The pancreas is a gland located deep in the abdomen, between the stomach and the spine. It produces enzymes that aid digestion and hormones that control blood sugar levels.
Pancreatic cancer forms when cells within the organ begin to divide uncontrollably and form a tumor. Cells grow out of control and can spread to other tissues and organs.
In Italy, pancreatic cancer affects more than 14,000 people a year, with a survival rate of 7-8%.
It is predicted that the by 2025 the number of people affected by the disease will be 557.668.
Pancreatic tumors are exocrine or neuroendocrine (endocrine) tumors. This classification is based on the type of cell inside the pancreas that begins to divide uncontrollably. Knowing the type of cancer is important because each type acts differently and responds to different treatments.
About 93% of pancreatic cancers are exocrine cancers. The most common type of pancreatic cancer is adenocarcinoma.
About 7% of pancreatic cancers are neuroendocrine tumors (pancreatic NETs or PNETs), also called islet cell tumors. They often grow slower than exocrine tumors.
When there are changes in the DNA inside the cell, a tumor can develop. These changes can be inherited from parents or they can arise over time. Changes that occur over time can happen from exposure to something harmful or they can happen randomly.
Hereditary genetic mutations
Disorders studied for pancreatic cancer connections include: BRCA mutation, cystic fibrosis, familial adenomatous polyposis, familial atypical multiple melanoma, Lynch syndrome, hereditary pancreatitis, PALB2 mutation, and Peutz-Jeghers syndrome.
Family history of pancreatic cancer
If a person has two or more first-degree relatives (mother, father, brother, or child) who have had pancreatic cancer or a first-degree relative who developed pancreatic cancer before age 50, you may be at a higher risk. to develop pancreatic cancer.
Family history of other cancers
The risk of pancreatic cancer increases if there is a family history of ovarian, breast or colon cancer, hereditary pancreatitis or familial melanoma.
Diabetes
Pancreatic cancer is more likely to occur in people who have long-standing (more than 5 years) diabetes. This can also be a symptom.
Pancreatitis
Chronic pancreatitis indicates an increased risk of developing pancreatic cancer. It is even higher in individuals with hereditary pancreatitis.
Smoking
People who smoke cigarettes are twice as likely to develop pancreatic cancer than people who have never smoked.
Obesity
Obese people have a 20% higher risk of developing pancreatic cancer than people of normal weight.
Ethnicity
African Americans and Ashkenazi Jews have a higher incidence of pancreatic cancer than individuals of Asian, Hispanic, or Caucasian descent.
Age
The chances of developing pancreatic cancer increase with age. Most people diagnosed with pancreatic cancer are over the age of 60.
Diet
Although more research is needed, a diet rich in red and processed meats can increase the risk of developing pancreatic cancer. A diet rich in fruits and vegetables can reduce the risk.
Stomach ache
Pain in the upper abdomen could be caused by a pancreatic tumor that pushes or invades nerves or organs near the pancreas.
Mid-back pain
Pain in the middle of the back could be caused by a pancreatic tumor pushing or invading the nerves or organs near the pancreas.
Jaundice
Yellowing of the skin and eyes (jaundice), caused by an excess of bilirubin (a component of bile) in the blood. Jaundice can also cause itchy skin, abnormally dark urine, and light or clay-colored stools.
Unexplained weight loss can be an early symptom and can occur without any pain or apparent change in digestion.
Change in stool
Many pancreatic cancer patients experience diarrhea, constipation, or both. Diarrhea consisting of soft, watery, oily or foul-smelling stools can be caused by an insufficient amount of pancreatic enzymes in the intestine.
Loss of appetite
Pancreatic cancer can decrease appetite or change the taste of food.
Indigestion. This can include poor appetite, nausea, and vomiting. It is common for pancreatic cancer to cause problems with nutrition and digestion of food. Symptoms may include: feeling full when eating, bloating, flatulence.
Diabetes
New-onset diabetes in people over the age of 50 and a sudden change in blood sugar levels in diabetics who previously had well-controlled diabetes.
A pancreatic tumor can only be seen in an imaging study such as a computed tomography (CT), magnetic resonance imaging (MRI), or endoscopic ultrasound (EUS). Next, a sample of the tumor tissue is taken to make the exact diagnosis.
The pancreas is located deep in the abdomen, so doctors usually can’t see or “feel” the tumor during a physical exam. Also, pancreatic cancer symptoms aren’t always obvious and usually develop over time. Doctors can use several tests to make a diagnosis. But there is no standard test for diagnosing pancreatic cancer. This makes the diagnosis even more complicated.
Treatment of pancreatic cancer depends on the patient’s general health and the stage of the disease. Standard treatments for pancreatic cancer are surgery, chemotherapy, radiation, or a mix of these.
Recently the FDA approved a targeted therapeutic drug (Olaparib for BRCA mutation) for pancreatic cancer and an immunotherapy (Keytruda).
Surgery
About 20% of patients with pancreatic cancer can undergo surgery to remove the tumor. For eligible patients, surgery is the best option for long-term pancreatic cancer survival. The data shows that high-volume hospitals have higher success rates and fewer complications.
Chemotherapy
Chemotherapy uses drugs to kill cancer cells by preventing them from growing and dividing. These drugs travel through the bloodstream and target cancer cells throughout the body.
Chemotherapy can shrink tumors or stop their growth. It can be given alone or with surgery, targeted therapy, radiation therapy, or a mix of these.
Radiotherapy
Radiation therapy uses energy in the form of particles or electromagnetic waves. It can damage cancer cells to prevent them from growing and dividing. The goal of radiation is to prevent tumor growth or shrink it without damaging nearby healthy organs or tissues.
Doctors can use radiation therapy to:
• Relieve pain caused by the tumor
• Try to shrink the tumor before surgery
• Destroy any cancer cells that may be in the area after surgery
Clinical trials are research studies that examine the effectiveness of new treatments.
Clinical trials are the only way for researchers to prove whether new treatments help people with pancreatic cancer. Pancreatic cancer patients participating in clinical research have better outcomes. Every treatment available today has been approved through a clinical trial.