The pancreas is a glandular organ located below the stomach that produces digestive enzymes and insulin, a hormone that regulates blood sugar. Pancreatic cancer develops when the cells of this organ begin to grow uncontrollably, forming a tumor. This abnormal growth can interfere with the vital functions of the pancreas. This abnormal growth interferes with the functions of the pancreas, affecting digestion and blood sugar control. Its development is usually silent, making early diagnosis difficult.
Symptoms of pancreatic cancer
The symptoms of pancreatic cancer can be vague and nonspecific, especially in the early stages, making early diagnosis difficult. Furthermore, the symptoms may vary depending on the location of the tumor.
Early symptoms:
in the initial stages, symptoms may be mild or even nonexistent. Some of the first symptoms that may develop include:
General feeling of discomfort in the abdomen.
Indigestion.
Mild fatigue.
Loss of appetite.
Late symptoms:
as the disease progresses, the symptoms become more evident and specific. Some of the late symptoms of pancreatic cancer include:
Abdominal or back pain: it can be dull and constant, or intermittent and sharp, often radiating towards the back. It usually gets worse after eating or when lying down.
Jaundice: yellowing of the skin and sclera (white part of the eyes), accompanied by dark urine and light-colored stools, due to obstruction of the bile duct by the tumor.
Significant weight loss: decreased appetite and weight loss for no apparent reason.
Intense fatigue: a feeling of extreme tiredness and lack of energy that interferes with daily activities.
Nausea and vomiting: they can be persistent and make eating difficult.
Changes in stool: fatty, floating, foul-smelling stools (steatorrhea), due to fat malabsorption.
New-onset diabetes: the tumor can affect insulin production, leading to diabetes.
The severity and presentation of these symptoms vary from person to person. It is essential to seek medical attention if you experience any of these symptoms, especially if you have any risk factors.
Types of pancreatic cancer
Pancreatic cancer classification is essential for determining prognosis and the most appropriate treatment. It is classified according to different criteria:
1. Histological type: it refers to the type of cell from which the tumor originates.
Pancreatic ductal adenocarcinoma: it is the most common type (approximately 90% of cases). It originates in the cells that line the pancreatic ducts.
Acinar adenocarcinoma: it originates in the acinar cells, which produce digestive enzymes.
Adenosquamous carcinoma: it combines features of adenocarcinoma and squamous cell carcinoma.
Neuroendocrine carcinoma: it originates in a type of specialized cell called a neuroendocrine cell that can secrete hormones.
Other types: there are other less common types, such as mucinous cystadenocarcinoma, undifferentiated carcinoma, and sarcoma.
2. Staging: it describes the extent of the cancer at the time of diagnosis. The TNM (Tumor, Nodes, Metastasis) staging system is the most widely used.
Stage I: the tumor is confined to the pancreas and is small (less than 2 cm).
Stage II: the tumor is larger (more than 2 cm) or has spread to nearby lymph nodes.
Stage III: the tumor is larger than in stage II, or it has greater lymph node involvement or involvement of nearby structures, but it has not yet spread to distant organs.
Stage IV: the cancer has spread to distant organs, such as the liver, lungs, or peritoneum (metastasis).
Causes of pancreatic cancer
Despite advances in research, the exact causes of pancreatic cancer are still not fully known. Certain genetic mutations and risk factors are known to contribute to its development. ciertas mutaciones genéticas y factores de riesgo contribuyen a su desarrollo.
There are various factors that can increase the risk of developing pancreatic cancer. Controlling these factors, as far as possible, can contribute to prevention. Some of the most significant ones are:
Smoking.
Obesity.
Chronic pancreatitis: prolonged inflammation of the pancreas may predispose to cancer.
Family history.
Genetic mutations: certain inherited genetic mutations, such as those of the BRCA1, BRCA2 and CDKN2A genes, increase susceptibility.
Diabetes: long-standing diabetes can be a risk factor.
