Pancreatic Cancer: Symptoms, Diagnosis, and Treatment Options

Pancreatic cancer is a life-threatening disease that originates in the pancreas, an organ essential for producing digestive enzymes and regulating blood sugar levels through the release of insulin. Despite its relatively low incidence compared to other cancers, pancreatic cancer is often deadly due to its aggressive nature and the difficulty in detecting it at an early stage. Read on to learn about the symptoms, diagnosis, and treatment options for pancreatic cancer.

What is Pancreatic Cancer?

Pancreatic cancer occurs when abnormal cells in the pancreas begin to grow uncontrollably, forming a tumour. The pancreas, located behind the stomach, plays a dual role in the body by assisting with digestion and regulating blood sugar levels. Cancer in this organ disrupts these essential functions and can spread rapidly to other parts of the body if not caught early.

There are two main types of pancreatic cancer

1. Exocrine tumours, which account for about 95% of cases, originate in the cells that produce digestive enzymes.

2. Endocrine tumours (also called neuroendocrine tumours) develop in the hormone-producing cells of the pancreas. Though less common, they tend to have a better prognosis than exocrine tumours.

Pancreatic cancer is often referred to as a "silent killer" because symptoms rarely present themselves until the disease is in an advanced stage.

Symptoms of Pancreatic Cancer

One of the challenges in diagnosing pancreatic cancer early is that its symptoms are often vague and easily mistaken for other conditions. However, certain signs can indicate the presence of the disease, particularly if they persist or worsen over time.

1. Abdominal Pain

Pain in the upper abdomen or back is a common symptom of pancreatic cancer. As the tumour grows, it can press on nearby organs or nerves, causing discomfort. The pain may be more noticeable after eating or when lying down.

2. Jaundice

Jaundice, which causes the skin and the whites of the eyes to turn yellow, is often one of the first noticeable symptoms of pancreatic cancer. This occurs when the tumour blocks the bile duct, preventing bile from draining properly and leading to a buildup of bilirubin in the blood.

3. Weight Loss and Appetite Loss

Unexplained weight loss and a significant decrease in appetite are common among pancreatic cancer patients. This occurs partly due to the cancer’s interference with the body’s ability to digest food and absorb nutrients.

4. Digestive Issues

Pancreatic cancer can cause a range of digestive issues, including nausea, vomiting, and diarrhoea. The inability to properly digest fats may result in greasy, floating stools.

5. New-Onset Diabetes

Because the pancreas is responsible for insulin production, pancreatic cancer can disrupt blood sugar regulation, sometimes leading to the sudden development of diabetes in adults without other risk factors.

Diagnosis of Pancreatic Cancer

When pancreatic cancer is suspected, healthcare providers typically use a combination of imaging tests and biopsies to confirm the diagnosis. Here are the primary diagnostic tools:

1. Imaging Tests

Imaging tests such as CT scans, MRI scans, and ultrasounds are commonly used to detect tumours in the pancreas. These tests provide detailed images of the pancreas and surrounding structures, helping doctors locate the cancer and determine its size.

2. Endoscopic Ultrasound (EUS)

An EUS involves using a small tube with an ultrasound probe at the end, which is passed through the mouth and into the stomach. This allows doctors to obtain high-quality images of the pancreas and perform a biopsy if needed.

3. Biopsy

A biopsy, which involves removing a small sample of tissue for examination, is usually required to confirm a diagnosis of pancreatic cancer. The tissue is analysed under a microscope to determine whether it is cancerous.

4. Blood Tests

Some pancreatic tumours release specific proteins into the blood, such as CA19-9, which can serve as tumour markers. While these markers are not specific enough for early diagnosis, they can help monitor the progression of the disease or the effectiveness of treatment.

Treatment Options for Pancreatic Cancer

The treatment for pancreatic cancer depends largely on the stage of the disease and the patient’s overall health. Common treatments include surgery, chemotherapy, and radiation therapy, often used in combination to achieve the best possible outcomes.

1. Surgery

Surgery is the primary treatment option for pancreatic cancer that has not spread beyond the pancreas. The most common surgical procedure is the Whipple procedure (pancreaticoduodenectomy), which involves removing the head of the pancreas, part of the small intestine, bile duct, and sometimes a portion of the stomach.

In some cases, surgery may be used to remove tumours from other parts of the pancreas or to relieve symptoms caused by a blockage of the bile duct or intestine.

2. Chemotherapy

Chemotherapy uses powerful drugs to kill cancer cells or stop them from growing. It is often used before or after surgery to reduce the size of the tumour or destroy any remaining cancer cells. For patients whose cancer cannot be surgically removed, chemotherapy can help slow the progression of the disease and alleviate symptoms.

3. Radiation Therapy

Radiation therapy uses high-energy rays to target and kill cancer cells. It is sometimes combined with chemotherapy to increase its effectiveness. Radiation may be used before surgery to shrink the tumour or after surgery to kill any remaining cancer cells.

4. Targeted Therapy

Targeted therapies are newer treatments that specifically attack cancer cells without harming healthy cells. These drugs work by targeting specific molecules involved in cancer cell growth. Erlotinib is one such drug used to treat advanced pancreatic cancer.

5. Immunotherapy

Immunotherapy is a treatment that boosts the body’s immune system to fight cancer. While still being researched, immunotherapy has shown promise for some patients with advanced pancreatic cancer.

Pancreatic cancer is a challenging disease due to its subtle symptoms. However, advancements in diagnostic techniques and treatment options offer hope to patients. Awareness of the symptoms and risk factors, as well as the importance of early diagnosis, is vital to improving outcomes.