Pancreatic cancer is an organ located in the lower back part of the stomach in the abdomen and originates from the pancreatic organ. The pancreas releases enzymes that help the digestive system work in the body and produces hormones that help control blood sugar levels. It is possible to see many forms of growth in the pancreas with cancerous or benign tumors. The most common type of cancer originating from the pancreas originates from the pancreatic cells that line the ducts that allow the collection and transport of digestive enzymes from the pancreas. This type of pancreatic cancer is called pancreatic ductal adenocarcinoma. Although pancreatic cancer has good results when diagnosed early and treated early, it is very rare to be diagnosed at an early stage. The most important reason for the delay in the diagnosis is that it does not cause any symptoms until it spreads to other organs.
What is the Pancreas?
The pancreas is a small, hockey stick-shaped gland located at the back of the stomach. . The main functions of the pancreas are to help digest food and regulate blood sugar levels in the body. Insulin and glucagon, the two main hormones that regulate the blood sugar level, are produced by the pancreas and are also important in maintaining the blood sugar level. It occurs due to uncontrolled and abnormal reproduction caused by genetic changes, ie mutations. Due to these uncontrolled changes, it is possible to see tissue masses of different sizes. The masses do not always have to be in the form of malignant, that is, cancer, benign masses also develop on the basis of pancreatic cells, and benign tumors are not cancer.
What are the Types of Pancreatic Cancer?
In the pancreas Two types of tumors can develop and these are classified as exocrine tumors or neuroendocrine tumors. On average, 93% of pancreatic tumors develop as exocrine tumors, and adenocarcinoma, the most common type of pancreatic cancer, is in this group. Pancreatic adenocarcinoma is the first type of cancer that comes to mind when pancreatic cancer is mentioned. Among pancreatic adenocarsiomas In a, the most common type is ductal adenocarcinoma and originates from the ducts of the pancreas. The tumors that make up the remaining 7% of pancreatic tumors are neuroendocrine tumors. These neuroendocrine tumors that develop in the pancreas are called pancreatic neuroendocrine tumors and are also known as islet cell carcinoma or islet cell tumor. Some neuroendocrine tumors can produce excessive amounts of hormones. The name of the tumor varies according to the type of hormone made. For example, insulinoma is a tumor that arises from cells that secrete large amounts of insulin hormone. Pancreatic cancers have different classifications according to their location. Tumors located in the head of the pancreas are the most common type of pancreatic cancer. While pancreatic head tumors give early symptoms due to compression on adjacent tissues and organs, symptoms may be delayed in tumors located in the trunk and tail, which greatly reduces the possibility of early diagnosis.
Who Gets Pancreatic Cancer?
Pancreatic cancer is among the 10 most common cancer types in Turkey and the death rate due to pancreatic cancer is higher than the more common types of cancer. Pancreatic cancer accounts for approximately 3% of all cancers and 7% of cancer-related deaths, according to United States statistics. The incidence of pancreatic cancer is slightly higher in men than in women. Especially early symptoms of pancreatic cancer are overlooked. Pancreatic cancer is often associated with back pain. The symptoms that may occur as the disease progresses can be listed as follows.
- Pain in the upper abdominal quadrant, which may spread to the back region, especially after meals and when lying down, and whose severity decreases by leaning forward
- Back pain
- Yellowing of the skin and whites of the eyes, ie jaundice
- Fatigue and weakness
- Loss of appetite and subsequent weight loss
- Light-colored stools and dark-colored urine
- Diarrhea or constipation
- Bloating and indigestion
- New onset or worsening diabetes
- Nausea and vomiting
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- Itching. The answer to the question of where the itching occurs in pancreatic cancer varies individually, and a widespread itching is usually expected throughout the body.
What are the Risk Factors in Pancreatic Cancer?
The lifetime risk of developing pancreatic cancer is recorded as approximately 1 in 64. Factors that increase the likelihood of contracting a disease are known as risk factors. In addition to non-modifiable risk factors such as genetics and gender, there are also risk factors that can be changed. The main risk factors are as follows.
- Using cigarettes and other tobacco products
- Obesity, increased weight and adiposity concentrated around the waist
- The presence of diabetes, especially the type closely associated with obesity Presence of 2 diabetes. A new diagnosis of diabetes, despite being at an advanced age and having a normal weight or body mass index, raises suspicion of pancreatic cancer.
- Exposure to chemical dyes, powders or cleaning agents
- Chronic pancreatitis
- Alcohol consumption
- Hereditary chronic pancreatitis due to mutations passed from parents to children
- Hereditary syndromes that are passed from parent to child
- Being over 45 years old and male, female or male does not cause variability in the symptoms of pancreatic cancer, the symptoms are usually common.
- Being black skin
How is Pancreatic Cancer Diagnosed?
It is very difficult to diagnose pancreatic cancer because pancreatic cancer does not show any symptoms at an early stage, and it is not possible to manually examine the pancreas in physical examination due to its anatomical location. If pancreatic cancer is suspected, the healthcare professional may refer to imaging tests to obtain an image of the internal organs. endos Coarse ultrasound (EUS) is one of the most preferred imaging modalities. In endoscopic ultrasound, a thin tube with a camera at the end is sent through the mouth into the stomach. Thanks to the probe at the end of the endoscope, an image of the pancreas can be obtained from the stomach wall. In some cases, a tissue sample is taken from the pancreas with the help of ultrasound during the procedure and the biopsy sample is sent to the laboratory for investigation. Tumor markers for pancreatic cancer can also be examined through blood tests. High blood levels of the carbohydrate antigen CA 19-9, which is a form of protein produced by pancreatic cells, may raise suspicion of the pancreas. Computed tomography, PET imaging and magnetic resonance imaging are also among the auxiliary imaging methods.
What are the Stages of Pancreatic Cancer?
Pancreatic cancer can be seen in five different stages. The size, location and spread of the tumor are important in staging.
- Stage 0: In this stage, called carcinoma in situ, there is an appearance characterized by abnormal cells in the pancreatic tissue. This stage may progress to advanced stages and may spread to tissues.
- Stage 1: There is a tumor located in the pancreas.
- Stage 2: The tumor has spread to the surrounding tissues, organs and lymph nodes along with the pancreas.
- Stage 3: Cancer has spread to major blood vessels around the pancreas and lymph nodes may also be affected.
- Stage 4: Stage 4 pancreatic cancer is generally considered advanced if it spreads to the liver. At this stage, the cancer has spread to distant organs such as the liver, lungs, and lymph nodes. Pancreatic cancer Stage 4 is the stage most often diagnosed as pancreatic cancer.
How is Pancreatic Cancer Treated?
Treatment options vary in pancreatic cancer shows. The options can be summarized as follows.
- Pancreatic cancer surgery: It is the surgical removal of the tumor in the pancreas. Lymph nodes around the pancreas may also be removed. One of the frequently preferred procedures in pancreatic cancer is the Whipple procedure, and in this method, the head of the pancreas, as well as the gallbladder, part of the small intestine, and nearby lymph nodes are removed.
- Radiation therapy: It is preferred to kill cancer cells.
- Chemotherapy: In this method, cancer Certain cells are tried to be killed with chemicals and drugs. The duration of chemotherapy in pancreatic cancer varies according to the stage and size of the disease and the clinical characteristics of the patient.
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