November is Pancreatic Awareness Month
According to the American Cancer Society, pancreatic cancer represents roughly 3% of all cancer diagnosis in the United States, yet it accounts for almost 7% of all cancers-related deaths. Pancreatic cancer is the fourth leading cause of cancer-related deaths among both males and females in America.
Although overall, survival rates for cancer have increased over the last few decades, pancreatic cancer is often fatal. The combined survival rate for all stages of pancreatic cancer show that 20% of pancreatic cancer patients survive one year, and just 7% of those with pancreatic cancer survive five years or more. In a given year, about 44,000 people in America are diagnosed with pancreatic cancer. Of those, 38,000 people die from it.
Early Detection Increases Survival Rates
The survivability of pancreatic cancer is closely tied to early detection and treatment. If pancreatic cancer is detected early, the five-year survival rate jumps from 7% to 25%. Unfortunately, at this time, there is no single reliable test which can detect pancreatic cancer.
Because pancreatic cancer typically does not cause early symptoms, it often goes undetected until it has reached an advanced stage. Even if it does cause symptoms, they may be vague and/or blamed on other causes.
What is the Pancreas?
The pancreas is an elongate organ that sits behind the stomach. It is about six inches long, and less than two inches wide. It is shaped somewhat like a fish, with a wider head and a tapering tail. The pancreas lies in the right side of the upper abdomen.
The pancreas is made up of two main kinds of cells, exocrine and endocrine. The exocrine glands within the pancreas create enzymes that help in the digestion of foods. These enzymes are released through small tubes called ducts. Endocrine cells, on the other hand, produce glucagon and insulin, which help control blood sugar (also called blood glucose).
There is no single form of pancreatic cancer. In fact, there are over 20 different kinds of tumors of the pancreas. The most common type of pancreatic cancers arise from exocrine cells within the pancreas. Like all cancers, pancreatic cancer begins when cells within the body begin to multiply out of control, often spreading to other areas of the body.
Risk Factors for Pancreatic Cancer
Per the American Cancer Society, the risk factors for developing pancreatic cancer include:
● A history of smoking: roughly 20-30% of cancer of the pancreas diagnosis are believed to be linked to smoking
● Obesity: being overweight increases you risk for developing cancer by as much as 20%
● Age: most people who get cancer of the pancreas are over the age of 45. The average age for pancreatic cancer is 71
● Chemicals: exposure to certain chemicals such as those used in metalworking or dry cleaning have been linked to certain forms of pancreatic cancer
● Genetics: although someone does not have to have a family history of pancreatic cancer, it does tend to run in families and can have a genetic component.
● Health Conditions: people with diabetes have a higher risk of getting pancreatic cancer, as do those who have a history of pancreatitis, although most people who have pancreatitis do not develop cancer of the pancreas
● Liver Health: having cirrhosis of the liver increases the chance of developing pancreatic cancer
● Alcoholism: a history of alcohol abuse increases the chance of getting cancer of the pancreas
● Ulcers: ulcers realated to H. Pylori and/or increased stomach acid concentrations many also increase the risk of developing pancreatic cancer
Signs and Symptoms
As noted, most of the symptoms associated with pancreatic cancer do not begin until the cancer has progressed and/or metastasized (spread) to other areas.
Certain kinds of pancreatic cancer can create different symptoms too. Some tumors, for example, secrete hormones. If a tumor does produce hormones, it can affect other areas of the body. For example, certain pancreatic cancers such as gastrinomas cause the stomach to produce too much acid, while others increase the amount of insulin or other hormones.
The symptoms of pancreatic cancer may also depend on where in the pancreas the cancer is located.
If a tumor is in the body of the pancreas, symptoms might include upper abdominal pain or back pain. If a tumor is present in the head of the pancreas, it is more likely to cause weight loss or jaundice. If cancer arises in the tail of the pancreas, it may cause indigestion or pain after eating.
Please note, the symptoms listed below can also be caused by other conditions. Symptoms of Pancreatic Cancer may include:
● Fatigue (feeling tired)
● Abdominal Pain
● Unintended weight loss or loss of appetite
● Back Pain
● Facial flushing
● Abdominal cramping and water stools
● Pain after eating
● Nausea and/or vomiting
● Pale stools and or dark urine
● Blood clots
● Gallbladder or liver enlargement
● Jaundice (yellowing of the skin or eyes)
● Fatty tissue abnormalities (uneven fatty deposits under the skin)
Staging of Pancreatic Cancer
Once pancreatic cancer has been diagnosed, staging helps determine how far it has spread. It can also help healthcare providers understand how well a patient is likely to respond to treatment. Staging takes advanced testing and can be very complex. It should be noted that there are many categories which are not represented below. This is only a generalized outline for staging pancreatic cancers:
● Stage 0: The cancer is situ, meaning it has not spread from where it started
● Stage I: The cancer is confined to the pancreas (and no larger than 2 cm)
● Stage II: The cancer has spread to nearby structures, but not distant sites
● Stage III: The cancer has spread to a wider area, but not distant sites
● Stage IV: The cancer has spread to distant organs and sites
Treating Pancreatic Cancer
Depending on the type, location, and stage of the pancreatic cancer, treatment may include surgery to remove the tumor or bypass blocked ducts and or affected areas of the small intestine, radiation to shrink the tumor, nerve blocks to help reduce pain, and/or chemotherapy. In many cases, the treatment may be palliative, meaning that it helps to improve the quality of life by reducing symptoms such as pain, but does not treat the cancer itself.
Pancreatic cancer is challenging to treat, but there is hope. Medical researcher around the world are working to create better screening, diagnostic, and treatment tools to fight pancreatic cancer.
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This content does not represent medical advice. It is not meant to diagnose or treat any condition. It is not intended as a substitute for the advise of a qualified medical provider.