Pancreatic Cancer

Pancreatic cancer is cancer that grows in the pancreatic tissue . Pancreatic cancer can be experienced by anyone , but it is more common in people over the age of 55 years .

The pancreas has a number of important functions for the body, including producing the hormones glucagon and insulin which are responsible for maintaining stable blood sugar levels in the body. The pancreas also produces enzymes that help the body digest nutrients in food.

Pancreatic cancer occurs when cells in the pancreas grow abnormally and out of control. The early stages of this cancer are often asymptomatic. Usually, new symptoms appear when the cancer has spread to other organs of the body.

Pancreatic cancer is one of the deadliest types of cancer . Of all cases of pancreatic cancer, only about 9 percent of sufferers can survive up to 5 years after being diagnosed with this disease.

Pancreatic Cancer Types

Pancreatic cancer is divided into two types, namely:

Pancreatic adenocarcinoma

Pancreatic adenocarcinoma is pancreatic cancer that grows from exocrine cells, which are cells that produce pancreatic enzymes. It is estimated that 95 percent of all pancreatic cancer cases are pancreatic adenocarcinoma .

Pancreatic neuroendocrine tumors (NETs)

Pancreatic neuroendocrine tumors are a type of pancreatic cancer that grows in endocrine cells, which are cells that produce hormones and manage blood sugar levels.

Pancreatic Cancer Causes and Risk Factors

It is not known exactly what causes pancreatic cancer. However, there are several factors that can increase a person's risk of developing pancreatic cancer, namely:

Aged over 55 years
Having excess body weight
Have blood type A, B, or AB
Suffer from diabetes, chronic pancreatitis , inflammation of the gums (gingivitis), or periodontitis
Suffering from Helicobacter pylori infection , hepatitis C, gallstones, or cirrhosis of the liver
Have a history of genetic disorders that can increase your risk of cancer, such as neurofibromatosis type 1 , a family history of ovarian cancer or breast cancer, and a family history of pancreatitis
Have a family history of pancreatic cancer
Eating too much red meat
Consuming alcoholic beverages
Smoke

Pancreatic Cancer Symptoms

Pancreatic cancer in its early stages (stages) generally does not cause symptoms. However, as cancer cells develop and reach an advanced stage, symptoms that can appear include:

Loss of appetite
Weight loss for no apparent reason
Itching on the skin
Bloated
Nausea and vomiting
Diarrhea
Constipation
Dark urine
Pale stools
The body gets tired easily
Yellowing of the skin and whites of the eyes (sclera).
Blood clotting
Abdominal pain that radiates to the back
Fever or chills

Pancreatic cancer can also trigger other diseases, such as diabetes and depression . However, often these diseases are not recognized as part of the symptoms of pancreatic cancer .

When to see a doctor

Check with your doctor if you experience the above symptoms, especially if you are at risk for pancreatic cancer. Also, tell your doctor if you have a family history of pancreatic cancer or a genetic disease. Your doctor may advise you to undergo pancreatic cancer screening.

For patients who have undergone treatment, continue to check with the doctor regularly. Examination is still needed even though the cancer has been successfully removed, to prevent the possibility of cancer cells growing again.

Pancreatic Cancer Diagnosis

The doctor will ask about the patient's symptoms and medical history, including asking about the patient's lifestyle, such as smoking habits and eating patterns. Next, the doctor will carry out a physical examination, including by looking for signs of jaundice and detecting lumps in the stomach.

After that, the doctor can also carry out several supporting examinations to confirm the diagnosis, such as:

Blood test, to detect CA19-9 protein and to measure levels of the hormones insulin, glucagon, and somatostatin, which are associated with pancreatic cancer cells
Scanning with a CT scan, PET scan, or MRI, to see the condition of the pancreas and other organs in the body
Endoscopic ultrasound (EUS), to see the condition of the pancreas from inside the stomach with an endoscope and ultrasound
Endoscopic retrograde cholangiopancreatography ( ERCP ), which is endoscopy assisted with X-rays, to determine the condition of the bile duct and pancreas
Octreotide scan or octreoscan , to detect the presence of pancreatic cancer originating from endocrine cells
Biopsy or taking samples of tissue suspected of being pancreatic cancer for further examination under a microscope

After the patient is confirmed to have pancreatic cancer, the doctor will determine the severity of pancreatic cancer. This determination will assist the doctor in choosing the right method of treatment.

