Pancreatic cancer
Pancreatic
cancer is caused by the abnormal and uncontrolled growth of cells in the
pancreas – a large gland that's part of the digestive system. Around half of all new cases are
diagnosed in people aged 75 or over. It's uncommon in people under 40
years of age.
Symptoms of pancreatic cancer
In the early stages, a tumour in the
pancreas doesn't usually cause any symptoms, which can make it difficult
to diagnose.
It's important to remember that these
symptoms can be caused by many different conditions, and aren't usually the
result of cancer. But you should contact your doctor if you are concerned, or
if these symptoms start suddenly.
The first noticeable symptoms of
pancreatic cancer are often:
- pain
in the back or stomach area – which may come and go at first and
is often worse when you lie down or after you've eaten
- unexpected weight loss
- jaundice – the most obvious sign is
yellowing of the skin and whites of the eyes; it also causes your
urine to be dark yellow or orange and your stools (faeces) to be
pale-coloured.
Other possible symptoms of pancreatic
cancer include:
- nausea
and vomiting
- bowel
changes
- fever
and shivering
- indigestion
- blood
clots.
You may also develop symptoms of diabetes if you have pancreatic
cancer, because it can produce chemicals that interfere with the normal effect
of insulin.
Endocrine pancreatic cancer
There are also a number of
different endocrine tumours that cause different symptoms, depending on the
hormone the tumour produces.
Causes of pancreatic cancer
It's not fully understood what causes
pancreatic cancer, but a number of risk factors for developing the condition
have been identified.
Risk factors for pancreatic cancer
include:
- age – it
mainly affects people who are 50-80 years of age
- smoking – around one in three
cases is associated with using cigarettes, cigars or chewing tobacco
- having a history of certain health conditions – such as diabetes, chronic pancreatitis (long-term
inflammation of the pancreas), stomach ulcer and Helicobacter
pylori infection (a stomach infection).
In about 1 in 10 cases, pancreatic
cancer is inherited from a person's parents. Certain genes also increase your
chances of getting pancreatitis, which in turn increases your risk of
developing cancer of the pancreas.
Diagnosing pancreatic cancer
Your doctor/ GP will first ask about your
general health and carry out a physical examination. They may examine your
tummy (abdomen) for a lump and to see whether your liver is enlarged. They will also check your skin and
eyes for signs of jaundice and may request a urine
sample and blood test.
If your doctor suspects pancreatic
cancer, you'll usually be referred to a specialist at a hospital for further
investigation. You may have either:
- an ultrasound scan
- a computerised tomography (CT) scan
- a magnetic resonance imaging (MRI) scan
- a positron
emission tomography (PET) scan – where you're given an injection of a
very small amount of radioactive medication, known as a tracer, which
helps to show up cancers in an image.
Depending on the results of a scan,
further tests may include:
- an endoluminal ultrasonography (EUS) endoscopy – a
type of endoscopy which allows close-up
ultrasound pictures to be taken of your pancreas
- an endoscopic retrograde cholangiopancreatography (ERCP) – a
type of endoscopy which is used to inject a special dye into your
bile and pancreatic ducts; the dye will show up on an X-ray and highlight any tumours
- a laparoscopy – a surgical procedure
that allows the surgeon to see inside your body using a
laparoscopy (a thin, flexible microscope).
A biopsy, where a small sample is taken from a
suspected tumour, may also be carried out during these procedures.
NICE guidelines
In 2015, the National Institute for Health and Care Excellence (NICE) published
guidelines to help GPs recognise the signs and symptoms of pancreatic cancer
and refer people for the right tests faster.
Treating pancreatic cancer
Cancer of the pancreas is difficult
to treat. It rarely causes any symptoms in the early stages, so it's often
not detected until the cancer is fairly advanced. If the tumour is large,
treating the cancer will be more difficult. If you have been diagnosed with
pancreatic cancer, your treatment will depend on the type and location of
your cancer, and how far it's advanced. Your age, general health and personal
preferences will also be taken into consideration.
The first aim will be to completely
remove the tumour and any other cancerous cells. If this isn't possible,
treatment will focus on preventing the tumour growing and causing further
harm to your body. The three main treatments for
pancreatic cancer are:
- surgery
- chemotherapy
- radiotherapy.
Some types of pancreatic cancer only
require one form of treatment, whereas others may require two types of
treatment or a combination of all three.
Recovering from surgery
Recovering from pancreatic cancer
surgery can be a long and difficult process. You will probably experience some pain
after your operation. The staff at your hospital will make sure you have
adequate pain relief. After any type of surgery to your
digestive system, your bowel will temporarily stop working. This means you
won't be able to eat or drink straight away.
You will gradually be able to sip
fluids, before eventually being able to drink and eat more regularly. You
may be referred to a dietitian, who can advise you about what foods you
should eat following your operation.
After the tumour has been removed,
you'll probably have a six-month course of chemotherapy, which greatly increases your
chance of being cured. But because cancer of the pancreas is
difficult to diagnose and treat, many people don't recover completely.
Treatment can be very effective in
helping to ease symptoms and make you as comfortable as possible. Chemotherapy
can help shrink your tumour and slow down its growth.
Source: NHS Choices