Table of contents:
- Definition
- What is pancreatic cancer?
- How common is pancreatic cancer?
- Signs & symptoms
- What are the signs and symptoms of pancreatic cancer?
- Yellowing of the skin and eyes (jaundice)
- Stomach pain or back pain
- Nausea and vomiting
- Swelling of the gall bladder and liver
- Blood clots
- When to see a doctor?
- Causes & risk factors
- What are the causes of pancreatic cancer?
- What increases the risk of pancreatic cancer?
- Diagnosis & Treatment
- How is pancreatic cancer diagnosed?
- What are the treatment options for pancreatic cancer?
- Operation
- Chemotherapy
- Radiotherapy
- Home care
- What lifestyle changes and home care can help to cure pancreatic cancer?
- Prevention
- How do you prevent pancreatic cancer?
Definition
What is pancreatic cancer?
Pancreatic cancer is a type of cancer that starts in the pancreas. The pancreas is a gland that is located behind the stomach and just in front of the spine.
The job of this gland is to help digest food, and produce various hormones including insulin to control blood sugar levels.
The most common type of pancreatic cancer is exocrine cancer. This type is subdivided into pancreatic adenocarcinoma which usually starts from the pancreatic duct. In a few cases, it occurs in cells that make pancreatic enzymes (acinar cell carcinoma).
Then, there is also ampullary cancer, which starts in the ampulla vater (the area where the bile duct and pancreatic duct join and empties into the small intestine). This type of cancer can cause blockages in the bile ducts.
Pancreatic cancer is a non-communicable disease. Therefore, joint activities with cancer sufferers, such as eating together or making physical contact will not cause the disease to transfer to healthy people.
How common is pancreatic cancer?
Pancreatic cancer is a type of cancer that is quite common in Indonesian society. It was recorded that there were 4,940 new cases in 2018 with a death rate of 4,812 people, as reported by Globocan.
Signs & symptoms
What are the signs and symptoms of pancreatic cancer?
Pancreatic cancer symptoms vary widely. That is why everyone is very likely to experience different symptoms. There are those who feel the characteristics of pancreatic cancer at an early stage, or some are just experiencing symptoms at the late stage.
More specifically, recognize the following very common signs and symptoms of pancreatic cancer:
Yellowing of the skin and eyes (jaundice)
This condition indicates yellowing of the skin and whites of the eyes, and it is one of the early symptoms experienced by people with pancreatic cancer.
Jaundice occurs when bilirubin or a yellow-brown substance produced by the liver builds up in the bile ducts due to growing abnormal cell tissue (malignant tumor).
This symptom is sometimes accompanied by dark urine, itchy skin, pale and oily stools. This could be a sign that the cancer has reached the liver.
Stomach pain or back pain
Pancreatic cancer also commonly causes symptoms of abdominal pain or back pain. The abnormal cells that appear in the tail of the pancreas, can grow large and begin to press on nearby organs and nerves, causing pain.
Nausea and vomiting
When the tumor presses on the end of the stomach, it will make it difficult for food to pass. As a result, you will continue to experience symptoms of pancreatic cancer in the form of nausea and vomiting. In the long run, this condition can make your appetite worse and you lose weight dramatically.
Swelling of the gall bladder and liver
Cancer cells that have blocked the bile ducts, can make bile build up. As a result, the size of the bile will be much larger. Sometimes doctors can feel this swelling, which is a large lump under the right side of the ribs.
In addition, the symptom that is also being felt is an enlarged liver. This condition shows symptoms of end-stage pancreatic cancer because the cancer has spread to healthy organs. Swelling can sometimes be seen and is characterized by swelling under the right rib.
Blood clots
Blood clots can sometimes also be a symptom of cancer, and are characterized by pain, swelling, redness, and warmth in the legs. When the blood clot breaks and travels to your lungs, you will have difficulty breathing and chest pain.
When to see a doctor?
If you experience the above symptoms of cancer, check with your doctor. Especially if symptoms do not improve after general treatment, they get worse over time.
Causes & risk factors
What are the causes of pancreatic cancer?
The cause of pancreatic cancer is not certain. However, pancreatic cancer occurs when the DNA changes in the cells. DNA itself contains a series of commands for cells to function properly.
When a gene mutation occurs, a series of commands within it can be damaged. As a result, cells act abnormally. Cells will continue to divide without control and do not die, thus forming a malignant tumor.
Gene mutations can be inherited from parents, can also be owned by a person after birth. Several types of genes that are prone to mutating and causing pancreatic cancer are p16 , TP53, KRAS, BRAF, and DPC4 (SMAD4).
What increases the risk of pancreatic cancer?
Although the cause of pancreatic cancer is not known with certainty, experts have already found a number of factors that can increase the risk, such as:
- Have a smoking habit or continue to be exposed to secondhand smoke.
- Being overweight (obesity), the risk increases by 20 percent.
- There are problems with the pancreas, such as diabetes or chronic pancreatitis (inflammation of the pancreas).
