Pancreatic cancer is considered one of the fatal diseases for which the survival rates have not substantially improved over the last forty years. According to a recent fact sheet provided by the Pancreatic Cancer Action Network in the U.S., pancreatic cancer is the 11th and 8th most common type of cancer diagnosed in men and women, respectively. The improvements made in the management of pancreatic cancer are mainly related to better quality of life with improved chemotherapy drugs, endoscopic treatment, and safer surgeries by surgeons specialising in pancreatic surgery.
The signs and symptoms of pancreas cancer can be very subtle, often with unexplained loss of appetite or unexplained loss of weight. In the majority of these cases, pancreatic cancer is detected in the later stages, where treatment may not be curative. That’s why pancreas cancer is called the “silent” cancer.
The pancreas performs certain important functions, such as the secretion of insulin and glucagon hormones (for blood sugar control), along with essential enzymes that help in food digestion and absorption in the intestine.
The staging (extent) of pancreatic cancer determines the size of the tumour and whether it has metastasised (spread) to other areas of the body. Knowing the stages of cancer is crucial for doctors to develop an effective treatment plan for each patient.
The staging systems for pancreatic cancer include:
Stage 0
Also referred to as carcinoma in situ, at this stage, the presence of abnormal cells is confined only to the lining of the pancreatic duct. They have not yet invaded or spread to nearby normal tissues.
Stage I
At this stage, the tumour is localised only to the pancreas and is no bigger than 4cm across.
Stage II
The tumour can measure more than 4 cm and is either limited to the pancreas or grows slightly outside the pancreas to nearby tissues or 1-3 lymph nodes. However, the tumour has not spread to distant sites.
Stage III
During this stage, the tumour has spread to 4 or more lymph nodes and/or into the major blood vessels or nerves surrounding the pancreas. The tumour can be of any size and has not spread to distant sites.
Stage IV
This is the most advanced stage of the disease (metastatic cancer). At this point, the cancer has reached distant organs of the body, including the liver, lungs, bones, or the inner lining of the abdomen (peritoneum).
Four symptoms that are usually noticed in patients affected with pancreas cancer include:
Advanced imaging of the body:
A CT scan or MRI of the patient’s abdomen is done to detect the presence of pancreatic mass, image the pancreatic duct and plan for surgery.
Endoscopic Retrograde Cholangiopancreatography or ERCP
In this test, a fibreoptic scope is used to look at the stomach and the small intestine. Subsequently, an X-ray dye is injected into the pancreatic ducts to take X-rays of the pancreas and check for the irregularities of the pancreatic ducts.
Biopsy
In this procedure, small pieces of tissue are biopsied to establish the nature of the tumour.
The treatment of pancreatic cancer may vary depending on which part is affected as well as the stage of the disease. If detected early, surgery is usually the first treatment option. In the intermediate stages of the disease, chemotherapy may be given to downstage the disease before surgery is considered. To date, surgical resection remains the only potentially curative option for pancreatic cancer. The pancreas itself is divided into 3 parts – the head, the body and the tail of the pancreas. Pancreas cancer surgery may also be intended for both preventing and relieving the symptoms.
Typically, two main types of surgery are used for treating pancreatic cancer, namely:
Other surgical options may include palliative surgery (bypass surgery). This surgery may be performed by a pancreatic cancer doctor if tests indicate that the tumour is locally advanced and cannot be removed completely. Palliative surgery aims to relieve or prevent certain conditions, such as a bile duct or intestine blockage caused by the cancer. Laparoscopic staging of pancreas cancer may occasionally be necessary. In laparoscopy, small cuts are made in the abdomen using a video camera to visualise the extent of pancreatic cancer dissemination to adjacent areas as well as other abdominal organs.
Other treatment options may include radiotherapy to relieve pain and chemotherapy as a radiosensitiser to relieve pain in patients with advanced-stage pancreatic cancer.
Pancreatic cancer surgery may result in the following complications:
For further information on pancreatic cancer, please call us at 64751488 and get instant support from our specialist.
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