Overview of pancreatic cancer
What is the pancreas?
Your pancreas is about 6 inches (15 cm) long and looks like a pear lying next to it. It releases hormones including insulin, which helps your body process the sugar in the food you eat and it produces digestive juices to help your body digest food.
What is pancreatic cancer?
- Pancreatic cancer is a cancer that begins in the pancreas, an important endocrine organ located behind the stomach. Cancer begins when the cells in the body begin to lose control.
- Pancreatic carcinoma is the most common cancer. Pancreatic tumors (NET) are a less common type and are discussed in pancreatic neuromas
- Cancer can affect the endocrine gland or exocrine gland in the pancreas.
- Pancreatic cancer is difficult to detect and diagnose early.
Types of pancreatic cancer
Pancreatic cancer is classified according to the part of the affected pancreas: the part that produces digestive (exocrine) or insulin and other hormones (endocrine).
Exocrine pancreatic cancer
Although there are several different types of exocrine pancreatic cancer, 95% of the cases are due to pancreatic cancer.
Less common pancreatic cancers include:
- Adenosquamous cancer
- Squamous cell carcinoma
- Giant cell carcinoma
- Acinar cell carcinoma
- Small cell carcinoma
Endocrine pancreatic cancer
Other cells of the pancreas produce hormones that are released directly into the blood (endocrine system). Cancerous tumors arising from these cells are called pancreatic neuromas or island cell tumors.
Endocrine pancreatic cancer is uncommon including:
- VIPomas (from cells that make intestinal peptides)
Some pancreatic island tumors do not secrete hormones and are called pancreatic non-secreting tumors.
Because pancreatic cancer usually doesn’t cause noticeable symptoms in its early stages, the disease is usually not diagnosed until it spreads outside the pancreas. This is one of the main reasons for poor survival.
Common symptoms of pancreatic cancer that occur prior to diagnosis include:
- Jaundice. When pancreatic cancer prevents the duct from releasing bile into the intestine, bile components build up in the blood. This causes yellow skin and eyes, a condition called jaundice. The same obstruction causes dark urine, light stools and itching.
- Stomachache. Pancreatic cancer can cause dull pain in the upper abdomen radiating to the back. The pain can come and go.
As it grows and spreads, pancreatic cancer affects the whole body. Such symptoms may include:
- Weight loss
- Loss of appetite
- High blood sugar. Some people with pancreatic cancer develop diabetes because the cancer weakens the pancreas’ ability to produce insulin.
- Blood clots: Sometimes, the first clue that someone with pancreatic cancer is a blood clot in a large vein, usually in the leg.
However, some other conditions can cause similar symptoms, so doctors often cannot diagnose pancreatic cancer until later.
Contact a doctor immediately or go to the nearest health facility if you are concerned about any possible symptoms.
Causes of pancreatic cancer
Pancreatic cancer occurs when cells in the pancreas grow uncontrollably dividing and spreading, forming a malignant tumor. Some risk factors are known to increase the risk of pancreatic cancer:
- Is one of the important risk factors for pancreatic cancer.
- The risk of pancreatic cancer is twice that of smokers compared to those who have never smoked. About 25% of pancreatic cancer is attributed to smoking.
Contact with some chemicals
Severe exposure to certain chemicals used in the dry cleaning and metalworking industries can increase a person’s risk of pancreatic cancer.
- The risk of developing pancreatic cancer increases as people age. Pancreatic cancer appears as all patients are over 45 years old.
- About two-thirds are at least 65 years old. The average age at the time of diagnosis was 70 .
- Men are more likely to develop pancreatic cancer than women.
- Tobacco use is higher in men, increasing the risk of pancreatic cancer.
- In some families, the high risk is due to genetic syndrome. In other families, the gene causing the increased risk is not known.
- Although a family history is a risk factor, most people with pancreatic cancer have no family history.
Genetic changes can be passed from parent to child and can cause up to 10% of pancreatic cancer.
