He pancreatic cancer It is one of the most aggressive tumors, difficult to detect and one that spreads more rapidly. Although it does not present a high incidence in the population, it has the highest mortality rate of all tumors. Normally, when it shows its face, it has already caused metastasis. “At the time of diagnosis less than 20% of patients they will be susceptible to being resected (which consists of removing the tumor completely), given the advanced stage of the disease”, writes Dr. Teresa Macarulla, from the Spanish Society of Medical Oncology (SEO).
Pancreatic cancer kills around 95,000 people each year in Europe and, in recent years, we are witnessing an increase in cases. Thus, if some 8,338 new cases were estimated for 2020 and 7,427 deaths from this cancer were recorded, the expected cases for 2022 were 9,252, according to the latest SEO count. Furthermore, it is “the third leading cause of cancer death in Europe and the only one that shows a continuous lack of progress in its detection”, according to the report European cancer mortality predictions for the year 2023 published in the specialized journal Annals of Oncology.
For all these reasons, knowing what to expect from this disease may help to better cope with the situation. In this article you will find all the information about pancreatic cancer, including risk factors, symptoms, detection and treatment depending on which stadiums.
What is pancreatic cancer?
Pancreatic cancer is a type of cancer that originates in the pancreas, when malignant cells begin to grow out of control. In this regard, the pancreas in the body is located behind the stomach and colon, in close contact with important abdominal structures such as the duodenum, the bile duct, the intestinal arteries and veins, the aorta, etc. This can make the tumor invades other organs and spreads quickly.
Pancreatic cancer most frequently originates in the region of the pancreas called the head (60% of cases). Less frequently, it can originate from the area called the body or tail of the pancreas. Most patients diagnosed with pancreatic cancer have a age between 65 and 70 years. It is rare for this tumor to occur in patients under the age of 60, in which case the doctor must rule out its association with a genetic alteration.
very low life expectancy
The survival rate for pancreatic cancer is the lowest of all cancers. Not only that, currently its mortality has increased due to an increase in its incidence. Thus, between men is only 7% and in women 10%. This data contrasts with other cancers such as prostate and testicular cancer (90% survival rate among men), thyroid cancer (93% survival rate in women) or breast cancer (86%).
This is due, according to experts, to two factors: detected late because there are no symptoms evident until the tumor is advanced and begins to metastasize very soon. Famous people such as Steve Jobs (founder of Apple), the tenor Luciano Pavarotti, the actor Patrick Swyze or the Spanish singer Rocío Jurado died from this deadly cancer.
However, there are beacons of hope to improve the diagnostic situation for pancreatic cancer. Recently, a European project called PANCAID has been announced, which aims to achieve early detection of this disease through a blood test. The investigation, which has just begun, will receive 10 million euros from the European Commission until 2027. There are other advances like this: The test that detects prostate cancer with an accuracy of 94%.
Risk factors for developing pancreatic cancer
There are different factors that have been suggested as possible contributors to the growth of these tumors. Some studies have pointed to the longstanding diabetes mellitus as a possible etiology of pancreatic cancer. Diabetes onset is very common some time before the diagnosis of pancreatic cancer, however, it is still it is not known exactly how diabetes can influence the tumor or the tumor itself in diabetes.
On the other hand, recurrent chronic pancreatitis has been studied as a possible factor, but there is no conclusive study in this regard. More feasible is tobacco: about 30% of pancreatic cancer cases could be associated with smoking. On the other hand, hereditary syndromes are also a common explanation: approximately 10% of pancreatic cancers are associated with genetic alterations such as Peutz-Jeghers Syndrome, familial pancreatitis, familial malignant melanoma, Lynch Syndrome, among others.
Pancreatic Cancer Symptoms: Jaundice
Having one or more of the symptoms below does not mean you have pancreatic cancer. However, if you have any of these symptoms, it is important that a doctor examine the patient to study them. One of the first signs in most people with this disease is the jaundicewhich manifests itself through skin and eyes that turn yellow.
It is caused by the buildup of bilirubin, a dark green substance produced in the liver. Normally, it passes through the common bile duct to the intestines, where it helps break down fats that leave the body in the form of feces. But when the common bile duct becomes blocked, bile cannot get up to them and the amount of bilirubin in the body accumulates. Cancers that begin in the head of the pancreas They are close to the common bile duct. These can press on the duct and cause jaundice when they are still quite small, which sometimes means that these tumors can be found at an early stage. When cancer has jumped from the pancreas to the liver, jaundice is also common.
In addition to yellowing of the eyes and skin, other signs of jaundice are: dark urine (brown), pale or greasy stools (they can float in the toilet) and itchy skin (itching)
Pancreatic cancer is not the most common cause of jaundice. Other causes, such as gallstones, hepatitis, and other diseases of the liver and bile duct are much more common.
Other symptoms: pain in the abdomen, back and lack of appetite
He abdominal (belly) or back pain It is a common symptom in pancreatic cancer. Cancers that start in the body or tail of the pancreas can grow significantly and can begin to compress other nearby organs or nerves, often causing back pain. Discomfort in the abdomen or back are quite common and are more often caused by other conditions.
It is very common for people with pancreatic cancer to lose weight without trying. Often these people have little or no appetite. Also, if the cancer presses on the distal end of the stomach, making it difficult for food to pass through. This can cause nausea, vomiting and pain It tends to intensify after eating. Another sign is the enlarged gallbladder or liver. Sometimes a doctor can feel this enlargement during a physical exam (such as a large lump under the right side of the rib).
Sometimes the first sign that a person has pancreatic cancer is a blood clot in a large vein, often in a leg. This is called deep vein thrombosis (DVT). Symptoms may include pain, swelling, redness, and warmth in the affected leg. Sometimes a piece of clot can break off and travel to the lungs, making it hard to breathe. Still, having a blood clot usually doesn’t mean you have cancer. Last but not least, pancreatic cancer destroys insulin-producing cells causing diabetes and, more often, causes changes in blood sugar levels.
Pancreatic cancer treatment
Two types of surgeries may be used for pancreatic cancer: Potentially curative surgery is used when exam results and tests suggest that the cancer can be completely removed (resected) and the surgery as palliative treatmentwhich may be done if tests show the cancer has spread too far and to relieve symptoms or prevent certain complications.
The radiotherapy it uses x-rays or high-energy particles to kill cancer cells and may be useful in treating some pancreatic cancers. On the other hand, the chemotherapy (chemo into the bloodstream) can potentially be useful against cancers that have or have not spread to other areas. In most cases, chemotherapy is most effective when combinations of drugs such as Gemcitabine (Gemzar) or 5-fluorouracil (5-FU) are used.
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