Pancreatic cancer is often difficult for affected individuals to detect, because for a long time the cancer causes no symptoms or at best mild and uncharacteristic symptoms. Therefore, in more than half of patients, the diagnosis is not made until the cancer is already well advanced and has formed daughter tumors. Read here what symptoms may occur and how pancreatic cancer is treated.
Symptoms of pancreatic cancer.
Although initial signs of pancreatic cancer are often mild or uncharacteristic, more severe symptoms can often develop over time. The following signs require urgent evaluation:
- Persistent fatigue, poor performance.
- Loss of appetite, unexplained weight loss.
- Nausea, diarrhea
- Itching
- Abdominal pain (usually girdling from front to back) or even back pain (the pancreas is located in front of the spine and the tumor may press there)
- Yellowing of the conjunctiva and the skin
- Thrombosis of unclear cause
How the symptoms arise
Symptoms usually arise because the tumor presses on surrounding tissue and neighboring organs. If it is located at the common excretory duct of the pancreas and gallbladder, it may obstruct it, causing secretions to back up instead of draining into the small intestine. This causes digestive problems and jaundice; the pancreas may also become inflamed. However, the function of the pancreas, especially insulin production, is usually maintained for quite a long time.
In the rare hormone-producing tumors, symptoms may occur due to the excess hormone.
Pancreatic cancer examinations and diagnosis.
If the tumor is suspected, after a physical examination to confirm the diagnosis, the physician will primarily use imaging techniques to look for the tumor. These initially include:
- Ultrasound examination (abdominal sonography)
- Computed tomography (CT)
- Magnetic resonance imaging (MRI)
This is followed by X-rays, an endoscopy of the stomach, bile ducts and pancreatic ducts (ERCP), tissue sampling (biopsy) and blood tests. These procedures are used to determine the exact extent of the tumor and whether the cancer has already spread – important information for therapy and prognosis.
Treatment of pancreatic cancer.
Treatment of pancreatic cancer depends on the extent of the tumor and any metastases present. If the cancer is still confined to the pancreas, it is removed during surgery – along with surrounding pancreatic tissue or the entire organ.
In most cases, parts of the stomach, small intestine and bile ducts are also removed (Whipple operation) – a stressful procedure with a high mortality rate that is performed in specialized clinics. Depending on the location of the tumor, sometimes the spleen is also removed at the same time.
The operation is sometimes followed by chemotherapy. If the pancreas is removed, the resulting lack of digestive enzymes must be replaced and insulin injected, among other things.
Palliative therapy
If the tumor cannot be removed, that is, if a cure for pancreatic cancer is not possible, radiation and chemotherapy are used – to relieve pain and maintain digestion (palliative therapy). In the case of bile stasis, a tube can also be inserted into the narrowed ducts or an artificial connection between the bile duct and the intestine, or to the outside, can be created to allow the bile to drain. In addition, pain medications are given and, if necessary, pain pathways in the abdomen are sclerosed.
