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Overview

The pancreas is a gland about 6 inches long, shaped like a thin pear. It lies between the stomach and the spine. It has two main jobs in the body—to make juices that help digest (break down) food and to make hormones, such as insulin and glucagon, that helps control blood sugar levels. Pancreatic cancer is a disease in which malignant (cancer) cells form in the tissues of the pancreas.

Warning signs

  • Jaundice (yellowing of the skin and whites of the eyes)
  • Light-coloured stools
  • Dark urine
  • Pain in the upper or middle abdomen and back
  • Weight loss for no known reason
  • Loss of appetite
  • Feeling very tired

Some other symptoms are abdominal pain, back pain, fever with chills and vomiting.

Risk factors

  • Smoking
  • Being overweight
  • Old Age
  • Having a personal history of diabetes or chronic pancreatitis
  • Having a family history of pancreatic cancer or pancreatitis
  • Having certain hereditary conditions, such as multiple endocrine neoplasia type 1 (MEN1) syndrome, hereditary nonpolyposis colon cancer, hereditary breast and ovarian cancer syndrome, familial atypical multiple mole melanoma (FAMMM) syndrome

Progression

Stage I

The tumour is in the pancreas, has not spread to lymph nodes or other parts of the body

Stage II

The tumour extends beyond the pancreas, but has not spread to nearby arteries, veins, lymph nodes or other parts of the body

Stage III

The tumour has spread to nearby arteries, veins, and/or lymph nodes but has not spread to other parts of the body

Stage IV

Tumour has spread to other parts of the body (liver, peritoneum, lungs)

It can spread to adjuvant organ like small bowel, vessels, liver, lungs and give rise to jaundice and mass abdomen, back pain and vomiting.

Diagnosis

Primary diagnosis

Physical exam and history, blood chemistry studies, tumour marker tests

Advanced diagnosis

MRI, CT scan, and PET scan, abdominal ultrasound, endoscopic ultrasound, laparoscopy and biopsy (not mandatory)

Treatment in a nutshell

It is critical to get started on a treatment as soon as possible. Depending on the type and stage of the cancer and other factors, treatment options for people with pancreatic cancer can include:

  • Surgery
  • Ablation or embolization treatments
  • Radiation therapy
  • Chemotherapy and other drugs

Pain control is also an important part of treatment for many patients. Sometimes, the best option might include more than one type of treatment. Surgery offers the best chance of cure, for both proximal and distal parts of pancreas. Other options for advance tumours are endoscopic stenting (Jaundice and Vomiting), chemotherapy and radiotherapy.

Milestones

Tumours which are locally advance may need vascular resection and multi organ resection (both of which are being performed at Kokilaben Hospital).

Top tips

  • Avoid smoking, a major risk factor for pancreatic cancer.
  • Maintain a healthy weight.
  • Eat a low-fat diet.
  • Exercise regularly.
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