World Pancreatic Cancer Day was commemorated on November 21. This is a day intended to educate the public about the risks and symptoms of pancreatic cancer and the treatment options available for it.
The pancreas is a gland in your abdomen, between your spine and the stomach. In an adult, it is about 15 centimetres long and resembles a pear lying on its side. It is segmented into a head (surrounded by the initial part of the intestines-duodenum), neck and the tail which projects behind the stomach.
The pancreas secretes hormones (namely insulin and glucagon) into the blood stream to regulate sugar levels as well as producing and secreting enzymes through ducts into the digestive system. These enzymes help breakdown fats into smaller absorbable units.
Pancreatic cancer occurs when cells in your pancreas develop changes (mutations) in the regulatory genes, resulting in the abnormal growth and multiplication of cells exceeding the normal rate at which new cells replace dead cells. Programmed cellular death may also be disrupted resulting in too many cells. The cells of the ducts are the most common cancer of the pancreas (ductal cancer), mainly the head.
These cancerous cells may then form a mass known as a tumour, which can grow and invade and destroy healthy body tissues, resulting in their mutating and multiplying out of control, forming a tumour.
The tumour can grow to invade and destroy healthy body tissue. As times goes on, cancer cells can break away and spread to other parts of the body.
Treatments include surgery, chemotherapy and radiation therapy. However, pancreatic cancer survival rates are low because the disease is difficult to detect in the early stages. Symptoms often only become apparent after the cancer has spread and invaded other organs nearby or at a distance.
Types of pancreatic cancer
Most pancreatic cancer begins in the cells that line the ducts of the pancreas. This type of cancer is called pancreatic ductal adenocarcinoma or pancreatic exocrine cancer.
Less often, cancer can form in the hormone-producing cells or the neuroendocrine cells of the pancreas. These types of cancer are called pancreatic neuroendocrine tumours or pancreatic endocrine cancer.
Symptoms
In most cases, pancreatic cancer does not cause symptoms until the disease is advanced. When this happens, some of the signs and symptoms may include abdominal pain that spreads to the sides or back, loss of appetite, involuntary weight loss, jaundice and itching.
Other symptoms include light-coloured or floating stools, dark-coloured urine, a new diagnosis of diabetes or diabetes that suddenly becomes difficult to control, pain and swelling in an arm or leg which might be caused by a blood clot, tiredness and weakness.
Causes and risk factors
It is unclear what causes pancreatic cancer. Doctors have found some factors that might raise the risk of this type of cancer. These include smoking and having a family history of pancreatic cancer.
Other factors that might raise the risk of pancreatic cancer include type 2 diabetes, chronic inflammation of the pancreas called pancreatitis, obesity or being overweight and drinking a lot of alcohol and coffee.
Your risk of pancreatic cancer also increases with age. It is uncommon to be diagnosed with pancreatic cancer before the age of 45. According to the National Cancer Institute, nearly two-thirds of patients are 65 or older at the time of diagnosis.
Prevention
If you are someone with a high risk of pancreatic cancer, screening to look for signs of pancreatic cancer is important, especially if you do not have symptoms.
Your risk might be high if you have a strong family history of pancreatic cancer .
Pancreatic cancer screening usually involves genomics screening, imaging tests, such as MRI/Abdominal CT scan and ultrasound.
The main objective of screening is to find pancreatic cancer when the tumour that may be forming is small and the cancer most likely curable. Research is ongoing, so it is still not yet clear whether screening can lower the risk of dying from pancreatic cancer.
You should inform your doctor if you have a family history of pancreatic cancer. The healthcare team can review your family history and help you understand whether genetic testing might be right for you.
Genetic testing can find DNA changes that run in families and increase the risk of cancer. If you are interested in genetic testing, you may be referred to a healthcare professional who trained and specialised in genetics.
Lowering your risk
There are several ways of reducing your risk of pancreatic cancer. Stop smoking, if you practise this habit. Seek professional help to find out the best method that may help you stop smoking.
Drink alcohol only in moderation. Maintain a healthy weight. If you are at a healthy weight, work to maintain it by exercising and sticking to a healthy diet. Choose a diet rich in vegetables, fruit and whole grains with smaller portions.
If you need to lose weight, aim for a slow, steady weight loss. Work with a dietician to achieve the best results. Target to lose around half to one kilogram per week.
Exercising most days of the week can also help you lose weight. Slowly increase the amount of exercise every week but make sure you do not overexert yourself.
Cimas members can seek the advice of the multidisciplinary Cimas iGo team, which includes dieticians and wellness and fitness coaches.
Treatment
Treatment depends on the stage of the cancer and its location, as well as your overall health and preferences. Surgery to remove the cancer, radiation and chemotherapy or a combination of these are possible forms of treatment if the cancer is not too advanced.
If it is advanced, then these treatments are not likely to help. Treatment then will most likely consist of efforts to relieve the symptoms, including any pain, and making you as comfortable as possible.
