Pancreatic cancer is a malignancy caused by the formation of aggressive cancer cells in the tissues of the pancreatic gland. Located behind the stomach, between two lumbar vertebrae, the pancreas is an organ that secretes digestive enzymes, as well as producing and distributing insulin throughout the circulatory system to regulate blood sugar. Pancreatic cancer causes several nonspecific symptoms and is often discovered during diagnostic tests. It is aggressive and spreads quickly, so it is very important to diagnose it early, although it is always possible to resort to surgical options and treatments, such as radiotherapy and chemotherapy.
Steps
Step 1. Pay close attention to non-specific diseases
Since it is difficult to diagnose, it is extremely important Not ignore a number of recurring symptoms, which are chronic and / or bothersome (irritating):
- Abdominal pain and / or back pain;
- Nausea and / or digestive problems;
- Lack of appetite;
- Unexplained weight loss
-
Jaundice
(You can find a brief description of the symptoms before the "Tips" section)
Step 2. Consider the diagnosis of new-onset or long-standing type 2 diabetes as a valid reason to prospectively combine three laboratory tests for tumor markers useful in detecting pancreatic cancer, namely CA 19- 9 and the newer miR-196 and miR-200
Because? During studies of these tests in relation to diabetes, it was found that the vast majority of pancreatic cancer patients were also diabetic. Therefore, undergoing all three greatly improves the sensitivity of the results for pancreatic cancer detection.
- Tumor marker testing can be helpful if you and your doctor have any reason to suspect pancreatic cancer symptoms. It does not offer a definitive diagnosis because, even if they are present, some markers can be related to various health problems.
- Keep in mind that there is no single diagnostic investigation or a well-defined symptom picture that can advance the hypothesis of pancreatic cancer or detect its presence.
Part 1 of 3: Notice the Early Symptoms of Pancreatic Cancer
Step 1. Watch out for jaundice
It can be one of the first warning signs of pancreatic cancer and is characterized by a yellowish discoloration of the skin, eyes and mucous membranes due to excess bilirubin in the blood. Cancer, in fact, obstructs the ducts responsible for transporting bile in the intestine, leading to an accumulation of this substance in the blood, from which the yellowish color of the skin and sclera originates. In the case of jaundice, the stools are clear, the urine becomes dark, and the skin begins to itch. Check your skin and eyes in front of the mirror with the light on.
- Jaundice causes annoying itchy skin.
- The part of the eye that turns yellow is the sclera, also known as the "white of the eye".
- To make sure it is jaundice (if yellowing is not evident), your doctor may order blood or urine tests to check for impaired biliary excretion.
Step 2. Don't underestimate abdominal pain
One of the first symptoms of this cancer can sometimes be widespread abdominal pain or pain, although many people do not experience any discomfort until the cancer reaches an advanced stage. The pancreas is located between the stomach and the spine, very close to the central part of the intestine. Its job is to secrete insulin (which regulates blood sugar), hormones and digestive enzymes. If abdominal pain does not go away within a week, contact your doctor.
- Palpation of the pancreas is difficult and practically useless to check for mild or moderate swelling, because this gland is located behind or near other organs. Since the tumor often causes swelling of the liver and gallbladder - which are easier to palpate and control - it is possible to misdiagnose and confuse it with liver cirrhosis or cholecystitis.
- Because pancreatic cancer causes abdominal pain, fatigue, and diarrhea, early on it can be mistaken for infection, ulcerative colitis, Crohn's disease, and irritable bowel syndrome.
Step 3. Consider exhaustion and weakness
Another early sign of this disease - and many others - is a general sense of exhaustion, fatigue, and weakness. In the first stage of cancer, you may feel inexplicably tired and stop exercising or even leave the house.
Step 4. Watch out for high blood sugar
One of the main functions of the pancreatic gland is to secrete insulin, which carries glucose from the bloodstream to the cells, making it out of the blood vessels so that it is used in the form of energy. Therefore, when the pancreas becomes ill and loses its functionality, glucose remains in the blood system and its concentration tends to rise. When blood glucose reaches too high levels, certain symptoms occur, including lethargy (tiredness and fatigue), polydipsia (feeling very thirsty), weakness, diarrhea, weight loss, and polyuria (excessive urine excretion).
- To measure your blood sugar concentration, ask your doctor to order blood tests.
- Urinalysis also helps to tell if your blood sugar is high. They indicate, in fact, the possible inability of the body to control the transport of glucose in the blood, should it be present in excessive quantities in the urine.
Step 5. Watch out for chronic diarrhea or light colored stools
Diarrhea can be another warning sign of pancreatic cancer. It is caused by an excess of glucagon, which increases blood sugar. If the stool is light gray or almost white, or anyway lighter in color than normal, it indicates a systemic accumulation of bile.
A further clue confirming the fact that the pancreas is not functioning properly and does not produce sufficient enzymes for the digestion of fats (bile) is the production of fatty stools (steatorrhea), very smelly and which tend to float on the surface of the water
Step 6. See your doctor if you start experiencing these symptoms
Even a single isolated symptom could be an early sign of pancreatic cancer. If there is at least one of those listed, go immediately to the doctor's office.
Write down all symptoms and report them in detail
Part 2 of 3: Performing the Diagnostic Tests
Step 1. Undergo all necessary blood tests
If you have any of the symptoms described so far in a partial or complete way, your doctor or oncologist (the cancer specialist) may order a series of blood tests. There are several types to diagnose pancreatic cancer and also to rule out other causes related to abdominal symptoms. The main ones are: complete blood count with formula, liver function test, serum bilirubin, kidney function test and the search for various tumor markers.
