Pancreatic Cancer

Pancreatic Cancer Definition

To fully understand the nature of pancreatic cancer, it’s important to understand the role of the pancreas. This organ sits deep in the abdomen and is a vital part of the digestive system that also helps control blood sugar levels in the body.

Pancreatic cancer is defined as a cancer that originates in the pancreas. Unfortunately, this cancer is rarely found before it has spread to other organs. Even though the pancreas performs critical body functions, few people have an in depth knowledge of this organ. This is probably because its function is barely noticeable.

The pancreas is a long-flattened glandular organ, part of which is located between the stomach and the spine. The other part rests in the first part of the small intestine called the duodenum. Because of its location deep in the body, pancreatic cancer is difficult to detect in its early stages. Symptoms are often not felt until a pancreatic tumor grows large enough to impact the function of the liver, stomach, gallbladder, or spine.

Pancreatic Cancer Stages

Staging pancreatic cancer is the process of determining the location and size of the cancer, and whether it’s spread to local or distant sites within the body. Staging helps doctors identify treatment protocols that have the best chance of being effective. They also help doctors offer patients a prognosis for recovery.

To ascertain a patient’s pancreatic cancer stage, doctors use various diagnostic tests, so the final results may take some time to compile. Every form of cancer has its own staging descriptions, so it’s important to review the staging definitions unique to pancreatic cancer. While the TMN staging system is used for many cancers, it is not often used for pancreatic cancer.

Pancreatic cancer staging is divided into four separate categories, the criteria being whether is can be removed through surgical means or if and where it may have spread. These four staging classifications for pancreatic cancer are broken down as follows.

Resectable pancreatic cancer can be removed surgically. The surgery is usually performed immediately following diagnosis. Surgery may be localized in the pancreas if the cancer has not spread, or it may include areas outside of the pancreas as long as it hasn’t grown into important veins or arteries. Around 15% of patients are diagnosed with resectable cancer. Sometimes other treatments are performed before the surgery.

Borderline resectable pancreatic cancer describes a tumor that may be impossible or difficult to remove surgically upon initial diagnosis. In some cases, chemotherapy or radiation therapy is used to shrink the tumor so that surgery can be performed. The goal is to perform a surgery with “negative margins,” which means no visible cancer cells are left in the body after the surgery is completed.

Locally advanced pancreatic cancer describes a stage where cancer is still localized to the pancreatic region but surgery is not possible because it’s spread into nearby organs, veins, and/or arteries. This means that surgery could damage those surrounding structures, which is too high of a risk to the patient. For a cancer to be in the locally advanced stage it must not have spread to distant areas in the patient’s body. Around 40% of patients diagnosed with pancreatic cancer are staged as locally advanced.

Metastatic pancreatic cancer is a staging that describes a situations where the cancer has spread to other parts of the body like the lungs or liver, or distant areas in the patient’s abdomen. Around 45% of pancreatic cancer patients are diagnosed with this advanced stage.

While not used for pancreatic cancer in most cases, the TMN staging system is used for many other forms of cancer. If you would like detailed information on this type of staging please review one of our other cancer pages.

Pancreatic Cancer Symptoms (signs of Pancreatic cancer)

Unfortunately, the signs and symptoms associated with pancreatic cancer are often not observed until the disease is in an advanced stage. Some of the more common symptoms associated with pancreatic cancer include:

• Acute pain in the upper abdomen that may radiate to the back
• Unexplained depression
• Loss of appetite
• Unusual weight loss
• Blood clots
• Tiredness or fatigue
• Jaundice which is yellowing of the skin or eyes
• Diabetes

Most of these symptoms can be caused by other health issues, but they all are serious enough to justify a visit to your doctor. There are actually two kinds of pancreatic cancer, each with different symptoms. The first is exocrine pancreatic cancer and the other is pancreatic neuroendocine tumors. For this reason, the following information regarding the signs and symptoms associated with pancreatic cancer are broken down into these two categories.

Exocrine pancreatic cancer symptoms and signs
In their earliest stages, it’s unusual for pancreatic cancer to exhibit symptoms. When most patients are diagnosed with pancreatic cancer, it’s already spread outside of the pancreas. What follows are some of the symptoms associated with exocrine pancreatic cancer.

