Pancreas and Pancreatic Cancer

The pancreas is an elongated glandular organ, approximately 18 to 20 cm long, located deep in the abdomen, between the stomach and the spine.

It is divided into three parts: the largest is called the head and is in close contact with the duodenum, the middle part is called the body, and the thinnest part, which extends to the spleen, is called the tail.

The pancreas produces a number of very important hormones, including insulin and glucagon (which regulate blood sugar) and various enzymes (e.g., trypsin), which are transported by the pancreatic ducts into the intestine and contribute to the digestion and absorption of nutrients.

Pancreatic cancer occurs when cells, in most cases ductal-type cells, multiply uncontrollably.

Causes of Pancreatic Cancer

Various conditions underlie pancreatic cancer such as adenocarcinoma, but the mechanism promoting its development is unclear. The main known risk factors are smoking, obesity, and type 2 diabetes. There is currently no early detection and screening system, as exists for other types of cancer, such as mammography for breast cancer and colonoscopy for colorectal cancer. Pancreatic cancer can be hereditary, especially if at least two first-degree relatives are affected. Twenty percent of familial pancreatic cancers are caused by genetic mutations.

Signs and Symptoms of Pancreatic Cancer

Often, signs suggestive of a pancreatic tumor are mistaken for symptoms of liver or stomach problems due to the compression of the tumor mass on these organs and their structures.

Early symptoms of pancreatic cancer, which are difficult to link to the disease, include:

• Jaundice (the skin and eyes turn yellowish) due to a liver problem caused by the pancreatic tumor affecting bile function;
• Sudden onset of diabetes: this can be an early symptom, especially when it appears in the absence of a family history;
• Depression. Shortly after its appearance, for unknown reasons, pancreatic cancer would induce a decrease in mood, classifiable as depression, which precedes the diagnosis.

The most recurrent signs are:

• Generalized itching.
• Upper back pain, due to the pancreas' location near the spine.
• Stomach pain.
• Nausea, loss of appetite, indigestion.
• Sudden unexplained weight loss.
• Dark urine.
• Light-colored stools.

[dt_sc_button title="Free Quote" size="medium" style="bordered" icon_type="" link="url:https%3A%2F%2F127.0.0.1/tds%2Fdevis%2F" textcolor="#ffffff" bgcolor="#0c73ba">

Treatment of Pancreatic Cancer

Traditional Approaches

In operable pancreatic tumors, surgery is indicated, followed, if necessary, by adjuvant chemotherapy. In the case of locally advanced disease, chemotherapy may be followed by surgery for cases achieving operability, or even chemo-radiotherapy.

There are three surgical approaches:

• Duodenopancreatectomy. A very long name to designate the removal of the head of the pancreas and a part of the small intestine, which also includes a part of the surrounding healthy tissues.
• Total pancreatectomy. Several parts of your body are removed, including the entire pancreas, part of the small intestine and stomach, the common bile duct, the gallbladder, the spleen, and several lymph nodes located in this area.
• Distal pancreatectomy. When only the duodenum and the tail of the pancreas are removed.

A biliary bypass is also performed when the mass obstructs the ducts and does not allow the passage of bile from the liver to the small intestine.

Minimally Invasive Surgery in the Treatment of Pancreatic Cancer

Surgical therapy offers better chances of survival, but it is unfortunately feasible in less than 20% of cases, as the diagnosis is usually made at an advanced stage of the disease. In addition, it is a surgery that presents a high level of complexity, which has significant consequences on the length of hospitalization and the patient's functional recovery. Over the past ten years, efforts have focused on improving the disease diagnosis process and reducing the surgical impact on operable patients. In particular, interest in the laparoscopic approach, i.e., minimally invasive, has increased considerably, and the need to increasingly extend it in clinical practice has been asserted. International experts confirm that when the tumor is located in the body and tail of the pancreas, the minimally invasive technique yields better results than the traditional open approach.

Why is Pancreatic Cancer Diagnosis Difficult?

Pancreatic cancer is almost always discovered incidentally, during diagnostic tests for other diseases. Unfortunately, by the time symptoms appear, the cancer has spread to other organs, as some types of pancreatic cancer reach the vessels that radiate to the liver, producing widespread metastases. This could explain why, on average, only one in ten people with pancreatic cancer have localized cancer that has not yet spread. This explains why surgical removal of the tumor may often be insufficient, or even useless, if metastases already exist.

In people where pancreatic cancer is detected at an early stage, the probability of survival is six times higher. This explains why the search for substances (markers) that allow for early detection of cancer is particularly important for these pancreatic cancers.

It is difficult to recommend effective prevention, as not all the causes of pancreatic cancer are known. It is undoubtedly important not to smoke and to follow a diet rich in fruits and vegetables and low in alcohol.