Pancreatic cancer or pancreatic carcinoma is a rare cancer. Unfortunately, however, it is still currently considered very difficult to cure. In most cases, pancreatic cancer can no longer be cured because the disease is often detected and treated too late. Therefore, the earlier the disease is detected, the higher the chances of survival. One of the ways to prevent pancreatic cancer is to refrain from smoking and drinking alcohol, as well as eating a healthy diet and getting plenty of exercise and sports.
What is pancreatic cancer?
Infographic showing the anatomy and location of the pancreas with pancreatic cancer. Click image to enlarge. Pancreatic cancer or pancreatic carcinoma occurs relatively rarely, with a statistical probability of 3% of all cancers. The corresponding tumor is usually found in the so-called exocrine part of the pancreas on the posterior wall of the abdomen below the diaphragm. In most cases, the duct cells at the gland exits are malignantly altered (exocrine tumor). In rarer cases, pancreatic cancer begins in the hormone cells of the islets of Langerhans in the gland lobules (endocrine tumor). Due to the deceptive painlessness of this disease, pancreatic cancer is considered very treacherous, and when the danger is recognized, the patient and his or her physician often run out of time during treatment as a result of metastasis. Therefore, unfortunately, the chances of survival for pancreatic cancer detected late have not been too high until now.
Causes
The basic causes of pancreatic cancer are still unknown. However, there are a number of factors that have a favorable effect on the negative development of pancreatic cancer. For example, smokers have a three-and-a-half times higher risk of developing pancreatic cancer. High alcohol consumption also favors the development of the disease. In particular, the link between excessive tobacco and alcohol consumption has a dangerous effect. Pre-existing conditions such as stomach ulcers or chronic pancreatitis, but also changes in the genetic material, can lead to pancreatic cancer. In addition, environmental pollutants are currently also suspected of promoting pancreatic cancer. These include toxins such as herbicides (pesticides), pesticides (insecticides) and fungicides (fungus killers), but also electromagnetic fields, exhaust fumes, chromium and chlorine. But mind you, these factors are not causally responsible for pancreatic cancer or clearly proven scientifically.
Symptoms, complaints and signs
In the first phase of pancreatic cancer, no symptoms or only very mild symptoms appear. However, these can also occur with other diseases, so that those affected do not notice the danger in time and consult a doctor. Only when the cancer is more advanced and no treatment has taken place, stronger symptoms can appear. These include in particular: fatty stools, abdominal pain in the upper abdomen and a feeling of pressure, weight loss and loss of appetite, as well as vomiting and nausea. However, these symptoms also occur in a similar form in pancreatitis and can therefore be easily confused. The first symptoms appear in the advanced stage, in which a cure is usually no longer possible. Then, as in pancreatitis, there is pain in the left upper abdomen. They radiate into the back and may become belt-like around the body. These are increasing dull and excruciating pains that worsen especially at night. Furthermore, vague digestive complaints and feelings of pressure may occur. These often take the form of bloating, flatulence and stool irregularities. If fewer digestive juices are produced, so-called fatty stools and diarrhea may occur because fat digestion no longer functions properly. The stool becomes clay-colored. Furthermore, loss of appetite, nausea and possibly depression occur. This is followed by severe weight loss, which can be more than ten percent of body weight. Diabetes may also appear suddenly. If the tumor is located in the pancreatic head, there is increasing jaundice because the bile duct narrows. If the tumor extends into the abdomen, leg vein thrombosis and changes in skin pigmentation occur.In the late stage, metastases spread to the liver. They lead to liver enlargement, liver dysfunction, abdominal dropsy and extreme weight loss. After the first symptoms of pancreatic cancer appear, death occurs within a few months.
Course
Typically, pancreatic cancer develops with dangerous and completely painless absence of symptoms. Pancreatic cancer as an exocrine tumor spreads unnoticed after the tumor grows rapidly through the bloodstream and lymphatic system, initially to the surrounding body regions. In most cases, the liver is affected, but the lungs and even the skeleton are also at risk. This almost inevitably leads to a rather unfavorable prognosis. In the case of an endocrine tumor, the growth of the nodule initially displaces the surrounding tissue, while metastasis tends to progress slowly, giving hope for more successful treatment even in cases of pancreatic cancer detected late. Nevertheless, pancreatic cancer that is not detected in time is overwhelmingly fatal in the short or long term.
