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  • Writer's pictureDoç.Dr.Mutlu Ünver

What is Pancreatic Cancer? - Assoc. Prof. Dr. Mutlu Unver - Izmir, Turkey

Updated: May 1

Pancreatic cancer is a type of cancer caused by abnormal growth and uncontrolled proliferation of pancreatic cells. The pancreas is an important organ that secretes digestive enzymes and hormones.


Pancreatic cancer is usually caused by cells called adenocarcinomas, and this type of cancer occurs in the lining of the pancreas. In rare cases, other types can also occur, originating from the hormone-producing cells of the pancreas.

 

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Role and Location of the Pancreas


The pancreas is an important organ in the digestive system. It consists of three parts: head, body and tail. Digestive enzymes (such as amylase, lipase and trypsin) are produced by the pancreas and help digest food in the small intestine. In addition, pancreatic hormones (such as insulin and glucagon) play an important role in regulating blood sugar.


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Assoc. Prof. Dr. Mutlu Unver

Effects of Pancreatic Cancer


Pancreatic cancer disrupts the normal functions of the pancreas. Cancer cells can affect the structures and functions of the pancreas, reducing or blocking the production of digestive enzymes. This can disrupt the functioning of the digestive system, causing digestive problems, weight loss and nutritional problems. In addition, pancreatic cancer can lead to hormone imbalances, especially if insulin-producing cells are affected, which can lead to problems with blood sugar control.


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In advanced stages, pancreatic cancer can spread to other parts of the body by metastasizing to surrounding tissues or distant organs. In this case, the spread of cancer to different parts of the body may cause different symptoms and treatment options to be considered.


Pancreatic cancer is often asymptomatic in the early stages and can be difficult to diagnose. For this reason, it is often diagnosed in advanced stages when the cancer has progressed and symptoms appear.


Pancreatic cancer is often a challenging disease in terms of treatment options and prognosis. The treatment plan is determined depending on the stage of the cancer, general health and other factors.



Types of Pancreatic Cancer


What is Adenocarcinoma?


Adenocarcinoma, the most common type of pancreatic cancer, is made up of cancer cells that originate from the glands of the pancreas. This type of cancer arises from cells in the outer part of the pancreas. Adenocarcinoma is usually aggressive and can progress without symptoms in the early stages. Usually, when adenocarcinoma is diagnosed, the cancer is usually in advanced stages.


Pancreatic Benign Tumors and Symptoms


Benign tumors in the pancreas are abnormal cell growths that are not associated with cancer. Such tumors are usually different from cancerous tumors because they do not spread throughout the body or metastasize to other tissues. Benign pancreatic tumors can often cause the following symptoms: abdominal pain, weight loss, digestive problems and rarely jaundice.


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Mass Formation and Spread of Pancreatic Cancer


In pancreatic cancer, mass formation begins when cells multiply abnormally and come together to form a tumor. This mass may initially be confined within the pancreas. However, as the cancer progresses, this mass may spread to other parts of the pancreas or spread to surrounding tissues. The process by which masses spread determines the stage of the cancer and affects treatment options.


The types of pancreatic cancer and the processes of mass formation play an important role in the progression of the disease and treatment options. For diagnosis and treatment, it is crucial to accurately determine the type of cancer and the degree of spread.


Pancreatic Cancer Symptoms


Early Signs of Pancreatic Cancer


In the early stages, symptoms of pancreatic cancer can often be vague or mild. These symptoms may include:


Abdominal Pain and Discomfort:

Persistent or intermittent pain or discomfort in the abdomen.


Fatigue and Weakness:

Sudden or persistent fatigue, weakness or lack of energy.


Loss of Appetite and Weight Loss:

Sudden loss of appetite, decreased interest in food and involuntary weight loss.


Nausea and Vomiting:

Feeling nauseous and sometimes vomiting, especially after eating.


Digestive Problems:

A tendency to experience digestive problems such as constipation or diarrhea.


