Introduction
Although 10,000 people die of pancreatic cancer every year in Germany, it is difficult to detect the disease at an early stage. This in turn means that the diagnosis is usually only made in the enstage of pancreatic cancer and is therefore often no longer curable.
Important symptoms for the detection of pancreatic cancer
In the detection of patients with pancreatic cancer, there are no symptoms that appear early and explicitly point to this disease. The following are some symptoms that should give rise to a closer examination of the patient in order to detect pancreatic cancer as early as possible: With all these symptoms, however, it must be kept in mind that they can also have numerous other causes and are by no means a sure sign for the diagnosis of pancreatic cancer. – Upper abdominal pain
- Digestive disorders
- Yellowing of the skin (icterus) due to restriction of bile flow, often accompanied by itching, beer-brown urine and discoloured stool
- Strong and unintended weight loss, possibly also fever and increased night sweats
- Thromboses (formation of blood clots) without a recognisable reason (such as prolonged lying down with influenza)
- Diabetes mellitus or other sugar balance disorder
Medical diagnostics for the detection of pancreatic cancer
If there is a suspicion that a patient may have pancreatic cancer, appropriate diagnostic procedures should be initiated quickly to ensure or rule out the detection of pancreatic cancer at an early stage. First of all, the doctor must conduct a detailed discussion with the patient. Especially the above mentioned symptoms should be asked.
The doctor will also ask about certain diseases that are often associated with pancreatic cancer (among others and about a family predisposition for this disease. In addition, the doctor will ask about certain risk factors, i.e. – chronic pancreatitis
- Peutz-Jeghers Syndrome
- Smoking? – Alcohol?
- Cysts in the pancreas known? The patient is then examined. Here, attention is paid to general condition, weight and yellowing of the skin.
In addition, the so-called Courvoisier sign is often found during the pancreatic examination. This means that the doctor can palpate a bulging gall bladder if the skin is yellow (icterus), but this is not painful for the patient. Blood is then taken.
Here it can be seen whether the function of the pancreas is normal (sugar, lipase, amylase). It also looks for signs of bile accumulation due to narrowing of the bile ducts by the tumour (bilirubin, alkaline phosphatase, gamma-GT) and looks for general changes in the context of cancer (anaemia). If the suspicion of pancreatic cancer is confirmed in a further examination, the so-called tumour markers should also be determined (CA 19-9, CA 50).
These are later used primarily to assess the success of the therapy, but not for the early detection of pancreatic cancer. This means that after an operation, they should fall off significantly, but if pancreatic cancer grows again, they will rise again. With the help of an ultrasound examination, a change in the organ and the surrounding lymph nodes can be detected quickly and easily.
For this purpose, an ultrasound examination is carried out from the outside through the abdominal wall on the one hand and an ultrasound examination from the inside within the scope of a gastroscopy on the other. Samples of the suspicious area can also be taken, these are then examined under a microscope and the degree of degeneration and type of cancer can be determined. In addition, the entire abdominal cavity is visualised by means of CT (computer tomography) or MRI (magnetic resonance imaging) of the abdomen.
This can also show blood vessels, which are sometimes more common in pancreatic cancer. Furthermore, an ERCP (endoscopic retrograde cholangiopancreaticography) examination can be used to visualise the pancreatic ducts. For this purpose, contrast medium is injected into the ducts via the small intestine and x-rays are taken.
If the ducts for the digestive juices are narrowed by growths in the organ, this can be seen particularly clearly here. All these examinations serve to detect pancreatic cancer or other causes. They can also be used to assess the stage of the disease and, depending on this, to start a therapy.