Complications
Pancreatic cancer (pancreatic carcinoma) is fraught with numerous complications. For example, due to its anatomic proximity, there is a disruption of bile flow. This causes bile to back up to the gallbladder (cholestasis), which can lead to inflammation of the gallbladder (cholecystitis) or an abscess in the liver. In the worst case, the inflammation can spread throughout the entire body, leading to dangerous sepsis that can quickly result in death if left untreated. Furthermore, pancreatic cancer can also lead to blockage of the intestine (ileus), resulting in constipation and metabolic disorders. In addition, the section of intestine may become inflamed and die because the blood supply is also throttled. In rare cases, metabolic disorders occur due to the cancer, as not enough enzymes and hormones are produced. For example, diabetes may develop in the course of the disease. Too many hormones can also be produced, as in the case of an insulinoma, for example, leading to hypoglycemia. This is in contrast to glucagonoma, which leads to hyperglycemia. Gastrinoma increases the risk of developing a peptic ulcer. Overall, however, pancreatic cancer has a very poor prognosis and can only be fully treated if detected early. The 5-year survival rate at diagnosis is only less than one percent.
When should you see a doctor?
The pancreas is located in the back of the abdomen. Therefore, symptoms appear very late, and by the time a diagnosis is made, tumors have often spread beyond the boundaries of the organ. Early symptoms are usually nonspecific and diffuse. Malaise, flatulence, fatty stools and pain in the upper abdomen often already indicate pancreatic disease. If weight loss and back pain in the waist area are then added, this should be considered a warning signal. Jaundice can also be an indication of pancreatic cancer. The bile duct and pancreatic duct open together into the duodenum. If the tumor is located at this point, it blocks the bile duct and the bile accumulates, leading to yellowing. Likewise, a new onset of diabetes can be a warning signal. In rare cases, an acute inflammation of the pancreas occurs beforehand. If alcohol dependence or gallstones are ruled out, a tumor may be the cause. In all cases – except pancreatitis, which belongs in clinical treatment – the general practitioner is the first point of contact. A blood count with the pancreas values lipase and amylase as well as the liver values can give a first clue. So can an ultrasound examination, but this is complicated by the location of the pancreas. Intestinal gases often overlay this area. If the findings are unclear, a computer tomography or magnetic resonance imaging is recommended as soon as possible for precise clarification.
Treatment and therapy
Treatment of pancreatic cancer depends on the type of disease, the stage already reached, and the patient’s age and general health. However, surgery during which the tumor and surrounding lymph nodes are removed is an inevitable measure in this regard. However, the success of such an operation requires that the progress of the disease is still limited to the pancreas.The following long-term treatment for pancreatic cancer may vary depending on the stage of the disease. Choices include chemotherapy or radiation therapy, as well as a combination of both. In addition to radiation therapy, erlotinib is also used to treat pancreatic cancer. This is a metastasis blocker, but it is usually only considered for patients in whom the disease is so advanced that surgery seems hopeless from the outset. In terms of treatment, pancreatic cancer is a protracted affair that often can be completely cured only if detected early.
Outlook and prognosis
Pancreatic cancer has a very high mortality rate. Initially, the tumor affects only the pancreas itself. However, in later stages, it rapidly spreads to surrounding tissues and organs. These include the spleen, duodenum, stomach, liver and colon. In addition, the malignant tumor also forms distant metastases via distribution through the lymph nodes in the lungs or bones. Due to the massive space requirement, in many cases liver function is impaired because of congestion of the bile duct. Additional pancreatitis may result from blockage of the glandular outflow. The secretion of hormones is then considered to be severely reduced in some cases and insulin deficiency with diabetes develops as a consequence. The chances of survival depend on the time of diagnosis of the cancer. Rapidly spreading adenocarcinoma has an unfavorable prognosis due to the aggressive nature of the tumor cells. The mortality rate is significantly lower for the rare cystadenocarcinoma. It does not spread over a long period of time and grows relatively slowly. A pure attack of the endocrine section even allows the successful removal of the complete tumor in later stages. If surgical intervention is not possible, life expectancy is on average a maximum of five months after diagnosis. After five years, only 0.2% to 0.4% of those affected are still alive. In general, pancreatic cancer is therefore considered one of the most dangerous tumor diseases of the gastrointestinal tract.
What you can do yourself
Patients with pancreatic cancer can optimize their diet to improve their health. There are already several research approaches, according to which the regular consumption of vegetables from the cruciferous family can be supportive of the initiated cancer therapy. Eating broccoli, cauliflower or Brussels sprouts can therefore help and strengthen the patient. The diet should be balanced and healthy overall. The intake of vitamins and trace elements is particularly important to support the patient’s own immune system and to achieve an improvement in well-being. Despite existing complaints and feeling unwell, the patient should pay attention to sufficient exercise. Daily stays in fresh air support the oxygen supply, relieve the cardiovascular system and strengthen the organism. The consumption of harmful substances such as nicotine or alcohol should be avoided as a matter of principle. On the other hand, techniques that contribute to mental strengthening are helpful. Daily exercise and training sessions that lead to inner stabilization and the development of new confidence are highly recommended. In addition to autogenic training, meditation or yoga, cognitive behavioral therapies can promote optimism or a positive outlook on life. An exchange of the affected person in self-help groups or forums can give new impulses. In addition, patients with the disease and recovering patients can give each other mutual assistance in dealing with the disease in everyday life.
