Synonyms
Pancreatic carcinomaThe main symptom (leading symptom) of pancreatic cancer is the initially painless development of jaundice (icterus), which causes conspicuous yellowish discoloration of the skin and eyes. The reason for the development of jaundice in pancreatic cancer patients is the fact that the bile ducts become very narrow as the cancer grows. The yellowing of the skin is a sign of the final stage of pancreatic cancer and therefore occurs very late.
Only in cases in which the direct transition between the excretory duct and the duodenum (papilla duodeni major) is blocked by the tumour can jaundice be understood as a relatively early warning sign. A clearly perceptible sign of pancreatic cancer is the occurrence of pain that is constantly increasing in intensity, which is mainly felt in the abdominal cavity and the flanks. The pain may radiate into the area of the thoracic spine, as in the case of an inflammation of the pancreas.
The rather unspecific signs include an enormous weight loss within a very short time and conspicuously heavy sweating during the night (night sweat). One speaks of conspicuous night sweat as soon as the affected patients state that they have to change their clothes and/or bed linen several times a night because of the high fluid loss. The rise in core body temperature (fever) is also one of the unspecific signs of cancer.
Since the actual function of the pancreas is strongly influenced and restricted by the cancer, digestive problems and diarrhoea are also among the signs of pancreatic cancer. In cases where the endocrine, hormone-producing part of the pancreas is affected, normal insulin production in particular is reduced to a minimum. In the course of this reduced insulin production, many patients can develop so-called secondary diabetes.
The absorption of sugar into the cells and the actual utilization of sugar is strongly impaired. In the course of diabetes, further symptoms may occur which are not caused by pancreatic cancer but only by its accompanying disease. Among the most common symptoms are a conspicuously frequent urge to urinate and a strong feeling of thirst.
In addition, the affected patients often feel increasingly weak and complain of persistent fatigue and exhaustion. This leads to a general decline in the performance of the patients. In extreme cases, there may even be a sudden inexplicable deterioration in vision. It can also be observed that wounds generally heal much more poorly and often begin to weep.
Anatomy of the pancreas
The pancreas is an organ that is part of the gastrointestinal tract and performs important tasks in the course of digestion and absorption of nutrients. The large gland is located in the C-shaped loop of the duodenum and extends from there to the left kidney and spleen. It can be divided into two functional units.
One of these units (endocrine pancreas) is responsible for the production and release of hormones such as insulin or glucagon, the other functional unit (exocrine pancreas) forms various digestive enzymes which are transported into the lumen of the duodenum via an excretory duct system. Cancers of the pancreas (pancreatic carcinoma) are relatively widespread and are becoming increasingly common. Possible causes for the development of pancreatic cancer have not yet been identified.
Nevertheless, it is assumed that smoking, excessive consumption of alcohol, a high-fat diet and various hereditary diseases greatly increase the probability of developing pancreatic cancer. Most tumours of the pancreas develop in the area of the pancreas head, i.e. in the immediate vicinity of the duodenum. In about 20 percent of cases, tumour growth starts from the pancreatic body.
Most signs (signs, symptoms) of pancreatic cancer appear quite late in the course of the disease. Inaccurate (unspecific) signs such as fever, fatigue, weight loss and night sweats, which are generally caused by cancer in general (but can also have other reasons), are caused by an unspecific defence reaction (immune response) of the body and an increased metabolism of the cancer cells. These signs sometimes occur in earlier stages of pancreatic cancer, but are usually not recognized as threatening and only in exceptional cases lead to early detection of the cancer.
On the contrary, this disease is characterized by the fact that all early symptoms are usually fatally absent. In advanced stages of pancreatic cancer, more serious and, above all, more threatening signs of pancreatic cancer are added, which usually lead to its detection. These (jaundice, digestive disorders, secondary diabetes mellitus with its consequences, pain) can then be explained by the suppressive (invasive) growth of the tumour.
This tumour squeezes the main bile duct (Ductus choledochus) with its increasing volume, resulting in a bile stasis (cholestasis). Digestive disorders and jaundice (icterus) are the result. The tumour can also displace the healthy tissue of the pancreas so that it can no longer function properly (exocrine and endocrine pancreatic insufficiency).
This leads to diarrhoea, fatty stools and diabetes mellitus with all its consequences (increased thirst, increased urine volume, etc.) The tumour can also grow in the direction of the back and, especially through pressure (compression), affect nerves, muscles and the spinal column located there, which can lead to pressing or stabbing pain in this area (in the middle back, but also on the flanks or in the upper abdomen). In rare cases, pancreatic cancer can lead to an increased coagulability of the blood due to a non-specific activation of the immune system and cause the formation of a clot (thrombosis). If unexplained clot formation repeatedly occurs in a patient, pancreatic cancer should also be considered as a possible cause.
