What is pancreatic cancer?

Pancreatic cancer is cancer of the pancreas. Cancer of the pancreas can be of many types adenocarcinoma being the commonest type. It can affect any part of the pancreas i.e, head, body, or tail. There are many other types of cancers affecting the pancreas but they are rarer than adenocarcinoma of the pancreas.

What are the symptoms of pancreatic cancer?

Pancreatic cancer is usually asymptomatic. It can manifest in many ways with a few symptoms that are specific to pancreatic cancer are –

• Jaundice
• Abdominal pain radiating to the back
• Nausea/vomiting
• Upper back pain
• Recent worsening of sugar control in diabetic patients

Pancreatic cancer has non-specific signs and symptoms

• Weight loss
• Fatigue
• Abdominal distension
• Indigestion

Who is at risk of developing pancreatic cancer?

Various risk factors that have been found to be associated with pancreatic cancers are

• Smoking
• Obesity
• Type 2 diabetes
• Family history of pancreatic cancer
• Chronic pancreatitis
• Hereditary conditions, such as Lynch syndrome or gene mutations.

How is pancreatic cancer diagnosed?

Various investigations can be used to diagnose pancreatic cancer.

• Ultrasound abdomen
• Multiphasic CECT abdomen – can stage the disease as well as give a good assessment of resectability of cancer.
• MRI SCAN of the abdomen
• Endoscopic ultrasound (EUS) with a needle biopsy.

A combination of these investigations can provide a pretty accurate diagnosis of pancreatic cancers.

How is pancreatic cancer treated?

Pancreatic cancer requires multimodal therapy for its treatment i.e, surgery, chemotherapy, or radiation therapy.

Surgery remains the mainstay of treatment for pancreatic cancer. Complete resection is one of the most significant factors in the treatment of pancreatic cancer. This can be assessed by multiphasic CECT , EUS . So pancreatic surgeons can decide the resectability of disease from these investigations and can expand the list of resectability by using various surgical means e.g, resection of vein or vascular reconstruction which is a most important factor in deciding the success of surgery for pancreatic cancer. So the patient must be assessed by a pancreatic surgeon before deciding upon any form of therapy e.g, stenting for jaundice in pancreatic cancer. The case discussed in the tumor board involving a pancreatic surgeon can provide the best chance for the treatment of pancreatic cancer.

Why pancreatic cancer is usually detected in late stages?

The pancreas is surrounded by important blood vessels that carry blood supply to the liver and intestine. These blood vessels are involved early in cancer of the pancreas thus precluding removal of a tumor that is the main form of treatment. Moreover, the majority of these cancers are asymptomatic and are thus detected at late stages when it has already spread locally of distantly.

Are all cysts of the pancreas cancerous?

No, the majority of cysts of the pancreas are being. But few cyst carries the risk of turning into cancer or are cancerous themselves. EUS FNAC and EUS fluid testing can help in the diagnosis of these cysts and thus early treatment.

How can pancreatic cancer be prevented?

Unfortunately, most pancreatic cancer cannot be prevented, but you can reduce your risk by maintaining a healthy weight, stopping smoking, and limiting your alcohol intake. Other risk factors include chronic pancreatitis and family history. Occasionally, precancerous lesions can be identified and, if removed early, can prevent pancreatic cancer from developing.

Can one liver without a pancreas?

Yes, one can live without a pancreas but with supplementation of insulin and enzymes. Diabetes that results from the absence of the pancreas is difficult to manage and requires insulin but is still difficult to work as blood sugar levels vary widely.