Pancreatic cancer is more common in people with diabetes.
- Chronic pancreatitis, long-term pancreatitis, is associated with an increased risk of pancreatic cancer. Chronic pancreatitis is sometimes caused by a genetic mutation.
- People with inherited pancreatitis are at higher risk for pancreatic cancer.
- smoke or be exposed to cigarette smoke
- being overweight has a 20% higher risk of pancreatic cancer.
- lack of exercise
- a diet high in red meat and fat and low in vegetables
- Long-term and heavy drinking can lead to chronic pancreatitis, a risk factor for pancreatic cancer
How does pancreatic cancer form?
Pancreatic cancer occurs when cells in the pancreas grow mutated in their DNA. These mutations cause cells to grow uncontrollably and to continue living after normal cells die. These accumulated cells can form tumors. Untreated pancreatic cancer spreads to nearby organs and blood vessels.
Most pancreatic cancer tumors begin in the ducts of the pancreas. This type of cancer is called pancreatic carcinoma or pancreatic outpatient cancer. Rarely, cancer can form in hormone-producing cells or pancreatic nerve cells. These types of cancers are called islet cell tumors, pancreatic endometrial cancers and pancreatic neuropathy tumors.
Treatment of pancreatic cancer depends on the stage of the cancer. It has two goals: kill cancer cells and prevent the spread of disease.
Depending on your needs, your pancreatic cancer treatment plan may include minimally invasive gastrointestinal techniques, chemotherapy, radiological interventions or other innovative methods.
- The decision to use surgery to treat pancreatic cancer has two things: the location of the cancer and the stage of the cancer. Surgery may remove all or some parts of the pancreas.
- This may remove the original tumor, but it will not remove the cancer that has spread to other parts of the body. Surgery may not be suitable for people with advanced pancreatic cancer for that reason.
The three main surgical procedures that can help people with pancreatic cancer are:
- Nipple procedure : The surgeon removes the head of the pancreas and sometimes the entire pancreas, along with part of the stomach, duodenum, lymph nodes and other tissues. This is a complicated and risky procedure.
- Pancreas Removal Surgery: The surgeon removes the tail of the pancreas and sometimes other parts of the pancreas along with the spleen. Doctors often recommend this procedure to treat islet cell tumors or neuromas.
- Total pancreatectomy : The surgeon removes the entire pancreas and spleen. It is possible to live without the pancreas but diabetes can occur because the body no longer produces insulin cells.
Radiotherapy is a treatment for cancer that uses high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:
- External radiotherapy uses a device outside the body to send radiation to the cancer.
- Internal radiotherapy uses radioactive substances that are sealed in needles, beads, wires or catheters placed directly into or near the cancer.
The way radiotherapy is given depends on the type and stage of cancer being treated. External radiation therapy is used to treat pancreatic cancer.
- A cancer treatment that uses drugs to stop the growth of cancer cells, either by destroying the cells or by stopping them from dividing.
- These drugs can be injected into a vein or taken. The type of chemotherapy given depends on the type and stage of cancer being treated.
- In some cases, your doctor may combine other treatments with chemotherapy
Treatment with chemicals
Chemoradiation treatment combines chemotherapy and radiation therapy to increase the effects of both.
- This type of cancer treatment uses drugs or other measures to specifically target cancer cells and work to destroy them. These drugs are designed to not harm healthy or normal cells.
- Tyrosine kinase inhibitors (TKIs) are targeted drugs that block the signals needed for tumor growth. Erlotinib is a type of TKI used to treat pancreatic cancer.
Immunotherapy tries to boost a person’s immune system or provide them with ready-made components of the immune system to attack cancer cells.
- Monoclonal antibodies : A form of immunotherapy that uses an injection of artificial monoclonal antibodies. The immune system proteins are made to contain on a specific molecule such as carcinoembryonic antigen (CEA) sometimes found on the surface of pancreatic cancer cells.
