Pancreatic cancer is growing cancer in network pancreas. Pancreatic cancer could experienced by anyone, but more often happen to people aged on 55 years.
The pancreas has a number of important functions for the body, including producing the hormones glucagon and insulin, which are responsible for maintaining stable blood sugar levels in the body. The pancreas also produces enzymes that help the body to digest the nutrients in food.
Pancreatic cancer occurs when cells in the pancreas grow abnormally and uncontrollably. The early stages of this cancer are often asymptomatic. Usually, new symptoms appear when the cancer has spread to other organs of the body.
Pancreatic cancer is one of the most deadly types of cancer. Of all cases of pancreatic cancer, only about 9 percent of patients who can survive up to 5 years after being diagnosed with this disease.
Types of Pancreatic Cancer
Pancreatic cancer is divided into two types, namely:
Pancreatic adenocarcinoma
Pancreatic adenocarcinoma is pancreatic cancer that grows from exocrine cells, which are cells that produce pancreatic enzymes. It is estimated that 95 percent of all pancreatic cancer cases are pancreatic adenocarcinoma.
Pancreatic neuroendocrine tumors (NETs)
Pancreatic neuroendocrine tumors is a type of pancreatic cancer that grows in endocrine cells, which are cells that produce hormones and manage blood sugar levels.
Reason and Risk Factors Pancreatic Cancer
It is not known exactly what causes pancreatic cancer. However, there are several factors that can increase a person's risk of developing pancreatic cancer, namely:
- Over 55 years old
- Have excess weight
- Have blood type A, B, or AB
- Have diabetes, chronic pancreatitis, gingivitis, or periodontitis
- Suffering from a bacterial infection Helicobacter pylori, hepatitis C, gallstones, or cirrhosis of the liver
- Have a history of genetic disorders that can increase your risk of cancer, such as neurofibromatosis type 1, a family history of ovarian or breast cancer, and a family history of pancreatitis
- Have a family history of pancreatic cancer
- Eating too much red meat
- Consuming alcoholic beverages
- Smoke
Symptoms of Pancreatic Cancer
Pancreatic cancer in its early stages generally does not cause symptoms. However, as cancer cells develop and reach an advanced stage, symptoms that can appear include:
- Loss of appetite
- Weight loss for no apparent reason
- Itchy skin
- Bloated
- Nausea and vomiting
- Diarrhea
- Constipation
- Dark urine
- Pale stools
- Body tired easily
- Yellowing of the skin and whites of the eyes (sclera)
- Blood clotting
- Stomach pain that radiates to the back
- Fever or chills
Pancreatic cancer can also trigger the emergence of other diseases, such as diabetes and depression. However, often these diseases are not recognized as part of the symptoms of pancreatic cancer.
When to go to the doctor
Check with your doctor if you experience the above symptoms, especially if you are at risk for pancreatic cancer. Also, tell your doctor if you have a family history of pancreatic cancer or any genetic disease. Your doctor may recommend that you undergo pancreatic cancer screening.
For patients who have undergone treatment, continue to check with the doctor regularly. Examination is still needed even though the cancer has been successfully removed, to prevent the possibility of cancer cells growing again.
Pancreatic Cancer Diagnosis
The doctor will ask about the patient's symptoms and medical history, including asking about the patient's lifestyle, such as smoking habits and diet. Next, the doctor will perform a physical examination, including by looking for signs of jaundice and detecting a lump in the stomach.
After that, the doctor can also run several supporting tests to confirm the diagnosis, such as:
- A blood test, to detect the protein CA19-9 and to measure levels of the hormones insulin, glucagon, and somatostatin, which are linked to pancreatic cancer cells
- Scans with CT scans, PET scans, or MRIs, to see the condition of the pancreas and other organs in the body
- Endoscopic ultrasound (EUS), to see the condition of the pancreas from inside the stomach with endoscopy and ultrasound
- Endoscopic retrograde cholangiopancreatography (ERCP), which is an endoscopy assisted by X-rays, to determine the condition of the bile ducts and pancreas
- Octreotide scan or octreoscan, to detect the presence of pancreatic cancer originating from endocrine cells
- Biopsy or sampling of tissue suspected of being pancreatic cancer for further investigation with a microscope
After the patient is confirmed to have pancreatic cancer, the doctor will determine the severity of the pancreatic cancer. This determination will help the doctor in choosing the right treatment method.
