‘Pancreatic cancer’ although it is a rare cancer, it is considered a dangerous cancer due to its unclear symptoms, which resemble common gastrointestinal diseases. As a result, most patients are diagnosed with pancreatic cancer at an advanced stage. Pancreatic cancer is therefore another type of cancer with a high mortality rate. The general public often confuses pancreatic cancer with liver cancer, but despite both having the word ‘liver’ in their names, they are completely different cancers.
What is the function of the pancreas?
Although it has the word ‘liver’ in its name, the pancreas is not the liver. The pancreas is an organ about 15 centimeters in size, located in the middle of the abdominal cavity behind the stomach and beneath the liver. The main function of the pancreas is to produce digestive juices or enzymes that help digest food. It also produces hormones such as insulin and glucagon, which help regulate blood sugar levels.
What causes pancreatic cancer?
More than 90% of pancreatic cancers arise from abnormalities in the pancreatic duct cells responsible for transporting digestive enzymes. The other 10% are caused by abnormalities in the hormone-producing cells within the pancreas itself.
The more you smoke, the higher the risk of pancreatic cancer
This is not a typo or misreading. Smoking is not only a major cause of lung cancer but also affects the pancreas and can lead to pancreatic cancer. Studies have found that smokers have a 74% higher risk of developing pancreatic cancer compared to non-smokers. However, smoking is not the only cause. Other risk factors for pancreatic cancer include:
- Certain genetic disorders
- Chronic pancreatitis from alcohol consumption or pancreatic stones
- Older age, especially those aged 65 and above
- Obesity
- Having family members or relatives with pancreatic cancer
3 Stages of Pancreatic Cancer
The staging of pancreatic cancer is usually based on treatment guidelines and is divided into 3 stages:
- Resectable stage: The tumor is not very large, has not spread to other organs, and has not invaded nearby major blood vessels.
- Borderline stage: The tumor is relatively large and may have invaded nearby major blood vessels but has not spread to other organs. Pancreatic cancer at this stage may be treated with chemotherapy or radiation to shrink the tumor to a size that can be surgically removed.
- Metastatic stage: The cancer has spread to other organs such as the liver or peritoneum.
How to treat pancreatic cancer
For almost all types of cancer, the main effective treatment is “surgery.” However, in the case of pancreatic cancer, surgery must be combined with chemotherapy or radiation therapy as follows:
1. Surgical treatment of pancreatic cancer
Surgery is the only primary treatment that can potentially cure the disease if the entire tumor can be removed. This depends on the stage and severity of the disease. If the tumor is located in the head of the pancreas, it may be necessary to remove the duodenum and bile duct along with creating a bypass for the intestines. If the tumor is in the body or tail of the pancreas, treatment may involve removing the pancreas along with the spleen and nearby lymph nodes.
For metastatic stages where surgery is not possible, if there is obstruction of the digestive tract caused by the tumor pressing on the intestines or jaundice caused by the tumor pressing on the bile duct, surgery may be performed to create a bypass to relieve symptoms.
2. Chemotherapy or radiation therapy for pancreatic cancer
Patients with pancreatic cancer at all stages must receive chemotherapy or radiation therapy in conjunction with surgery to improve treatment effectiveness after surgery. The choice of treatment method will be assessed and selected by the physician. Chemotherapy may also be given before surgery in borderline cases to shrink the tumor to a resectable size. For patients with metastatic disease, chemotherapy or radiation is used as palliative treatment to slow disease progression.
Additionally, there are adjunctive treatments to reduce symptoms caused by the disease, including:
- Biliary drainage catheter insertion to reduce jaundice in patients with metastatic disease or acute cholangitis.
- Intestinal stent placement for patients with metastatic disease who have intestinal obstruction.
What symptoms indicate a risk of pancreatic cancer?
- Upper abdominal pain radiating to the back
- Jaundice (yellowing of the eyes and skin)
- Abnormally dark urine
- Abnormally pale stools
- Loss of appetite and unexplained weight loss
- Vomiting due to intestinal obstruction
How to screen for pancreatic cancer
For individuals at risk, such as:
- Having more than 2 first-degree relatives (parents, siblings, children) with pancreatic cancer
- Having more than 3 second-degree relatives (aunts, uncles) with pancreatic cancer
Doctors usually recommend regular pancreatic health screening at least once a year using the following methods:
- Abdominal ultrasound
- Magnetic resonance imaging (MRI)
- Endoscopic ultrasound