Pancreatic Cancer Symptoms

Symptoms of Advanced Pancreatic Cancer


As pancreatic cancer progresses, symptoms can become more pronounced. Advanced stage symptoms include:


Jaundice:

Symptoms of jaundice, such as yellowing of the skin and eyes (icterus), can be caused by blocked bile ducts.


Abdominal distension:

A feeling of swelling, discomfort or pressure in the abdomen.


Pain and Severe Discomfort:

Pain and discomfort in the abdomen may increase, especially as the cancer progresses.


Jaundice and Change in Urine Color:

Dark urine and light stools are signs of jaundice.


High Sugar Levels:

High blood sugar levels associated with the hormone-producing cells of the pancreas being affected.


Back Pain Pancreatic Cancer


Pancreatic cancer can cause some symptoms, including back pain. Back pain in particular can be one of the symptoms associated with pancreatic cancer. There may also be symptoms such as digestive problems, yellowing of the skin and constant fatigue.


Stages of Pancreatic Cancer


Pancreatic cancer stages are used to determine how far the disease has progressed and how far it has spread in the body. Staging is important in determining treatment options and assessing the prognosis of the disease. It is usually defined in terms of the following stages:


Stage 0 Pancreatic Cancer (Precancerous): 

Cancer cells are only found in a specific area within the pancreas. At this stage, cancer cells have not spread to other tissues or organs.


Stage 1 Pancreatic Cancer: 

The cancer is confined to a specific area of the pancreas and has not spread to nearby tissues.


Stage 2 Pancreatic Cancer: 

The cancer may have spread to a larger area of the pancreas and may have spread to some neighboring organs or tissues.


Stage 3 Pancreatic Cancer: 

The cancer may have spread to the large vessels around the pancreas or to nearby organs. However, it has not yet spread to distant organs (distant metastases).


Stage 4 Pancreatic Cancer: 

At this stage, the cancer has spread beyond the pancreas and metastasized to surrounding tissues, other organs or distant sites (such as the liver, lung, brain).


Each stage plays an important role in determining the treatment plan and prognosis of the disease. Pancreatic cancer diagnosed in the early stages usually offers a better chance of cure, while treatment options may be more limited for cancers diagnosed in advanced stages.


Therefore, once the stage of the cancer is determined, treatment strategies and the patient's prognosis can be better understood.


Pancreatic Cancer Diagnosis


Diagnostic Methods and Tests in Pancreatic Cancer


Pancreatic cancer is usually diagnosed with the following methods:


Pancreatic cancer Imaging Tests: 

Imaging tests such as computed tomography (CT) scans, magnetic resonance imaging (MRI), ultrasonography and positron emission tomography (PET) can help show abnormalities and masses in the pancreas.


Pancreatic cancer Blood Tests: 

Blood tests can help determine the presence of cancer by measuring levels of cancer markers (such as CA 19-9). However, these markers alone are not enough to diagnose pancreatic cancer.


Pancreatic cancer Endoscopic Ultrasonography (EUS): 

This method uses ultrasound to observe problems such as pancreatic cancer in more detail. This endoscopic test can provide important information about the size and location of cancerous lesions and their relationship with nearby tissues.


Pancreatic cancer Biopsy: 

A biopsy is often necessary to confirm the diagnosis of pancreatic cancer. This means taking a sample of abnormal tissue and examining it under a microscope. The biopsy can usually be performed under endoscopic ultrasonography (EUS) or CT guidance.


Pancreatic Cancer Staging


Staging of pancreatic cancer is done to determine how far the disease has progressed and spread. Staging is usually based on the following factors:


Pancreatic cancer Tumor size: 

The size of the cancerous tumor and the areas to which it has spread are assessed.


Pancreatic cancer Nodules and Lymph Nodes: 

The lymph nodes around the pancreas are checked for the presence of cancer cells.


Pancreatic cancer Metastases: 

This assesses whether the cancer has spread to other parts of the body (distant organs).


Pancreatic Cancer Treatment


Surgical Intervention in Pancreatic Cancer: Whipple Surgery and Open Pancreas Surgery


Whipple Surgery (Pancreaticoduodenectomy): 

In this surgery, the head of the pancreas, duodenum, gallbladder, bile ducts and sometimes part of the stomach are removed. This surgery is performed to remove tumors located at the head of the pancreas or in the ampulla (duodenal region).