Jaundice is the yellowing of the skin and eyes, and it’s often one of the first symptoms people experience who have pancreatic cancer. Jaundice is caused by the blockage of the body’s bile duct, preventing bile produced by the liver from reaching the intestines. A substance called bilirubin within the bile builds up in the body, causing jaundice.

The reason for this is that the pancreas is located near the bile duct. As the cancer grows, it begins to press on the duct, which causes jaundice. The tumor can cause this problem when it’s still quite small, which is a good thing because it may help doctors find the cancer in an early stage. However, if the cancer forms in parts of pancreas away from the bile duct, it may not be discovered until it’s in a more advanced stage.

Dark urine may be another sign of jaundice, because bilirubin levels in the blood increase until the urine become a brownish color. Greasy or light-colored stools may also be the result of a bile duct blockage. Stools may become greasy or float if bile can’t work their way into the intestine to break down fats. Finally, itchy skin may also be a sign of bilirubin build up in the skin.

Keep in mind that there are more common reasons for having jaundice other than pancreatic cancer. These include hepatitis, liver and bile duct diseases, and gallstones. Obviously, all of these conditions require medical care, so any sign of jaundice should motivate patients to seek medical attention.

Back or belly pain is another common symptom associated with pancreatic cancer. The reason for this pain is because these cancers grow to a large size and press on nearby organs. The pancreatic cancer may also spread into nerves around the pancreas, which also causes significant pain. As with jaundice, there are countless reasons why someone may experience back and belly pain, so it’s important to pay your doctor a visit for testing.

Weight loss and loss of appetite is quite common for people with pancreatic cancer. If this symptom accompanies another symptom like belly pain or jaundice, it”s a good idea to have a doctor take a closer look.

Nausea and vomiting is also a common sign of pancreatic cancer because the cancer may partially block the stomach as it grows. This makes it hard for food to pass through, which can cause vomiting and nausea. It’s common for the pain to get worse after eating a meal.

Enlargement of the Liver and/or gallbladder is a pancreatic cancer symptom that can be detected by a physical exam or through imaging tests. Pancreatic cancer can even cause the liver to become enlarged, especially if it’s spread to that organ.

Blood clots may occur in a large vein, often in the leg, when someone has pancreatic cancer. This condition is called DVT, which is short for Deep Vein Thrombosis. Symptoms of DVT include warmth in the effected leg, swelling, pain, and redness. If a piece of the clot breaks off and travels through the veins to the lung, the patient may experience sudden chest pain or find it difficult to breathe. This conditions is called a pulmonary embolism. Blood clots are usually caused by conditions other than pancreatic cancer.

Abnormalities in fatty tissue is another sign of pancreatic cancer. Fatty tissue lies just beneath the skin, and some people with pancreatic cancer develop an uneven texture in this fatty tissue, which is caused by the release of pancreatic enzymes.

Diabetes is a rare side effect of pancreatic cancer, and it’s caused by the destruction of insulin making cells. Symptoms may include hunger, thirst, and a frequent urge to urinate. Pancreatic cancer may also cause changes in blood sugar levels that are detectable via a blood test.

Pancreatic neuroendocine tumors symptoms and signs
These tumors are known to release excess hormones that travel into the bloodstream. Certain tumors make different hormones, which lead to the signs and symptoms associated with this form of pancreatic cancer.

Gastrinomas is a condition caused by pancreatic tumors that make a hormone called gastrin, which is responsible for telling the stomach to produce more acid. If there is too much gastrin being produced, the stomach makes too much acid, which is a condition known as Zollinger-Ellison syndrome. The end result are stomach ulcers that can lead to nausea and pain, and they may even start to bleed.

Symptoms of this condition include anemia, tiredness, shortness of breath, and tarry, black stool. If the ulcer starts to bleed severely, it can even lead to death.

Glucagonomas is a condition caused by pancreatic tumors that make a hormone called glucagon, which increases the levels of sugar in the blood. Symptoms are often mild, but glucagonomas can lead to diabetes. Symptoms of this condition may include a feeling of hunger or thirst, weight loss, diarrhea, or malnutrition.

The most common symptom of this condition is called necrolytic migratory erythema, which is a red rash that travels to different places on the skin. The rash may also create blisters and swelling.