- Cancer vaccines : Several vaccines to enhance the body’s immune response to pancreatic cancer cells. Unlike vaccines against infections like measles or mumps, these are designed to help treat non-preventive pancreatic cancer.
- Drugs that target the immune system: The immune system usually keeps it from attacking other normal cells in the body by using protein check points on immune cells that need to be activated. activates to initiate immune response
Prevention of pancreatic cancer
You may reduce your risk of pancreatic cancer if you:
- Quit smoking: If you smoke, try to stop. Talk to your doctor about strategies to help you prevent, including support groups, medications and nicotine replacement therapy. If you do not smoke, do not start.
- Maintain a healthy weight: If you have a healthy weight, work to maintain it. If you need to lose weight, lose weight slowly from 1-2 pounds (0.5 – 1 kg) a week. Combine daily exercise with a diet rich in vegetables, fruits and whole grains with smaller portions to help you lose weight.
- Choose a healthy diet: A diet full of colorful fruits and vegetables and whole grains can help reduce the risk of cancer.
See your genetic counselor if you have a family history of pancreatic cancer. Your doctor can review your family health history with you and determine if you can benefit from a genetic test to understand your risk of pancreatic cancer or other cancers.
Pancreatic cancer survival rate
Survival rates can tell what percentage of people with the same type and stage of cancer are still alive for a certain period of time usually 5 years after they are diagnosed.
- Five-year survival rate for local pancreatic cancer is 34%. Local pancreatic cancer is stages 0, 1 and 2.
- The five-year survival rate for regional pancreatic cancer that has spread to nearby structures or lymph nodes is 12%. Phases 2B and 3 fall into this category.
- Distal pancreatic cancer, or stage 4 cancer, has spread to other places such as lung, liver or bone, with a 3% survival rate.
However, your doctor cannot tell you how long you will live, but they can help you better understand how likely your treatment will be.
Reference Source Pancreatic Cancer:
- Source mayoclinic.org article Pancreatic cancer : https://www.mayoclinic.org/diseases-conditions/pancreatic-cancer/symptoms-causes/syc-20355421 , updated 9/3/2018.
- Source en.wikipedia.org Pancreatic cancer article : https://en.wikipedia.org/wiki/Pancreatic_cancer , updated 11/11/2019.
- Source of prestige thuoclp.com synthesis article Pancreatic cancer is what?: https://index-china.com/pancreatic-cancer/, updated 12/3/2020.
Assoc.Prof.Dr. Tran Ngoc Anh is currently Hanoi Medical University Hospital, Associate Professor, Department of Internal Medicine, Gastroenterology and Head of Department of General-Uematology of Hanoi Medical University. Consulting doctor at ThuocLP Pharmacy.
Professional qualifications, Academic degrees – Education:
Graduated from General Practitioner System, Hanoi Medical University
Graduated with a Master degree in Internal Medicine, Hanoi Medical University
Graduated from the training program specialized in Gastrointestinal, Henri Mondor Institute Center, University of Paris 6, French Republic 1996-1997; 1999
Graduated from the training program specialized in Gastrointestinal, North Royal Sydney Hospital, Australia; 2002
Graduated from a training program specialized in chronic liver diseases, Pizza, Italy 2009
Graduated with a PhD in Gastrointestinal, Hanoi Medical University
Associate Professor, Gastroenterology, Hanoi Medical University
Training and Scientific Research:
Published more than 200 articles in domestic and international specialized journals
Editor of many monographs and participates in compiling 2 textbooks.
Guide many students and graduate students of Hanoi Medical University
Manager of many grassroots research projects
Certificate of Good Clinical Practice (GCP: 2012, 2015), Ministry of Health
Specialized certificates: General gastrointestinal endoscopy, Interventional gastrointestinal endoscopy, General gastrointestinal ultrasound, Interventional gastrointestinal ultrasound (Bach Mai BV), Chronic liver disease.