The following is the stage or severity of pancreatic cancer:

Stage 0 (carcinoma in situ)
At this stage, abnormal cells are found in the pancreatic wall, but are not yet cancerous and have not spread.
S stadium 1
Stage 1 indicates that the cancer is only in the pancreas and has not spread to other organs, with a cancer size between 2-4 cm.
Stage 2
At stage 2, the cancer is more than 4 cm in size or has spread to the lymph nodes around the pancreas.
Stage 3
Stage 3 indicates that the cancer has spread to the nerves, major blood vessels, or to more than 4 lymph nodes near the pancreas, but has not spread to other organs.
Stage 4
Stage 4 means the cancer has spread widely to other organs of the body far from the pancreas, such as the lungs, liver, or peritoneum (the membrane that lines the inner wall of the stomach).

Pancreatic Cancer Treatment

Pancreatic cancer treatment will be adjusted to the stage of the cancer, the part of the pancreas affected by the cancer, and the patient's overall condition. The goal of treatment is to get rid of cancer cells so they don't spread to other organs.

Several methods that doctors can use to treat pancreatic cancer are:

Chemotherapy

Chemotherapy is the administration of special drugs to kill cancer cells. The drug given can be in the form of a single drug or a combination, either in the form of drinking (oral), injections, or infusions.

Chemotherapy may be used for early or advanced pancreatic cancer to shrink or control cancer growth.

Radiotherapy

Radiotherapy or radiation therapy is a procedure to destroy cancer cells, using high-energy rays, such as X-rays and protons. Radiation therapy can be done before or after surgery.

Radiotherapy can be combined with chemotherapy (chemoradiation). Usually, this combination is done before surgery to reduce the size of the cancer so that it is easier to remove.

Chemoradiation can also be done after surgery to reduce the risk of pancreatic cancer coming back. In addition, chemoradiation can also be performed on pancreatic cancer that cannot be treated with surgery.

Operation

Surgery is performed on pancreatic cancer that has not spread to other organs. Some of the types of surgery that can be performed are:

Whipple surgery or pancreaticoduodenectomy, which is an operation to remove the head of the pancreas and parts of other organs, such as the duodenum, gallbladder, bile ducts, lymph nodes, stomach, and large intestine
Distal pancreatectomy, which is surgery to remove the left side of the patient's pancreas and, if necessary, the spleen
Total pancreatectomy, which is a procedure to remove the entire pancreas

Please note, not all pancreatic cancer can be treated with surgery, such as in cancer that has spread to large blood vessels, or if the patient also suffers from liver failure or advanced heart failure . The reason is, in these conditions, the risk of complications due to surgery will be greater.

Apart from the methods above, there are also several treatment methods that doctors can do to relieve symptoms, namely:

Administration of opioid analgesics to relieve pain
Provision of antidepressants accompanied by counseling to relieve depression
Bypass surgery and placement of stents in the bile ducts, to relieve symptoms of jaundice, itching, and loss of appetite

Pancreatic Cancer Complications

Pancreatic cancer can develop and cause a number of complications, such as:

Weight loss, which can occur due to the pancreas not producing enough digestive enzymes, or due to cancer pressing on the stomach, making it difficult for the patient to eat
Jaundice, which can result from cancer blocking the bile ducts
Abdominal pain, due to cancer cells in the pancreas that continue to grow and press on the nerves in the stomach
Obstruction or blockage of the intestine , due to pancreatic cancer pressing on the duodenum, so that food that has been digested in the stomach cannot go down to the intestine