Open Pancreas Surgery (Total Pancreatectomy): 

In this surgery, the entire pancreas can be removed, including the gallbladder and sometimes nearby lymph nodes. It is a rare surgical procedure and is usually preferred when the cancer has spread to a large area of the pancreas.

 

Radiotherapy and Chemotherapy for Pancreatic Cancer


Pancreatic Cancer Radiotherapy: 

A treatment that uses high-energy rays to kill cancer cells or control their growth. In pancreatic cancer, radiotherapy can be used to shrink the tumor before surgery, for postoperative treatment or to control symptoms.


Pancreatic Cancer Chemotherapy: 

A form of treatment that aims to kill cancer cells or control their growth using drugs. In pancreatic cancer, chemotherapy can be used for pre- or post-operative treatment, to control the spread of cancer or to relieve symptoms.


Targeted Therapies for Pancreatic Cancer


Pancreatic Cancer Targeted Drug Therapies: 

Drugs that target specific cancer cells can stop the growth of cancer cells or kill them. For example, drugs that block cell growth signals or kill cells can be used as targeted therapies.


Pancreatic Cancer Immunotherapy: 

This treatment method involves drugs that stimulate or strengthen the body's immune system to fight against cancer cells. In pancreatic cancer, immunotherapy can help the immune system fight the cancer.


These treatment methods can be applied depending on the stage of pancreatic cancer, its spread and the patient's general health. The treatment plan is usually tailored to the patient's condition by a specialist oncologist.


Pancreatic Cancer Recovery Process


Symptoms and Process of Recovery in Pancreatic Cancer


Pancreatic cancer treatment may differ depending on the person's general health, the stage of the cancer and the treatment methods used. Some symptoms and the process of recovery may include:


Pancreatic Cancer Pain Management:

Pain may be experienced frequently after surgery or during the treatment process. Pain can be controlled with medications recommended by the doctor.


Pancreatic Cancer Wound Healing:

The wound healing process in the postoperative period is important. Wound care should be done in accordance with the doctor's recommendations to accelerate the healing process and prevent complications.


Pancreatic Cancer Energy Level and Fatigue:

The treatment process can often cause fatigue and loss of energy. Rest, regular exercise and a balanced diet can increase energy levels during the healing process.


Care Recommendations and Nutrition in Pancreatic Cancer


Pancreatic Cancer Balanced Nutrition:

Nutrition plays an important role in the treatment of pancreatic cancer. Food can be difficult to digest, so light, easily digestible and nutritious foods should be preferred.


Pancreatic Cancer Fluid Consumption:

Fluid intake is important. Consuming water, fruit juice or juicy fruits can help to maintain the body's fluid balance.


Pancreatic Cancer Protein and Energy Needs:

High-calorie and protein foods recommended by the doctor or dietitian should be consumed to meet protein and energy needs.


Rehabilitation After Pancreatic Cancer Surgery


Pancreatic Cancer Physical Therapy and Exercise:

Physical therapy and exercises are important in the post-operative rehabilitation process to restore muscle strength, increase mobility and support the healing process.


Pancreatic Cancer Psychological Support:

Pancreatic cancer treatment and recovery can be emotionally challenging. Receiving psychological support can support the patient's mental health.


Pancreatic Cancer Follow-up Examinations:

Regular medical check-ups after treatment are important to monitor the healing process and to detect possible complications early.


Pancreatic Cancer Prevention


Risk Factors Pancreatic Cancer and Preventive Steps


What are the Risk Factors for Pancreatic Cancer?


There are some risk factors that play a role in the development of pancreatic cancer. These include smoking, obesity, excessive consumption of high-fat and processed foods, genetic factors, and chronic pancreatitis. Knowing these risk factors is important for understanding cancer risk.


What are the Preventive Steps for Pancreatic Cancer?


While there is no guarantee of completely preventing pancreatic cancer, some steps can help reduce the risk of cancer. These include adopting a healthy lifestyle (balanced diet, regular exercise), reducing smoking and alcohol consumption, preventing obesity and having regular health check-ups. In addition, if there are familial risk factors, it is also important to consult a doctor regularly and stay under control.