Insulinomas is a condition caused by pancreatic tumors that make insulin, too much of shich causes low blood sugar. This causes the patient to experience sweating, confusion, rapid heartbeat, and fatigue. If blood sugar drops too low, it can lead to seizures and even coma.

Somatostatinomas is a conditions caused by pancreatic tumors that make somatostatin, which is a hormone that regulates other hormones. Tumors of this nature can cause symptoms that include loss of appetite, nausea, weight loss, jaundice, and others. Because early symptoms are nonexistent or mild, these tumors are often in an advanced stages when diagnosed.

VIPomas are tumors that make a substance called vasoactive intestinal peptide, which can cause diarrhea that gets worse over time. There are some other symptoms a person may experience if they have this tumor, including muscle cramps, vomiting, flushing, and a feeling of weakness. Digestion issues are also common with these tumors.

Ppomas are tumors that make pancreatic polypeptide, which helps regulate the endocrine pancreas, and the exocrine pancreas. Belly pain, watery diarrhea, and pain in the belly are all symptoms of this kind of tumor.

When cancer spreads from the pancreas to other parts of the body, it’s highly likely the liver will be effected. This can damage liver function and even cause jaundice. If the cancer spreads to the lungs, the patient may find it difficult to breathe, and if it spreads elsewhere there will be corresponding symptoms.

Pancreatic Cancer Statistics

In the United States, it is estimated that 2018 will see about 29,000 cases of pancreatic cancer in men, and 26,000 cases in women. Of these 44,300 will die from the disease, which is about 80%. This represents about 3% of all cancers in the United States, and about 7% of all cancer deaths.

About 1 in 63 men and 1 in 65 women will develop pancreatic cancer in their lifetime. However, it’s important to understand that certain risk factors greatly increase a person’s chances of developing this life-threatening disease.

Exocrine pancreatic cancer survival rates
A five year survival rate measures how many people survive at least five years after being diagnosed with pancreatic cancer. If a patient can be treated with surgery, they tend to live longer on average. The 5 year survival rate for people with Stage IA pancreatic cancer is about 14%, and for Stage IB it is reduced to 12%.

Stage IIA pancreatic cancer has a 5 year survival rate of 7%, and it drops to 5% with Stage IIB. The 5 year survival rate for Stage III pancreatic cancer is a mere 3% , and only 1% for patients with Stage IV.

Neuroendocrine pancreatic tumors survival rates when surgery is performed
Patients suffering from pancreatic neuroendocrine tumors have a far better chance of survival than those with exocrine pancreatic cancer. In fact the 5 year survival rate for Stage I patients is over 60%. Stage II patients have a survival rate of more than 50%, and Stage III’s have a 5 year survival rate of 41%. Stage IV patients have a 5 years survival rate of 16%.

Statistics are often misleading, and there are treatments available even for patients with Stage IV pancreatic cancer.

Causes of Pancreatic Cancer

Scientists do not know what exactly causes pancreatic cancer, but they have identified risk factors that increase the chance of developing the disease. Some of the risk factors can be avoided and others cannot.

Some risk factors are related to genetics and DNA that resides in the cells that make up the pancreas. DNA is a chemical residing in cells that carries genes, and these genes control how cells function. Some genes help cells stay alive, grow, and divide. Others maintain a certain order to cell division, repair mistakes in the DNA, or cause cells to die when the time is appropriate.

Pancreatic Cancer

Changes to DNA are called mutations, which can cause the genes to do the opposite of what they’re intended to do. Some of these mutations may be inherited and others may be acquired. There is nothing that can be done to control inheriting gene changes that increase the risk of developing pancreatic cancer, but acquired gene mutations are often preventable.

One example of a preventable gene mutation would be ones caused by smoking tobacco. However, it is now known exactly why these mutations take place, even though it is knows that the behavior plays a key role. It’s possible that genes can also mutate randomly and without any external cause.

Pancreatic Cancer Screening and Prevention

The best way to prevent pancreatic cancer is to reduce risk factors. However, this doesn’t necessarily mean that pancreatic can be prevented. Nobody has control over their own age, ethnicity, or genetics, but they can control certain behaviors that are known to increase the risk of pancreatic cancer.