- Tumor markers are substances sometimes present in the circulatory system of cancer patients. Two are associated with pancreatic cancer: CA 19-9 and carcino-embryonic antigen (CEA).
- The values of these markers are not elevated in all pancreatic cancer patients, while in some perfectly healthy people they could be very high for various reasons. Therefore, these are not very precise indicators of the disease, but mostly a relatively inexpensive and non-invasive test that can still help determine if further tests are needed.
- It is often advisable to check hormone levels, since the blood concentration of some substances (such as chromogranin A, peptide C and serotonin) is generally very high in patients with this tumor.
Step 2. Undergo all necessary imaging tests
If the oncologist you are treating has strong suspicions of pancreatic cancer (based on telltale symptoms and blood tests), you will need to undergo a number of diagnostic tests, the most common being: computed tomography and / or MRI of the abdomen, endoscopic ultrasound of the pancreas and endoscopic retrograde cholangiopancreatography (ERCP). Once the results of a test indicate a high risk of cancer, you will be subjected to more detailed tests to learn about the spread of the cancer - this methodology is called staging.
- Endoscopic ultrasound is performed with the use of a device that can detect images of the pancreas inside the abdomen. An endoscope is inserted into the esophagus to the stomach to take the images.
- ERCP involves inserting an endoscope in order to inject a contrast fluid into the pancreas. After that, we proceed with an x-ray that goes to highlight the bile ducts and other parts of the organ.
Step 3. Consider a biopsy to confirm the diagnosis
Once you have carried out several tests that seem to support the suspicion of cancer, you should carry out a final examination to ascertain the diagnosis and establish which cells are most involved: this is the pancreatic biopsy. The patient is anesthetized and can be performed in three different ways: percutaneous, endoscopic and surgical.
- Percutaneous biopsy (also called fine needle aspiration) consists of inserting a long, thin and hollow needle that pierces the skin of the abdomen to reach the pancreatic gland and take a piece of tissue / tumor.
- Endoscopic biopsy is done by inserting an endoscope through the esophagus that goes down to the stomach to reach the small intestine and get close enough to the pancreas to take a sample of tissue.
- Surgical biopsy is more invasive because it involves an incision on the abdomen and the insertion of a laparoscope to take a sample and observe the spread of the tumor.
Part 3 of 3: Summary of Symptoms
Step 1. Notice nonspecific signs and symptoms
They can indicate pancreatic cancer or some other disorder. Because they are likely to be ambiguous early on, they are often not associated with poor pancreas function until the disease is quite advanced. The early ones include:
- Moderate abdominal and / or back pain
- Nausea (without vomiting);
- Lack of appetite (food is less tempting);
- Unexplained significant weight loss;
- Jaundice (accompanied by itching).
Step 2. Pay attention because in the following steps the following may appear:
- Chronic pain;
- Severe nausea
- Frequent vomiting;
- Food malabsorption;
- Changes in blood sugar or diabetes (because the pancreas produces and releases insulin but does not work properly).
Step 3. Be aware that pancreatic cancer prognosis and staging are not easily ascertained
The location of this gland is not easily detectable or visible by imaging tests. The stages of cancer are as follows:
- Stage 0: not widespread. A single layer or small group of cells in the pancreas, not yet visible in imaging tests or with the naked eye.
- Stage I: local growth. Pancreatic cancer grows inside the pancreas: in stage I-A it is less than 2cm in diameter, but in stage I-B it is greater than 2cm.
- Stage II: local diffusion. Pancreatic cancer is larger, protrudes outside the gland, or has spread to nearby lymph nodes.
- Stage III: spread to neighboring tissues. The tumor has enlarged by vascularizing or enclosing nearby nerves or lymph nodes (probably not operable unless it has a very limited spread), but without metastases in distant organs.
- Stage IV: distant spread. The tumor has spread to distant organs, such as lungs, liver, colon. It is most likely inoperable.
Advice
- Consider treating the cancer at whatever stage it is. Treatments can decrease and / or slow down its spread and foster the hope of remission (even if no medical or radiological therapy is known).
- There is a correlation between diabetes and pancreatic cancer although not all diabetics develop this form of cancer.
- The risk of pancreatic cancer is higher in people with a BMI greater than 30, as well as in those who smoke, abuse alcohol, ingest a lot of trans fats, are highly exposed to toxic chemicals, and eat a rich diet. of processed and smoked meats.
- If someone in your family has suffered from pancreatic cancer, there is a 10% chance that you can develop it too. Watch for symptoms and see your doctor as soon as you notice any.
Warnings
- Digestive enzymes can escape from the tumor-affected pancreas and colonize surrounding tissues, inflaming them to damage and death. Therefore, in the later stages this disease is very painful: cancer cells can also spread to other organs, creating metastases and compromising their functionality.
- Surgical procedures such as chemotherapy and radiotherapy do not permanently stop pancreatic cancer. It is a very aggressive form of cancer. Rarely (in less than 10% of cases) these treatments prove effective. The mortality rate hovers around 92.3% over the 1-5 years after undergoing chemotherapy, surgery and radiotherapy (source: National Cancer Institute). It could start to spread even when it is absolutely undetectable, so in the United States the survival rate fluctuates around 7.7% of cases over 5 years of treatment.
- If left untreated, metastatic pancreatic cancer (already spread) has an average life expectancy of 3-5 months or 6-10 months if it is locally advanced (stage IV).
