The human pancreas is an organ in the digestive system, which produces important hormones and assists in the digestive process. Amongst those hormones, the most important it produces include insulin, pancreatic polypeptide, glucagon and somatostatin. The pancreas also excretes digestive enzymes that help the body absorb nutrients from food and helps digest food in the small intestine. The enzymes also help obtain important elements from food including proteins and carbohydrates.
Pancreatic Cancer arises from malformed cells in the pancreas tissues itself that lead to tumors. The most common type is adenocarcinoma which accounts for 95% of all instances of pancreatic cancer. A lesser number come from islet cells and are designated neuroendocrine tumors. The type of pancreatic cancer present, the location of the tumors and the size of the tumors can mean widely varying symptoms but they usually include lower back pain, jaundice and abdominal pain.
Pancreatic Cancer is one of the most common cancers in the world, ranking 8th globally, but 4th in the USA. Unfortunately, the survival rates for this kind of cancer are very low with 5 year survival rates for localized pancreatic cancer around 20%. For people who have advanced pancreatic cancer, which is usually the state of the cancer by the time it is detected, life expectancy is usually less than a year.
Symptoms of Pancreatic Cancer
Unfortunately, just like a number of other types of cancer, the early stages of pancreatic cancer do not show any obvious and distinctive symptoms. That is one of the reasons the survival rates for pancreatic cancer are so low – it’s not usually discovered until a late stage.
Some of the more common symptoms include:
- Sudden weight loss
- Loss of appetite, nausea
- Pain in the upper abdomen and lower back
- Jaundice (yellow tinting of the eyes)
- Darkened urine
- Pale colored stool (associated with the jaundice)
- Blood clots in portal vessels, which may lead to Trosseau Sign
- Diabetes or elevated blood sugar levels
Pancreatic cancer will usually metastize to to the lymph nodes, then liver and even the lungs on rare occaisions. Symptoms from cancer in those locations may also appear.
Pancreatic Cancer Risk Factors
As with most forms of cancer, having a family history of this form of cancer greatly increases the likelihood you will have it, as much as a 10% greater risk in the case of pancreatic cancer The genes that are responsible for hereditary gene cancer have not been found yet, but links with certain gene mutations and syndromes have been found. Some of those syndromes and mutations include: Peutz-Jeghers syndrome, autosomal recessive ataxia-telangiectasia, hereditary non-polyposis colon cancer and familial adenomatous polyposis.
The older you are, the greater your risk of developing pancreatic cancer with most cases occurring over the age 60.
A poor diet or excessive amounts of certain foods also increases the risk of pancreatic cancer. If your diet is low in vegetables and fruits, but high in red meat you have an increased risk of pancreatic cancer. Drinking a lot of sugar sweetened drinks also increases your risk of pancreatic cancer with a link between fructose consumption and the growth of pancreatic cancer cells.
If you have diabetes mellitus, you also have an increased risk of contracting pancreatic cancer. If you smoke cigarettes you are greatly increasing your chance of contracting pancreatic cancer.
Some studies have linked alcohol consumption to pancreatic cancer but not all research is in agreement on that link.
Pancreatic Cancer Prevention
The best form of prevention for pancreatic cancer is not smoking, as smoking cigarettes is responsible for an estimated >30% of pancreatic cancer incidents.
Having a varied and healthy diet will also help prevent pancreatic cancer. So a variety of whole grains and vegetables will help prevent the illness. Reducing or eliminating red meat intake will also decrease the risk of pancreatic cancer.
Vitamin D has also been shown to have a role in preventing pancreatic cancer, with individuals who consumed 300 to 450 IU of vitamin D having a 43% lower risk of contracting the illness compared to those who had less than 150 IU vitamin D per day. 150 IU is less than what is recommended for good general health. However the World Health Organization found the link between vitamin D not necessarily persuasive. The WHO found a link between Vitamin D intake and colorectal cancer though, so correcting any vitamin D deficiencies would be well advised. Just remember that excessive vitamin D intake can be harmful, so talk with your doctor.
Other vitamins that play a role in reducing the risk of pancreatic cancer include Vitamin B, Vitamin B12, Vitamin B6 and folate. However they should be consumed in food, not in tablet form. Mushrooms and eggs are both very good sources of Vitamin B if you are reducing intake of red meat.
Maintaining a healthy weight is also a preventative for most cancers as is regular aerobic exercise.
If you have a family history of pancreatic cancer, you should undertake regular screening after 50.
Pancreatic Cancer Treatment & Prognosis
For exocrine pancreas cancer, surgery is often used not as a cure, but to prolong life or address metastasis of the cancer. The “Whipple Procedure” is the most common curative surgery for pancreatic cancer and involves removing the head of the pancreas and the curve of the duodenum. That makes a bypass from stomach to jejunum. It can only be performed if the patient is likely to survive such major surgery and the cancer is localized.
Radiation is occasionally used to treat this form of cancer, often in conjunction with other treatments.
Chemotherapy is used in palliative care for pancreatic cancer, not as a method for curing the cancer. It often improves the quality of life for late term pancreatic cancer patients.
For pancreatic neuroendocrine tumors, they are often surgically removed but sometimes may be left in place and carefully monitored. These kinds of tumors can also respond to radiation therapy and hormone therapy.
Exocrine pancreatic cancer has a very poor prognosis because it shows very few early symptoms and is usually only caught at a late stage.
For pancreatic cancer of all stages the 1 year survival rate is 25%, the 5 year survival rate is approximately 5%. When the pancreatic cancer is locally confined, 5 year survival is 20%. It is one of the most deadly forms of cancer and to maximise your chances of preventing and detecting it you should maintain good health and get screening if you are at high risk due to family history, age or poor health.