What is the Importance of Genetic Testing in Pancreatic Cancer?


Genetic testing may be recommended when there is a history of pancreatic cancer in some families. These tests can help determine a person's risk of cancer and help take early action. People with a family history of pancreatic cancer are advised to assess their risk through genetic counseling.


What is the Importance of Health Checkups in Pancreatic Cancer?


Going for regular medical check-ups is critical for identifying the risk of cancer and diagnosing it at an early stage. Regular health checks before symptoms appear can help diagnose and treat the disease at an early stage.


Pancreatic Cancer and Quality of Life


Lifestyle Changes in Pancreatic Cancer


Lifestyle changes are important for people diagnosed with pancreatic cancer. These can include steps such as adopting healthy eating habits, exercising regularly, and quitting or reducing smoking and alcohol consumption. These changes can support the treatment process and improve quality of life.


The Role of Diet and Nutrition in Pancreatic Cancer


Nutrition is important for people with pancreatic cancer. A diet that is easy to digest, high in protein, fiber and healthy fats can increase nutrient intake in the body. In some cases, nutritional supplements may also be recommended.


The Importance of Exercise in Pancreatic Cancer


Regular exercise is also important for people being treated for pancreatic cancer. Exercise can increase strength in the body, boost energy levels and improve overall health.


Psychological Support and Counseling in Pancreatic Cancer


Pancreatic cancer treatment can be personally and emotionally challenging. Psychological support and counseling can help patients and their relatives cope with stress, receive emotional support and better manage the treatment process.


Misconceptions about Pancreatic Cancer


False Beliefs and Facts:


a. Cancer Develops Only in Smokers:


Although pancreatic cancer is more common in smokers, smoking alone does not cause pancreatic cancer. Other factors can also be effective; genetic factors, family history, obesity can also increase the risk.


b. Pancreatic Cancer Only Occurs in the Elderly:


Although pancreatic cancer usually occurs in older people, it can also occur in younger people. Age may be a factor that increases the risk of cancer, but it can occur in any age group.


c. Pancreatic Cancer Shows Early Symptoms:


Unfortunately, pancreatic cancer is often asymptomatic in the early stages and is usually recognized when symptoms are advanced. This can delay diagnosis and make treatment more difficult.


d. Only Abdominal Pain is a Symptom of Pancreatic Cancer:


Abdominal pain is one of the symptoms of pancreatic cancer, but it is not limited to this symptom. Symptoms such as fatigue, loss of appetite, weight loss, jaundice can also be signs of pancreatic cancer.


e. Pancreatic Cancer Treatment is Always Effective:


Treatment options may be limited for pancreatic cancer. It may be curable in case of early diagnosis, but in advanced stages, treatment options may be more difficult and the cancer may not be controlled.


f. Alternative treatments can cure cancer:


Alternative therapies do not cure cancer. They may relieve some symptoms or be comforting when used as a complement, but evidence-based medical treatments are important to treat cancer.


Interesting Statistics and Research on Pancreatic Cancer


General Statistics on Pancreatic Cancer:


  1. Pancreatic cancer is one of the deadliest forms of cancer. It is often not diagnosed in the early stages and treatment options may be limited.

  2. Pancreatic cancer has a lower survival rate than other types of cancer.

  3. The incidence of pancreatic cancer may vary in certain geographical areas.


Recent Advances and Innovations in Pancreatic Cancer:


  1. Advances in medicine and technological developments may lead to changes in the way pancreatic cancer is diagnosed and treated. For example, advances in imaging techniques may improve early diagnosis.

  2. Research shows that pancreatic cancer is associated with genetic factors and that certain genetic mutations contribute to the development of this type of cancer.


New Approaches to Fight Pancreatic Cancer:


  1. Drug development and targeted therapies show promise in the treatment of pancreatic cancer.

  2. New treatment modalities such as immunotherapy are being researched and their efficacy in the treatment of pancreatic cancer is still being studied.


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