Pancreatic cancer: symptoms, diagnosis and treatment

Pancreatic cancer is a very serious form of cancer. About 2,200 people are affected by this disease every year. The pancreas is an organ located at the top of the abdominal cavity. The pancreas, as it is also called, is located behind the stomach and in the arch of the duodenum.

Pancreas

The pancreas is an elliptical organ. The gland produces substances that are important for the daily functioning of humans. This involves enzymes and hormones. The enzymes that are released have an important function in processing food. The hormones relate to metabolism, intestinal function and the digestive process. The pancreas consists of three parts, namely the head below the liver, the middle part behind the stomach and the tail which is located near the spleen.

Symptoms

  • Persistent pain in the top or middle of the abdomen
  • Disrupted bowel movements
  • Decreasing appetite
  • Loss of weight
  • Feeling of weakness

The complaints can vary. The symptoms depend on where the tumor is located in the pancreas. Symptoms usually only occur when the cancer has spread to another organ or cancer cells end up in nerve pathways near the pancreas. Cancer that develops in the head is often discovered earlier due to symptoms such as jaundice. A growth in the tail is often discovered when the bile duct is blocked. This causes bile to accumulate in the bile ducts, gallbladder and liver. When the bile cannot escape, complaints such as fatigue occur. The stool becomes thin and white. Because bile dye enters the blood, the skin and whites of the eyes turn yellow. Urine may turn dark. Itching may also occur. Pancreatic cancer mainly occurs in people over sixty years old.

Diagnosis

If you report to your GP with complaints, he or she will first listen to your story and possibly conduct a physical examination. If pancreatic cancer is suspected, a referral will be made to a specialist. This doctor will have various tests performed, such as an ultrasound scan, a CT scan or an MRI scan. This allows the upper abdomen to be visualized. Depending on the results, there may be a follow-up study. This can be done via ERCP examination, endo-ultrasound and laparoscopy. During an ERCP examination, a tube with a camera enters the throat. This images the esophagus, stomach and duodenum, among other things. During an ultrasound endography, a tube with a camera is also inserted. An ultrasound device is hooked to this. This makes the pancreas visible, among other things. A laparoscopy is keyhole surgery. This can be used to check whether there are any metastases. After these tests, the specialist can see how far the cancer has progressed. The treatment can be tailored to this.

Therapy

Pancreatic cancer is a difficult type of cancer to treat. Tumors in the tail are difficult to operate on. When the cancer is located in the head of the pancreas, surgery is often still possible. The surgeon proceeds to remove the head of the pancreas, the entire duodenum, part of the stomach and the entire gallbladder. This is called a Whipple operation. Twenty percent of patients who undergo such surgery are still alive after five years. To stimulate the drainage of bile, a stent can be placed in the large bile duct, so that the tumor can no longer block the bile duct. If there is a bowel obstruction, a bypass operation can be performed. Radiation therapy is often performed to control pain and limit blood loss. Chemotherapy is performed to inhibit pancreatic cancer. That often only brings relief for a short time. There are also good medications and nerve-blocking injection techniques to combat the pain. Pancreatic cancer often cannot be cured and treatments are aimed at making the patient’s life as bearable as possible.

Cause

The exact cause of the development of pancreas is unclear. The risk of developing pancreatic cancer is increased if you smoke or if the pancreas is chronically inflamed. In approximately five percent of cases, there is a hereditary predisposition to developing pancreatic carcinoma.

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