Cancer Society’s estimated 2017 statistics, over 53,000 people will be diagnosed with pancreatic cancer (3% of all cancer diagnoses) and just over 43,000 of them will die from it (7% of all cancer deaths). An individual’s chance of getting pancreatic cancer is 1 in 65.

Causes of Pancreatic Cancer

The cause of pancreatic cancer has not yet been determined. However, several risk factors have been identified. Some of these risk factors can be changed, such as the following:

• Smoking
• Obesity
• Age
• Gender (higher for males)
• Race (higher for African Americans)
• Family history
• Inherited genetic syndromes
• Chronic pancreatitis
• Cirrhosis of the liver

Symptoms of Pancreatic Cancer

Most symptoms of pancreatic cancer show themselves after cancer has spread to other organs. This is the reason pancreatic cancer is often diagnosed at later stages. Sometimes the tumor can be detected incidentally on abdominal CT scan or Ultrasound done for other reasons.

• Jaundice
• Belly pain
• Weight loss
• Nausea
• Blood clots
• Diabetes

Diagnosis of Pancreatic Cancer

• Medical history and physical exam focused mostly on the belly
• Abdominal Imaging using CT scan and Abdominal ultrasound
• Blood tests for tumor makers like CA 19-9
• Biopsy
• ERCP or EUS

Staging of Pancreatic Cancer

The diagnostic tests not only help in making the diagnosis but also in determining the stage of cancer (how far cancer has spread). Some stages of pancreatic cancer have multiple criteria. The American Joint Committee on Cancer system (TNM system) is used for staging.

Stage 0: Cancer is only in the top layer of pancreatic duct cells.

Stage I: Cancer has not spread beyond the pancreas and is no bigger than 2 cm.

Stage II: Cancer is confined to the pancreas and is bigger than 4 cm, but has not spread to nearby lymph nodes or distant sites.  OR Cancer is no bigger than 2 cm but has spread to no more than 3 nearby lymph nodes. OR Cancer is bigger than 4 cm and has spread to no more than 3 nearby lymph nodes

Stage III: Cancer is confined to the pancreas, is no bigger than 2 cm, and has spread to 4 or more nearby lymph nodes, but has not spread to distant sites. OR The cancer is outside the pancreas and is growing in nearby blood vessels, but has not spread to distant sites.

Stage IV: Cancer has spread to distant sites (liver, lungs, bones, or lining of the abdominal cavity). It can be any size and may or may not have spread to nearby lymph nodes.

Treatment of Pancreatic Cancer

Mostly, more than one treatment option is used. Treatments options include the following:

• Surgery
• Ablation or embolization
• Radiation therapy
• Chemotherapy

Prevention of Pancreatic Cancer

There is no sure way to prevent pancreatic cancer, but avoiding the risk factors that can be controlled is a good way to lower your risk.

• Don’t smoke
• Maintain a healthy weight
• Limit alcohol use
• Limit exposure to chemicals

Resources: 

• https://www.cancer.org/research/cancer-facts-statistics.html
• www.cancer.gov
• http://www.cancer.org/
• www.gastro.org