For one, do not smoke tobacco. Quitting may not be easy, but it significantly reduces the risk of developing many forms of cancer, including pancreatic cancer. Also, remain at a healthy weight for your height and age. Choose food and beverages that help you maintain your weight, and that are full of the vitamins you need to maintain a healthy immune system.

Limiting alcohol use may also help prevent developing pancreatic cancer, even though it’s link to the disease is unproven. However, heavy alcohol use can lead to cirrhosis or pancreatitis, which are both known to increase a person’s risk of developing pancreatic cancer.

Lastly, if you’re exposed to chemicals in your workplace, familiarize yourself with their potential dangers and limit exposure.

Pancreatic Cancer Treatments

Once your pancreatic cancer is staged, your doctor will discuss treatment options. You should weight these choices carefully by considering your overall health, side effects, the impact to your family, and the cost. There are always risks to any treatment, so you should familiarize yourself with potential dangers. Side effects of some treatments can also be debilitating and lead to depression, which is also important to think about.

Surgery
There are two types of surgery used for pancreatic cancer and these include potentially curative surgery and palliative surgery. The former is used when tests show that the cancer can be completely removed. The latter is preferred when imaging tests reveal that the cancer is too widespread for complete removal. Palliative surgery is often performed to prevent further complications or relieve symptoms, but the end-goal isn’t curative in nature.

There are many factors to consider before surgery, and it’s a high-risk option that requires a great deal of skill and preparation. There is also a risk of complications resulting from the surgery, many of which can lead to other health issues, but this is still often the “best case scenario.”

Pancreatic cancer spreads very quickly, so surgery is often palliative. One such procedure is called Bypass surgery, which offers relief for a blocked bile duct. Before agreeing to surgery, it’s important to talk to your doctor and get all of the facts. Also, talk to your family and weight the risks to make the best choice possible regarding your health.

Embolization or ablation treatments
Both of these treatment are used to destroy tumors without removing them via surgery. It is often used in patients whose pancreatic cancer has spread to other organs, often the liver. While these treatments rarely cure the cancer on their own, they can be used to relieve or prevent symptoms, or may be used in tandem with other treatments.

Ablative treatments use extreme cold or heat to destroy tumors. These treatment don’t require a hospital stay, which is appealing for a variety of reasons. Radiofrequency ablation uses high-energy radio waves to heat the tumor and destroy the cancer cells. This treatment works well on small tumors.

Microwave thermotherapy is similar to radiofrequency ablation but microwaves are used instead of radio waves. Cryosurgery freezes a tumor to destroy the cancer cells using very cold gasses passed through a metal probe. This method is more effective for large tumors than the other ablation treatments, but may require anesthesia to block pain.

While there are some risks of minor side effects with ablation treatments, serious complications are rare, but possible.

Embolization treatments are done by injecting substances into an artery in an effort to block blood flow to cancer cells, which causes them to die. If a tumor in the liver is too large for ablation, embolization may be used. Embolization also doesn’t require an overnight stay in the hospital.

Arterial embolization is a process whereby a catheter is inserted into an artery through the inner thigh. It is threaded into the artery that feeds the tumor and a dye is injected into the blood so the doctor can monitor its path. Once the doctor guides it into place, small particles are injected into the artery, plugging it up and stopping the blood flow.

Chemoembolization combines chemotherapy with embolization, which is accomplished by using tiny beads that emit a chemotherapy drug for the embolization.

Radioembolization combines radiation therapy with embolization. Small radioactive beads are injected into the artery where they lodge in the blood vessels near the tumor and emit radiation. This is a low dose of radiation that is localized to the vicinity of the tumor.

While there are side effects to embolization that include fever, nausea, and pain, serious complications are rare, but can happen.

Radiation therapy
This treatment uses high energy X-rays to kill pancreatic cancer cells, and may be helpful for patients with exocrine pancreatic cancers. There are a few different circumstances which may warrant the use of radiation therapy.

After surgery, radiation therapy may be used in an attempt to reduce the risk of the cancer returning. In these situations, the radiation therapy is used in tandem with chemotherapy. If a tumor is borderline resectable, radiation therapy may be used before the surgery in at attempt to make it smaller so that it’s easier to remove.

If a cancer has grown beyond the pancreas, making surgery impossible, radiation therapy may be used as the main form of treatment. In these situations, it will likely be accompanied by chemotherapy. Radiation therapy is also sometimes used to relieve symptoms of advanced pancreatic cancer.