Old age: risk increases with age, being more common after age 65.
Sex: it is slightly more common in men than in women.
Race: people of African American descent have a slightly higher risk.
Complications of pancreatic cancer
Pancreatic cancer can lead to various complications that affect a patient’s health and quality of life. Early diagnosis and appropriate treatment are essential to prevent or control these complications. Some of the possible complications include:
Diabetes: the tumor can affect insulin production.
Obstructive jaundice: obstruction of the bile duct can cause jaundice and other biliary complications.
Weight loss: difficulty digesting food and loss of appetite can lead to significant weight loss.
Chronic pain: the tumor can cause persistent abdominal or back pain.
Intestinal obstruction: the tumor can block the small intestine.
Metastasis: the cancer can spread to other organs, such as the liver, lungs, and bones.
Diagnosis of pancreatic cancer
Diagnosing pancreatic cancer generally involves a combination of tests, including:
Computerized Tomography (CT scan): it uses X-rays to create detailed images of the pancreas and surrounding organs.
Magnetic Resonance Imaging (MRI): it uses magnetic fields and radio waves to create images of the pancreas.
Endoscopic ultrasound: it combines an ultrasound with an endoscopy to visualize the pancreas and obtain tissue samples (biopsy).
Positron Emission Tomography combined with Computed Tomography (PET-CT) or Magnetic Resonance Imaging (PET-MRI): these advanced techniques provide metabolic information about the tumor, helping to determine its extent and detect possible metastases.
Biopsy: it is the extraction of a small tissue sample for examination under the microscope to confirm the diagnosis.
Blood tests: blood tests can be performed to assess liver and kidney function and levels of tumor markers, such as CA 19-9, although this is not a definitive diagnostic marker.
Pancreatic cancer treatment is individualized according to the type, stage, and overall health of the patient. The goal of treatment may be curative (to eliminate the cancer) or palliative (to relieve symptoms and improve quality of life). Treatment options include:
Surgery: if the cancer is localized and has not spread to other organs, surgery may be an option to remove the tumor. The type of surgery depends on the location of the tumor. The most common surgery is pancreaticoduodenectomy (Whipple procedure), which is used to remove tumors in the head of the pancreas. Other surgeries include distal pancreatectomy (for tumors in the body or tail of the pancreas) and total pancreatectomy (for tumors that affect the entire pancreas).
Chemotherapy: it uses medications to destroy cancer cells. It can be given before surgery (neoadjuvant) to shrink the tumor, after surgery (adjuvant) to destroy remaining cancer cells, or as the main treatment for advanced or metastatic cancer.
Radiotherapy: it uses high-energy radiation to destroy cancer cells in a precise way.
HM Hospitales offers intensity-modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT), which allow for greater precision and minimize damage to healthy tissues.
Immunotherapy: it stimulates the patient’s immune system to recognize and destroy cancer cells. Some types of immunotherapy, such as immune checkpoint inhibitors, are being investigated as potential treatments for pancreatic cancer, although they have not yet been established as a standard treatment.
Pancreatic cancer treatment often involves a multidisciplinary approach, with the participation of surgeons, medical oncologists, radiation oncologists, gastroenterologists, radiologists, pathologists, and other specialists.
At HM Hospitales, clinical research is a priority in our fight against pancreatic cancer. We are committed to finding new and better treatment options for our patients. Currently, we participate in clinical trials that investigate innovative therapies, such as immunotherapy, which seeks to strengthen the immune system to fight cancer, as well as the use of state-of-the-art devices for more accurate diagnoses and targeted treatments that specifically attack cancer cells, minimizing side effects.https://www.hmhospitales.com/hm-ciocc/investigacion/
Remember that this article is for informational purposes only and does not replace professional medical advice. If you suspect you have pancreatic cancer, consult a specialist to obtain an accurate diagnosis and a treatment plan tailored to your needs.
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