The pancreas is an organ in the upper abdomen and is located behind the stomach, above the level of the belly button. It is located in close proximity to many important structures like the small intestine and important blood vessels and nerves. The pancreas performs two key functions: an endocrine function (makes insulin to regulate blood sugar levels) and exocrine function (produce digestive enzymes to help break down foods).
In pancreatic cancers, cancer cells can develop from both types of cells with endocrine (hormonal) and exocrine (digestive) functions.
Pancreatic Cancer Symptoms
The incidence of pancreatic cancer in Singapore has increased over the years, and is one of the common cause of cancer deaths for both males and females.
Symptoms of pancreatic cancer may not appear until it has grown and developed further. Pancreatic cancer is also more frequently diagnosed in advanced stages as compared to early on in the course of the disease. Early first signs can be absent or quite subtle. Most pancreatic cancers are found after the cancer has grown or progressed, and it is highly lethal as it grows and spreads rapidly.
In advanced stages, symptoms of pancreatic cancer can occur such as:
- Nausea and vomiting
- Poor appetite and weight loss
- Abdominal bloating
- Back pain and abdominal pain
- Pale/Greasy stools
- Dark urine
- Enlarged lymph nodes in the neck
Causes Of Pancreatic Cancer
No identifiable cause is found in most people who develop pancreatic cancer and it remains unclear. However, those with certain risk factors may have increased likelihood of developing pancreas cancer. These include:
- Family history (first-degree relatives with the disease or history of genetic syndromes associated with pancreatic cancer)
- Long term pancreatitis (inflammation of the pancreas)
Doctors can suggest steps for you to take to lower your risk of pancreatic cancer by making healthy lifestyle choices such as:
- Lowering the fat in your dietary intake
- Eating more fruits and vegetables
- Reduce and stop smoking
- Regular exercising and avoid too much weight gain
- Limit alcohol use
Pancreatic cancer can be detected with CT scan or MRI. Ultrasound is not optimal to detect pancreatic cancer. Patient with suspected pancreatic cancer need to undergo at least a CT scan or MRI. In some cases, an endoscopic ultrasound examination may be necessary.
Pancreatic cancer, should be confirmed histologically when possible. A small piece of the cancer tissue is removed with a biopsy and put under the microscope for further examination. Special treatment of the tissue is often needed (staining).
Ca 19-9, a blood test, can be markedly raised in some pancreatic cancer but not all. It helps in diagnosis when it is markedly raised.
Treatment for pancreatic cancer depends on the subtype of the cancer and based on its stage – how far it has spread in the body. Pancreas cancer in the early stage can be treated and is also possible of being curable with surgery. Further treatment after the surgery is often recommended and it involves chemotherapy or radiotherapy. Palliative treatment is focused on reducing the pain.
For patients diagnosed with advanced pancreatic cancer, surgery may not often be possible thus treatment with chemotherapy and/or radiotherapy are opted to shrink the cancer, reduce symptoms, and extend lifespan. The cost of pancreatic cancer treatment is typically covered by Medisave and most health insurance providers.
Cancer screening tests can be done at a specialist clinic. If detected early enough, cancers are treatable and even curable. However, cancer screening strategies to prevent pancreatic cancer death is not yet a reality. Sometimes, cancer marker is used for this purpose. Unfortunately, cancer marker often is not accurate.
If someone without risk factors and symptoms were to have a raised ca19-9, more likely than not, he or she does not have pancreatic cancer. Doing ca19-9 to screen for pancreatic cancer creates a lot of anxiety for a lot of people without actually improving outcome most of the time.
If you happened to have elevated cancer marker, it does not mean that you definitely have cancer. You can speak to the specialist in gastroenterology who can then clarify your doubts and address your concerns.
- digestive illnesses