- Being exposed to certain chemicals in the workplace
- Age over 45 years and the risk increases at age 65 years and over.
- This disease affects men more often than women.
- Family history of pancreatic cancer.
- There are conditions associated with genetic defects, such as Lynch syndrome and Peutz-Jeghers syndrome.
Diagnosis & Treatment
This information cannot be used as a substitute for medical advice. Please ALWAYS consult a doctor.
How is pancreatic cancer diagnosed?
In order to make a diagnosis of pancreatic cancer, the doctor will perform the following medical tests:
- Physical examination. The doctor will ask about the symptoms you are experiencing, as well as check for swelling, and the color of your skin and whites of your eyes.
- Imaging test.This test is done to check for tumors, find out the location and how big the tumor is. These tests can include a CT scan, MRI, ultrasound, PET scan, and cholangiopancreatography (a special test to examine the pancreatic and bile ducts).
- Blood test.This test can detect pancreatic cancer by measuring the levels of CA 19-9 and carcinoembryonic antigen (CEA) in the blood.
- Biopsy. A test to make sure a tissue is cancerous or not by taking a small amount of tissue as a sample.
After the test is done, the doctor can determine the stage of the cancer, namely:
- Stage 1: cancer is still in the inside of the pancreas. The size of the tumor in the pancreas is less or more than 2 cm.
- Stage 2: cancer has started in the initial area of the small intestine, bile duct, or lymph nodes near the pancreas. Tumor size more than 4 cm.
- Stage 3: cancer has spread to the area of the stomach, spleen, large intestine, or blood vessels near the pancreas.
- Stage 4: cancer has spread to other parts of the body, such as the lungs, liver, or the lining inside the stomach wall (peritoneum).
What are the treatment options for pancreatic cancer?
Pancreatic cancer can be cured, but it depends on the stage, age, and the patient's overall health. Pancreatic cancer stages 1,2, and 3 that are not too severe can be cured.
However, some patients with stage 3 and 4 pancreatic cancer cannot recover from this disease because the cancer cells have spread to other areas of the body. Medication is still being carried out to help relieve symptoms while improving the patient's quality of life.
How to treat pancreatic cancer that doctors usually recommend is:
Operation
Surgery is the treatment for cancer from early stage to stage 4, which is the most recommended. If the tumor is in the head of the pancreas, the surgery is Whipple (pancreaticoduodenectomy).
Meanwhile, surgery for tumors on the body and tail of the pancreas is called distal pancreatectomy. The pancreas can also be completely removed, even lifting the blood vessels around the affected area.
The side effects that may occur after this surgery are bleeding and infection.
Chemotherapy
The next way to treat pancreatic cancer is chemotherapy, using drugs that kill cancer cells. Medicines commonly used in the treatment of cancer that has not spread are:
- Gemcitabine (Gemzar).
- 5-fluorouracil (5-FU).
- Oxaliplatin (Eloxatin).
- Albumin-bound paclitaxel (Abraxane).
- Capecitabine (Xeloda).
- Cisplatin.
- Irinotecan (Camptosar).
If it has spread, the drugs recommended in chemotherapy are:
- Gemcitabine (Gemzar).
- 5-fluorouracil (5-FU) or Capecitabine (Xeloda).
- Irinotecan (Camptosar) or Liposomal Irinotecan (Onivyde).
- Platinum agents: Cisplatin and Oxaliplatin (Eloxatin).
- Taxanes: Paclitaxel (Taxol), Docetaxel (Taxotere), and Albumin-bound paclitaxel (Abraxane).
Possible side effects of chemotherapy include nausea, vomiting, diarrhea, hair loss, and mouth sores.
Radiotherapy
Apart from chemotherapy, this cancer can also be treated with radiotherapy. This treatment relies on beams of radiation to shrink the size of the tumor and kill cancer cells.
Side effects that may occur from radiotherapy are skin problems, nausea and vomiting, and body fatigue.
Home care
What lifestyle changes and home care can help to cure pancreatic cancer?
Home care will focus on adopting a healthy lifestyle for cancer patients. One of them, choosing healthy foods for cancer, such as fruits, vegetables, nuts, seeds, and low-fat dairy products.
Then, limit your consumption of foods high in fat, meat, and foods high in sugar. In addition, stop drinking alcohol and smoking.
Currently the use of traditional medicine (herbal) for pancreatic cancer is being developed by scientists. However, no one has really been effective in treating cancer. So, always consult your doctor first if you want to use these drugs.
Prevention
How do you prevent pancreatic cancer?
There is no sure way to prevent pancreatic cancer. However, health experts argue that preventive measures can be taken by reducing the risk, such as:
- Quit smoking and drinking alcohol
This habit can increase the risk of developing pancreatitis, which can also increase the risk of cancer in the same organ.
- Control your weight
Obesity can increase the risk of many types of cancer. Therefore, you must pay attention to your ideal body weight by maintaining a diet and being diligent in exercising.
- Avoid chemical exposure
Certain chemicals can increase the risk of this type of cancer. So, always use protective equipment and be careful when working.