By: Daniel Gelrud, MD
The pancreas is an important organ responsible for the production of enzymes necessary for the digestion of food and insulin (a hormone that controls sugar levels in the blood). Pancreatic cancer is a disease in which malignant cells form in the pancreatic tissues. The risk factors for developing pancreatic cancer include smoking, diabetes, obesity, chronic pancreatitis and certain inherited conditions.
Initially pancreatic cancer tends to be silent but as it grows symptoms develop. Unfortunately, by the time symptoms develop the cancer has probably grown outside of the pancreas. The symptoms will depend on the location of the cancer. If the tumor is in the body of the pancreas, the patient will have belly or back pain and weight loss. Pancreatic cancer of the head of the pancreas tends to cause weight loss, belly or back pain, jaundice (yellow skin and eyes), dark urine, itching or light colored stool.
Is Pancreatic Cancer Increasing?
Pancreatic cancer has a poor prognosis and its incidence has been increasing over the last 15 years. Although it is not clear why this is happening, pancreatic cancer ranks 4th in cancer related deaths. By 2030 it is believed that pancreatic cancer will fall shortly behind lung cancer as the second highest cause of cancer deaths.
There are several reasons for the increase in pancreatic cancer. Firstly, there has been a rise in obesity and diabetes which are both risk factors for the disease. Secondly, the incidence of colon and breast cancer has been decreasing because of effective screening practices. The incidence of colon cancer in older adults has decreased 30% over the last decade because of the increasing use of colonoscopy as a screening tool. Thirdly, the general population has a higher life expectancy and pancreatic cancer is more common later in life.
How is Pancreatic Cancer Diagnosed?
The pancreas is a very difficult organ to image and obtain tissue from. This makes it very difficult to diagnose. After a patient develops symptoms suggestive of pancreatic cancer, your primary doctor will obtain a full history and physical exam and then he may order a CT scan or a MRI. After that the doctor will refer the patient to see a gastroenterologist with expertise in pancreatic diseases. A biopsy will be obtained using an Endoscopic Ultrasound (EUS) or with an ERCP (an endoscopic procedure that accesses the bile and pancreatic ducts). One of the main objectives for the imaging studies and EUS is to determine whether the cancer can be removed by surgery.
The best treatment for pancreatic cancer depends on how far it has spread, or its stage. Early stages can be treated with surgery. When the tumor has spread beyond the pancreas, then surgery is not possible. Other treatment modalities such as chemotherapy and radiation therapy can extend survival.
Pancreatic cancer is a common cause of cancer related deaths and its occurrence has been increasing over the last 15 years. Early diagnosis is crucial and it is imperative to consult with a physician who has experience with pancreatic cancer.