Pancreatic Cancer

Pancreatic cancer occurs when abnormal cells in the pancreas grow out of control, forming a mass of tissue called a tumour.

The pancreas lies behind the stomach and in front of the spine. It works to help the body use and store energy from food by producing hormones to control blood sugar levels and digestive enzymes to break down food.

Interesting Facts

  • Pancreatic cancer has one of the lowest survival rates of all cancers.
  • Survivalhas improved for most cancers over the last 40 years, but not for pancreatic cancer.
  • Pancreatic cancer is more common in developed countries but is on the rise in Africa.
  • Pancreatic cancer is slightly more common in men than in women.

The stages of pancreatic cancer are:

  • Stage 0: No spread. Pancreatic cancer is limited to top layers of cells in the ducts of the pancreas. The pancreatic cancer is not visible on imaging tests or even to the naked eye.
  • Stage I: Local growth. Pancreatic cancer is limited to the pancreas but has grown to less than 2 centimetres in diameter (stage IA) or greater than 2 centimetres, but no more than 4 centimetres (stage IB).
  • Stage II: Local spread. Pancreatic cancer is over 4 centimetres and is either limited to the pancreas or there is local spread where the cancer has grown outside of the pancreas, or has spread to nearby lymph nodes. It has not spread to distant sites.
  • Stage III: Wider spread. The tumour may have expanded into nearby major blood vessels or nerves, but has not metastasized to distant sites.
  • Stage IV: Confirmed spread. Pancreatic cancer has spread to distant organs.

Statistics

  • The 5-year survival rate for people with pancreatic cancer is 9%.
  • If the cancer is detected at an early stage when surgical removal of the tumour is possible, the 5-year survival rate is 34%. About 10% of people are diagnosed at this stage.
  • If the cancer has spread to surrounding tissues or organs, the 5-year survival rate is 12%. For the 52% of people who are diagnosed after the cancer has spread to a distant part of the body, the 5-year survival rate is 3%.
  • Pancreatic cancer is the twelfth most common cancer in the world.
  • The average lifetime risk of pancreatic cancer is about 1 in 64.

Signs and Symptoms

  • Jaundice: As pancreatic cancer blocks duct that releases bile into the intestine (common bile duct), the elements of bile build up in the blood. This turns the skin and the eyes yellow, a condition called jaundice. The same blockage causes dark urine, light-coloured stools, and itching.
  • Abdominal pain – Pancreatic cancer can cause a dull ache in the upper abdomen radiating to the back. The pain may come and go.
  • Back pain
  • Bloating – Some people with pancreatic cancer have a sense of early fullness with meals (satiety) or an uncomfortable swelling in the abdomen.
  • Nausea
  • Vomiting
  • Weight loss
  • Malaise
  • Loss of appetite
  • Elevated blood sugars – Some people with pancreatic cancer develop diabetes as the cancer impairs the pancreas’ ability to produce insulin. (However, most people with a new diagnosis of diabetes do not have pancreatic cancer).

Diagnosis

If your doctor suspects pancreatic cancer he may have you undergo one or more of these procedures.

  • Imaging tests that create pictures of your internal organs (CT, MRI or PET scans).
  • Using a scope to create ultrasound pictures of your pancreas.
  • Removing a tissue sample for testing (biopsy).
  • Blood test – Your doctor may test your blood for specific proteins (tumour markers) shed by pancreatic cancer cells.

Risk Factors

  • Gender – More men are diagnosed with pancreatic cancer than women.
  • Age – The risk of developing pancreatic cancer increases with age.
  • Race/ethnicity -Black people are more likely than Asian, Hispanic, or white people to develop pancreatic cancer.
  • Smoking – People who smoke are 2 to 3 times more likely to develop pancreatic cancer than those who don’t.
  • Obesity and dietRegularly eating foods high in fat is a risk factor for pancreatic cancer.
  • Chronic, heavy alcohol use can also increase the risk of pancreatic cancer.
  • DiabetesMany studies have indicated that diabetes, especially when a person has had it for many years, increases the risk of developing pancreatic cancer.

Treatment

Treatment for pancreatic cancer depends on the stage and location of the cancer as well as on your overall health and personal preferences. For most people, the first goal of pancreatic cancer treatment is to eliminate the cancer, when possible. When that isn’t an option, the focus may be on improving your quality of life and limiting the cancer from growing or causing more harm.

Treatments include:

  • Surgery
  • Chemotherapy
  • Radiation therapy
  • Clinical trials
  • Targeted therapy – is a treatment that targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival.
  • Immunotherapy, also called biologic therapy – is designed to boost the body’s natural defences to fight the cancer.