There are many side effects associated with radiation therapy, so it’s important to speak with your doctor and fully understand how this process works and what it does to you body.

Chemotherapy and drug therapy
Chemotherapy involves the use of cancer-fighting drugs that are taken orally or injected into a vein. Because these drugs enter the bloodstream, they travel all over the body, which makes them a useful option for cancers that have spread.

Chemotherapy may be used before surgery in an attempt to shrink the tumor. Radiation therapy may accompany the chemotherapy. It may also be used after surgery in an attempt to kill any remaining cancer cells. This may reduce the chance of the cancer returning at a later time. Chemo may also be used when pancreatic cancer is in an advanced stage, or when surgery is impossible.

Chemotherapy has many side effects that can lead to significant discomfort. As with all treatments, talk to your doctor so that you fully understand what these side effects may be and how they may affect your life.

There are some newer drugs available today that are used specifically to prevent pancreatic cancer cells from growing. These drugs only target the cancer cells, which is different than the way chemotherapy drugs work. When chemotherapy doesn’t work, something these other drugs will. For more information about new drug therapies for pancreatic cancer, talk to your doctor.

Alternative Treatments Used for Pancreatic Cancer

If a pancreatic cancer treatment falls outside of mainstream treatment protocols, it is considered “alternative.” If alternative treatment are used in tandem with mainstream treatments like chemotherapy and radiation therapy, they are considered “complementary” treatments. If treatments that fall outside of traditional medicine are used as primary treatment, then they are called “alternative.”

Some alternative treatments for pancreatic cancer focus on the body’s natural healing abilities, part of which is the immune system. The goal with these therapies is to reinforce the body’s natural defense system so it can effectively fight the cancer cells. Because of pancreatic cancer’s high mortality rate when mainstream treatment protocols are used, some patients opt for treatment that is less destructive and invasive.

Boosting the body’s immune system is usually accomplished with diet, vitamin supplements, and other alternative therapies like acupuncture and relaxation techniques. Alternative treatments may be especially helpful for patients using them in a complementary manner, or who are seeking relief from late stage cancer.

Some alternative pancreatic cancer treatments focus on the unique cancer inside of the patient in an attempt to develop a highly focused treatment protocol. Because every cancer is unique the individual, the idea is to use a broad range of testing to see what treatments are most effective at killing it. This is a different approach to treatment than using the one-size-fits-all approach used my mainstream medicine.

As with any medical treatment, cancer treatment is a highly personal matter that requires careful consideration. Always explore your options in detail so that you can make the best choices regarding pancreatic cancer treatment.

Vitamins and Supplements Used in the Treatment of Pancreatic Cancer

Vitamins play a key role in the prevention of many cancers, including pancreatic cancer, but vitamins and supplements are rarely used in mainstream treatment protocols. Some doctors contend that this approach is misguided, so they incorporate the use of supplements as part of treatment in an effort to boost the body’s natural cancer fighting abilities.

As an example, Vitamin B6 and Vitamin C are both proven to boost the body’s immune system. Vitamin C has even been shown to regenerate body tissues. Vitamin E and Vitamin A are can boost the body’s ability to fight infection, which may be extremely helpful after surgery.

Before using any supplement, talk to your doctor and make sure it’s use won’t hinder other treatments you may be receiving.

Natural Remedies that May Help Pancreatic Cancer

There are number of natural remedies that many cancer patients believe have the power to minimize symptoms and even fight the disease. Side effects caused by treatments like chemotherapy and radiation therapy may also be alleviated with certain natural remedies. Some of the most common natural remedies used by pancreatic cancer patients include massage, meditation, physical therapy, acupuncture, and counseling.

Dealing with the emotional turmoil of pancreatic cancer can also take a toll on the patient. The high mortality rate associated with the disease and the many side effects of treatment may lead to depression. Natural remedies can help, and these include hydrotherapy, herbal preparations, and dietary supplements.

Before using any natural remedy or treatment, be sure to speak with your cancer doctor and make sure it won’t interfere with other treatment protocols. Also remember that a healthy lifestyle, good nutrition, and daily exercise are the best ways to reduce risk factors and prevent the onset of cancer.

For more information regarding pancreatic, contact a member of the Causenta team.