Signs and symptoms
Pancreatic cancer is often difficult to detect early because the symptoms do not show until the cancer is quite advanced. It has been called the “silent killer” because the symptoms are sometimes vague or often go unnoticeable. Symptoms may include the following:
- Yellowing of the skin and eyes
- Urine may become darker
- Pain in the upper abdomen and back
- Loss of appetite
- Weight lss
Routine exams do not often reveal tumours since the pancreas is hidden behind other organs. Healthcare providers may not easily see or feel the presence of tumors. Thus, pancreatic cancer is often discovered late and spreads quickly.
Causes and risk factors
Some of the recognized risk factors for developing pancreatic cancer include the following:
- Male sex - There is a 1.3:1 male-to-female ratio of pancreatic cancer.
- Long-term diabetes
- Chronic pancreatitis - Inflammation of the pancreas often due to excessive alcohol intake or gallstones.
- Family history of pancreatic cancer
Diagnosis and tests
Pancreatic cancer is diagnosed through a complete physical exam. It is necessary for the doctor to know the patient's personal and family medical history. The doctor will check for general signs of health such as temperature, pulse, blood pressure, and often order blood, urine, and stool tests.
The physician may request for a "barium swallow," or "upper GI series." The test involves drinking a barium solution before x-rays of the upper digestive. The barium will reveal an outline of the pancreas on the x-ray results.
The doctor may request for other tests such as:
- Angiogram - Special x-ray of blood vessels.
- CT scans, x-rays - To get detailed pictures of a cross- section of the pancreas.
- Transabdominal ultrasound - To view the pancreas.
- Endoscopic retrograde cholangiopancreatogram (ERCP) – Special x-ray of the common bile duct
- Endoscopic ultrasound – A new procedure in diagnosing pancreatic cancer.
The best way to determine the presence of cancer is through a biopsy. The procedure involves removing some tissue from the pancreas. The pathologist examines it under a microscope to check for cancer cells. Forms of biopsy include the needle biopsy and brush biopsy. Sometimes there is a need a laparotomy. This operation helps the doctor determine the extent of the cancer. Determining the stage of the cancer is necessary for making treatment plans.
Pancreatic cancer is curable when found in its earliest stage. Once the cancer spreads, it becomes very difficult to cure. However, it can still be treated. The symptoms experienced by the patients can be relieved and their quality of life can be improved.
Pancreatic cancer may be treated with surgery where all or part of the pancreas may be removed. Sometimes a portion of the stomach, the duodenum, and other nearby tissues are also removed. In certain cases when the cancer in the pancreas is difficult to remove surgically, the surgeon may be able to create a bypass around the common bile duct or the duodenum if either is blocked.
Radiation therapy (also called radiotherapy) can be administered to damage cancer cells in order to stop them from growing. It can be given 5 days a week for 5 to 6 weeks. Radiation also helps relieve pain or digestive problems in cases where the bile duct or duodenum is blocked. Chemotherapy uses drugs to kill cancer. It can be given by mouth or by injection into a muscle or vein. It can be administered in cycles in between recovery periods.
As pancreatic cancer advances, certain complications may manifest:
- Jaundice – This is characterized by the yellowing of the skin and eyes, darkening of the urine and paling of the stool. Jaundice occurs when pancreatic cancer blocks the liver's bile duct.
- Pain – As the tumour gets bigger, it presses on the nerves of the abdomen which causes severe pain.
- Bowel obstruction – A growing tumour may press on the duodenum and can block the flow of digested food from the stomach into the intestines.
- Weight loss – This may be caused by factors such as nausea, vomiting, and difficulty of eating due to the tumor pressing on the stomach.
Prevention and control
There are no exact measures to prevent pancreatic cancer at this time. However, it is best to avoid major risk factors that can possibly lead to the disease such as smoking and drinking excessive alcohol. Studies show that smoking is responsible for 30% of pancreatic cancer cases. It is also beneficial to maintain a healthy weight, to eat well, and to engage in regular exercise. More fruits and veggies should be included in the diet and processed meats or foods that are high in fat should be avoided.
Cases in the Philippines
Rudy Fernandez, a prominent actor in the Philippines was diagnosed with periampullary cancer in 2007. He underwent treatment for the disease in Tokyo, Japan. However, later findings revealed that he actually suffered from pancreatic cancer. The actor succumbed to the disease at the age of 56 in 2008.
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- “ Action star Rudy Fernandez succumbs to cancer at 56.” GMANews.tv. (Accessed 2 November 2010.)