Pancreatic carcinoma (or more precise term in the narrower sense: ductal adenocarcinoma of the pancreas), pancreatic carcinoma, pancreatic cancer, pancreatic tumour English: pancreatic carcinoma
Definition
This tumor (ductal adenocarcinoma of the pancreas) is by far the most common cancer of the pancreas. It belongs to the malignant neoplasms. Benign tumours (which include, for example, serous cystadenoma) or other malignant forms (mucinous cystadenocarcinoma, acinar cell carcinoma) are very rare and are mentioned for the sake of completeness, but are not discussed in this topic. In most cases, pancreatic cancer occurs in the front part of the pancreas, the so-called head of the pancreas (see anatomy of the pancreas).
Epidemiology / Frequency
In western industrial nations, an average of 10 out of every 100,000 inhabitants fall ill every year. In the USA it is far more common than in Germany, Switzerland or Italy. The patients are generally between 65 and 85 years old. Only very rarely does it occur before the age of 40. Men fall ill more often than women.
Causes
The exact cause of pancreatic cancer is unknown. However, several risk factors have been proven in extensive social (epidemiological) studies. These include: In addition, there are a number of genetic diseases associated with pancreatic cancer (e.g. Peutz – Jeghers Syndrome, hereditary pancreatitis, and familial pancreatic cancer).
Similar to other tumours of the gastrointestinal tract, the development (pathogenesis) at the base of precursors is well researched. After a pre-damage, new growths that have not yet been displaced develop. These then increasingly lose the similarity with their original tissue and begin to grow into the entire organ or even cross the organ borders. The development of malignant tumours from precursors to benign forms to destructively spreading tumours is known as an adenoma – carcinoma – sequence. – long lasting inflammations of the pancreas (chronic pancreatitis)
- Smoking cigarettes
- Alcohol abuse /alcoholism
- As well as a diet very rich in fat and protein.
Signs of pancreatic cancer
Signs or symptoms of pancreatic cancer are difficult to determine. This is aggravated by the fact that symptoms only appear in advanced pancreatic cancer. At the beginning of the disease, most patients are free of symptoms.
In this case, the disease is only detected by routine examinations (ultrasound etc.). In advanced pancreatic cancer, the tumour begins to compress the duct of the pancreas, which can be associated with a disturbance in the flow of bile. This usually results in a yellowing of the skin and conjunctiva of affected patients, and this usually makes them go to the doctor.
The pancreas is also often affected by a disturbance in the flow of pancreatic fluids, which usually leads to a lightening of the stool and a darkening of the urine. In some cases this can also lead to a so-called fatty stool. The combination of both symptoms already gives rise to fears of a pancreatic drainage problem, although this has not been proven.
Since outflow problems in the pancreas area can also be caused by stones and inflammation, pancreatic cancer does not necessarily have to be behind the symptoms. Patients sometimes report belt-like abdominal pain, such as that caused by pancreatitis. It is then important to differentiate between inflammation and tumour attack of this organ.
Some patients only report back pain in the absence of abdominal pain. Back pain often does not primarily indicate a malignant disease of the pancreas, which can delay the diagnosis even further. Since the pancreas is also responsible for the production of insulin, a tumour infestation can also lead to a reduced supply of the vital insulin, with the result that blood sugar rises sharply and can be measured as abnormal. Patients who are not initially diagnosed with diabetes and who suddenly suffer from fasting blood sugar levels of 400 mg/dl and more should always consider pancreatic disease. The probability increases somewhat if the affected patients are younger, where adult-onset diabetes can be excluded.