What is Pancreatic cancer
The pancreas is located in the abdomen. There have cells with endocrine and exocrine functions; these endocrine and exocrine cells have got digestive and hormonal functions. Cancer cells develop on both of these types of functional cells.
- Most of the cancerous cells in the pancreas are adenocarcinomas.
- Pancreatic cancer is highly dangerous because it rapidly grows and spreads to the other body parts.
- Usually, pancreatic cancer is diagnosed in its later stages.
Function of pancreas
- This is a hormone-producing organ in the abdomen which is in front of the spine above the level of the belly button.
- It produces a hormone called insulin which regulates blood sugar levels.
- The second function is that it makes as well as secretes digestive enzymes in the intestine which helps in the breakdown of dietary proteins, fats and carbs.
Types of pancreatic cancer
- Pancreatic cancer is of two types. The one which is developed on the endocrine cells and the other one which develops on the exocrine cells.
- Islet cell cancer:- In this type of pancreatic cancer the cancerous cells attack endocrine cells called islet cells or pancreatic neuroendocrine tumours or PNETs.
- This type of cancers are rare and grow slowly when compared to the exocrine pancreatic cancers.
- These tumours release hormones into the bloodstream. The following are the hormones they produce (insulin, glucagon, gastrin, and other hormones)
- Exocrine Pancreas Cancers:- Exocrine part helps in enzyme secretion.
- The cancer of the Exocrine pancreas develops from the cells that line ducts which deliver enzymes to the small intestine. It is also called as pancreatic adenocarcinomas. Adenocarcinoma often comprises of most of the pancreatic ductal cancers.
- The cells divide more rapidly than the tissues that surround them.
They are divided into following sub types:
- Squamous: In this type squamous cells have tumors enriched with TP53 and KDMA mutations.
- Pancreatic progenitor:– These tumors are involved in pancreatic development and expresses genes such as FOXA2/3, PDX1, and MNX1.
- Aberrantly differentiated endocrine Exocrine (ADEX): These Tumors on the endocrine (NEUROD1 and RBPJL) Exocrine (NR5A2 and RBPJL) differentiation and the cells displays the genes (KRAS).
- Immunogenic:- These tumors are involved in acquired immune suppression.
Risk Factors of Pancreatic cancer
The following are the risk factors of pancreatic cancer:-
- The biggest risk factor of pancreatic cancer is increasing age.
- People with more than 60 years of age are at greater risk.
- Hereditary genetic syndromes from genetic mutations.
- BRCA-2 and BRCA-1 Gene mutations.
- Tobacco use
- Sedentary lifestyle
- People with a history of diabetes
- Pancreatitis also called as chronic pancreatic inflammation.
- Diet high in fat content like Western diet
- Overuse of certain drugs sitagliptin, exenatide, liraglutide and metformin have been linked to pancreatic cancer
- Pancreatic cysts also put an individual at risk of pancreatic cancer
- High intake of soda and coffee consumption
Signs and symptoms
The first signs or early symptoms of pancreatic cancer are not present. Symptoms usually appear once the tumor develops to a size which can be pressed in the nearby structures such as nerves, intestines and bile duct.
- In nerves- it causes generalized pain and back pain.
- In intestines- loss of appetite, nausea, weight loss
- Bile ducts- Causes jaundice, a yellowing of the skin and loss of appetite, and itching.
- In women, symptoms are different from men
- Symptoms of Exocrine pancreas
- Light-coloured stools
- Digestive problems
- Blood clots
- Enlarged gallbladder
- Greasy stools
- Nausea, vomiting
- Abdominal pain
- Back pain
Symptoms of Endocrine pancreas
- Insulinomas- In this case insulin-producing tumors lowers blood sugar levels
- Glucagonomas- it causes symptoms like thirst, frequent urination, skin rash termed as necrolytic migratory erythema
- Gastrinomas- It leads to ulcers, black tarry stools and anaemia.
- Somatostatinomas- it leads to diarrhea, belly pain, jaundice
- VIPomas- It causes severe watery diarrhea, digestive problems, high blood glucose levels
- PPomas- it causes abdominal pain, enlarged livers and watery diarrhea.
Diagnosis of pancreatic cancer
- Those patients with pancreatic cysts are undergone for the certain tests which mostly include
- CT scan
- Magnetic resonance cholangiopancreatography (MRCP)
- Endoscopic ultrasounds
- If the cancer is found in the early stages like stage 1 or 2 then surgery is the only curative procedure for pancreatic cancer
- Whipple procedure includes removal of tumors on pancreas
- After this adjuvant therapy is recommended which is a radiation therapy
- Chemotherapy agents like Tarceva or onivyde
- Immunotherapy agents like capecitabine
- These preventive measures reduce the risk of pancreatic cancer
- Quit smoking
- Maintain a healthy diet which includes daily intake of five bowls of fruits and vegetables.
- Exercise daily to maintain a healthy weight