The following is the stage or severity of pancreatic cancer:
- Stage 0 (carcinoma in situ)
At this stage, abnormal cells are found in the walls of the pancreas, but they are not yet cancerous and have not spread.
- Searlier 1
Stage 1 indicates that the cancer is only in the pancreas and has not spread to other organs, with the size of the cancer between 2-4 cm.
- Stage 2
In stage 2, the cancer is larger than 4 cm or has spread to the lymph nodes around the pancreas.
- Stage 3
Stage 3 indicates that the cancer has spread to nerves, large blood vessels, or to more than 4 lymph nodes near the pancreas, but has not spread to other organs.
- Stage 4
Stage 4 means the cancer has spread widely to other organs of the body that are far from the pancreas, such as the lungs, liver, or peritoneum (the membrane that lines the inner wall of the stomach).
Pemedicine Pancreatic Cancer
Treatment for pancreatic cancer will be tailored to the stage of cancer, the part of the pancreas that is affected by cancer, and the patient's overall condition. The goal of treatment is to get rid of cancer cells so they don't spread to other organs.
Some methods that doctors can use to treat pancreatic cancer are:
Chemotherapy
Chemotherapy is the administration of special drugs to kill cancer cells. The drug given can be a single drug or a combination, either in the form of drinking (oral), injection, or infusion.
Chemotherapy can be used in early or advanced pancreatic cancer to shrink or control the growth of the cancer.
Radiotherapy
Radiotherapy or radiation therapy is a procedure to destroy cancer cells, using high-energy rays, such as X-rays and protons. Radiation therapy can be done before or after surgery.
Radiotherapy can be combined with chemotherapy (chemoradiation). Usually, this combination is done before surgery to shrink the size of the cancer so that it is easier to remove.
Chemoradiation can also be done after surgery to reduce the risk of pancreatic cancer coming back. In addition, chemoradiation can also be performed on pancreatic cancer that cannot be treated with surgery.
Operation
Surgery is performed on pancreatic cancer that has not spread to other organs. Some of the types of surgery that can be performed are:
- Whipple surgery or pancreaticoduodenectomy, which is surgery to remove the head of the pancreas and parts of other organs, such as the duodenum, gallbladder, bile ducts, lymph nodes, stomach, and large intestine
- Distal pancreatectomy, which is surgery to remove the left side of the pancreas and, if necessary, the patient's spleen
- Total pancreatectomy, which is a procedure to remove the entire pancreas
Please note, not all pancreatic cancer can be treated with surgery, as in cancer that has spread to large blood vessels, or if the patient also has liver failure or advanced heart failure. The reason is, in these conditions, the risk of complications due to surgery will be greater.
In addition to the methods above, there are also several treatment methods that doctors can use to relieve symptoms, namely:
- Administration of opioid analgesics for pain relief
- Giving antidepressants accompanied by counseling to relieve depression
- Operation bypass and placement of a stent in the bile duct, to relieve the symptoms of jaundice, itching, and loss of appetite
Pancreatic Cancer Complications
Pancreatic cancer can develop and cause a number of complications, such as:
- Weight loss, which can occur because the pancreas does not produce enough digestive enzymes, or because the cancer presses on the stomach, making it difficult for the patient to eat
- Jaundice, which can result from cancer blocking the bile ducts
- Abdominal pain, due to cancer cells in the pancreas continuing to grow and pressing the nerves in the stomach
- Obstruction or blockage of the intestine, due to pancreatic cancer pressing the duodenum, so that food that has been digested in the stomach cannot go down to the intestine
Pancreatic Cancer Prevention
It is not known how to prevent pancreatic cancer. However, the risk of developing pancreatic cancer can be reduced by doing the following:
- Quit smoking
- Reduce or measure the consumption of alcoholic beverages
- Eat a balanced nutritious diet
- Maintain ideal body weight