The phrase “liver, kidneys, intestines, and stomach” may seem distant or unimportant to many. However, it’s time to reconsider. According to data from the Department of Medical Services and the National Cancer Institute of Thailand, liver cancer ranks as the most common cancer among Thais, with approximately 16,000 deaths each year. These alarming statistics underscore the importance of paying attention to liver and pancreatic health—before it’s too late.
Are the Liver and Pancreas the Same?
Although their names may sound similar, the liver and pancreas serve distinctly different functions. The liver performs multiple roles, primarily producing bile to aid digestion. It also plays a key role in metabolizing fats and carbohydrates, regulates blood glucose levels, eliminates toxins from drugs and chemicals, and produces certain proteins essential for blood clotting.
The pancreas, on the other hand, is part of the digestive system. It is a large gland located near the duodenum and extends toward the spleen. Despite the name, it is not a part of the liver. The pancreas is responsible for producing digestive enzymes that break down fats, proteins, and carbohydrates. These enzymes are released into the small intestine via the pancreatic duct, where they become active and aid digestion.
Moreover, the pancreas produces several hormones, most notably insulin and glucagon, which regulate blood sugar levels. These hormones are essential in maintaining normal glucose utilization throughout the body.
What Can Go Wrong with the Liver and Pancreas?
The liver is generally a resilient organ, but when damage occurs, it is often already extensive. One visible symptom is jaundice, or yellowing of the skin and eyes, which may indicate liver dysfunction or a bile duct obstruction—two different conditions requiring accurate diagnosis. Liver cirrhosis often presents only in advanced stages, with symptoms such as abdominal fluid accumulation, swelling, gastrointestinal bleeding, or gynecomastia (breast enlargement in males)—all signs of chronic liver disease.
In contrast, early symptoms of pancreatic disease typically fall into two categories: acute inflammation—most often due to chronic alcohol consumption—and chronic pancreatitis, which may present with symptoms related to diabetes or oily, mucus-like stools. In cases of pancreatic cancer, which is also common in Thailand, symptoms are often subtle or absent in the early stages. Patients may experience bloating, indigestion, and abdominal pain radiating to the back—often overlooked until the disease progresses significantly.
Risky Behaviors and Triggers
- Drug-induced liver damage: Although not all medications are harmful to the liver, most are metabolized by it. Accumulation of certain drugs can cause liver cell inflammation. For example, while paracetamol is commonly used and excreted via the liver, prolonged use should be monitored by a physician.
- Gallstones and pancreatitis: Gallstones that block the bile duct—especially at the distal end—can cause pancreatic inflammation.
- Chronic alcohol consumption: Alcohol is a major contributor to pancreatitis, comparable to the risk posed by gallstones.
In some cases, acute pancreatitis may occur without known causes such as alcohol or gallstones. Such cases require thorough follow-up, especially to rule out pancreatic cancer. Even initial imaging such as CT scans may miss early cancer signs due to inflammation obscuring the view.
Pancreatic Tumors
Pancreatic tumors are classified into two main types based on the originating cells:
- Exocrine tumors, most of which are malignant and originate from the enzyme-producing cells.
- Endocrine tumors, such as islet cell tumors, which are relatively rare.
While some tumors may be benign cysts resulting from pancreatitis, the majority of pancreatic tumors are malignant (pancreatic cancer).
Diagnostic Methods
- Ultrasound examination
- CT (Computed Tomography) scan
- MRI (Magnetic Resonance Imaging)
- Endoscopic Retrograde Cholangiopancreatography (ERCP), often combined with ultrasound to evaluate tumor characteristics and collect biopsy samples
- Fine-needle aspiration, along with tumor marker blood tests, to confirm pancreatic cancer
Symptoms of Pancreatic Cancer
In the early stages, pancreatic cancer is typically asymptomatic. When symptoms do occur, they are often severe and may include:
- Loss of appetite
- Nausea and vomiting
- Abdominal bloating
- Weight loss
- Yellowing of the skin and eyes
- Dark orange urine
- Reddish or black stools, or stools with visible blood
- Constipation or diarrhea
- Intermittent abdominal pain, especially around the lower back
Risk Factors for Pancreatic Cancer
- Smoking
- Diets high in animal protein and fat
- Diabetes
- Genetic predispositions
Surgical removal is the most effective treatment, but only if the cancer is detected early and has not yet spread. Unfortunately, by the time symptoms prompt medical attention, many cases are already in advanced stages and cannot be surgically treated.
Regular annual health check-ups are crucial for early detection and prevention of pancreatic tumors and related conditions.
