Pancreatic cancer is cancer originating in the pancreas.
Sx
Asymptomatic, usually in the disease's early stages
If a cancer in the head of the pancreas, obstructs the common bile duct, as it runs through the pancreas:
Jaundice (i.e. yellow tint in the white of the eyes or skin)
Light colored stools
Dark urine
Abdominal pain
Back pain
Cachexia (unexplained weight loss)
Loss of appetite
Patient information
What does having cancer of the pancreas look like?
Let's start with what the pancreas it. It is part of the digestive system, producing digestive enzymes. As you can see, it can be very vague type things, like weight loss, or loss of appetite.
Why do you become yellow?
That's called jaundice. And it's caused by the yellow pigment, bilirubin, seeping throughout the body.
Given that bile is made in the liver, and stored in the gallbladder, how is it related to pancreas cancer?
The vessel where bile runs out to the small intestine, the common bile duct, runs through the head of the pancreas. So if there's a cancer in the pancreas, it obstructs this vessel, causing bilirubin to build up and seep out throughout the body.
Pathophysioogy
Occurs when cells in the pancreas (i.e. glandular organ behind the stomach) begin to multiply out of control and form a mass
These cancers have the ability to invade other parts of the body
Risk factors
Tobacco smoking (25% of cases)
Obesity
Diabetes
Certain rare genetic conditions (7%)
Protective factors:
Stop smoking, decreases the chance of developing pancreatic cancer, and almost returns to that of the general population after 20 years
Maintain a healthy weight
Limit consumption of red or processed meat
Classification
Exocrine cancers (99%), which occurs in the exocrine component, which produces digestive enzymes. It includes:
Pancreatic adenocarcinoma, the most common (85% of cases). It starts within the part of the pancreas which makes digestive enzymes
Non-adenocarcinomas, includes several other types of cancer, can also arise from the cells of the pancreas
Pancreatic neuroendocrine tumors (PanNET, islet cell tumor) (1.5%), which arise from the hormone-producing cells of the pancreas. They are generally less aggressive than pancreatic adenocarcinoma. It includes:
Insulinoma, which is a tumor of the beta cells, that secretes insulin (i.e. reduces blood glucose)
Gastrinoma, which is a tumor of the pancreas or duodenum, that secretes excess gastrin (i.e. secretes gastric acid in the stomach) leading to ulceration in the duodenum, stomach and small intestine
Dx
Medical imaging, e.g. U/S or CT
Blood tests
Biopsy (examination of tissue samples)
Ix
Staged into 4 stages, from early (stage 1) to late (stage 4)
Tx
Screening, has NOT been found to be effective
Based upon staging, a combination of:
Surgery, the only Tx that can cure the disease, but can also be done to improve the quality of life w/o potential for cure
Radiotherapy
Chemotherapy
Palliative care, recommended early in even those receiving Tx that aims for a cure
Pain Mx
Drugs to improve digestion
Prognosis
Pancreatic adenocarcinoma has very poor prognosis
After Dx, 25% of Pt's survive 1 year, and 5% live for 5 years
For cancers Dx early, the 5-year survival rate rises to about 20%
Metastatic spread is usually to, all of which occur in 50%+ of fully advanced cases:
Liver
Peritoneal cavity
Lungs
Neuroendocrine cancers have better outcomes, at 5 years from Dx, 65% are living, although survival varies considerably depending on the type of tumor
Epidemiology
Sx that are specific enough to suspect pancreatic cancer typically don't develop until the disease has reached an advanced stage, when pancreatic cancer has often metastasized to other parts of the body
Rarely occurs <40yo
>50% occur in those >70yo
7th most common cause of cancer deaths, resulting in 330k deaths globally
In the USA, the 4th most common cause of deaths due to cancer
Occurs most often in the developed world, where 70% of new cases occur annually
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