Pancreatic Cancer: Symptoms, Diagnosis & Treatment

Types of Pancreatic Cancer

Pancreatic cancer is broadly classified into two main types:

• Exocrine tumors: The most common type, which accounts for over 90% of all pancreatic cancer cases. The most frequent form is adenocarcinoma, which originates in the pancreas's ducts that produce digestive enzymes. These tumors are often aggressive and are typically diagnosed at a later stage.
• Neuroendocrine tumors (NETs): A much rarer type, making up less than 10% of pancreatic cancers. Also known as islet cell tumors, NETs develop from the hormone-producing cells of the pancreas. They tend to grow more slowly and may or may not produce hormones.

Signs and Symptoms of Pancreatic Cancer

Unfortunately, you’ll not see any signs or symptoms in the early stages. Symptoms typically emerge only at the advanced stages when other digestive organs are affected.

Symptoms of pancreatic cancer may include:

• Abdominal pain that radiates to the back
• Unintended weight loss
• Loss of appetite
• Jaundice (yellowing of the skin and eyes)
• Dark-colored urine
• Light-colored stools or greasy stools
• New-onset diabetes or existing diabetes that becomes more difficult to control
• Nausea and vomiting
• Fatigue or general weakness
• Blood clots
• Itchy skin

If the following symptoms remain persistent, it’s always advisable to consult your doctor as early as possible.

Stages of Pancreatic Cancer

Pancreatic cancer is typically divided into four stages, based on how far it has spread in the body:

1. Stage I—The cancer is confined to the pancreas only
   
2. Stage II—The cancer has grown beyond the pancreas and may involve nearby tissues or lymph nodes
   
3. Stage III—The tumor has spread to major blood vessels or more lymph nodes
   
4. Stage IV—The cancer has metastasized to distant organs such as the liver, lungs, or abdominal cavity

Causes of Pancreatic Cancer

The actual cause of pancreatic cancer is unknown. However, DNA changes or mutations result to produce abnormal cell growth.

However, it’s believed that certain factors may increase the chance of occurrence of pancreatic cancer. The risk factors may include;

• Family history of pancreatic cancer
• Chronic pancreatitis (long-term inflammation of the pancreas)
• Smoking
• Obesity or a sedentary lifestyle
• Type 2 diabetes, especially long-standing or poorly controlled
• Age, particularly over 60 years
• Gender (slightly more common in men)
• A diet high in red and processed meats
• Heavy alcohol consumption, which can lead to pancreatitis
• Certain genetic syndromes, such as BRCA mutations or Lynch syndrome
• Exposure to certain chemicals in the workplace (e.g., pesticides, dyes, and petrochemicals)

Diagnosis

Diagnosing pancreatic cancer in its early stages is challenging, as it often develops silently and may not show up in routine imaging tests. However, if your doctor detects abnormalities in your reports or notes concerning symptoms, they may recommend the following diagnostic tests.

• Imaging Tests

Used to detect tumors, assess their size, and check for spread to other organs. These include:

• CT Scan (Computed Tomography)
• MRI (Magnetic Resonance Imaging)
• Endoscopic Ultrasound (EUS)
• PET Scan (Positron Emission Tomography)

• Blood Tests

Blood tests may include;

• CA 19-9 (Tumor Marker): Often elevated in pancreatic cancer patients, though not always.
• CEA (Carcinoembryonic Antigen): Another marker that may be elevated.
• Liver Function Tests: Abnormal liver enzymes may suggest bile duct obstruction due to a pancreatic tumor.
• Complete Blood Count & Metabolic Panel: Assess overall health and organ function.
• Biopsy

A biopsy is the only definitive way to confirm pancreatic cancer. The tissue sample is extracted through a fine needle for examination under the microscope.

• Staging Laparoscopy

A minimally invasive procedure allows surgeons to view the pancreas and surrounding organs to determine how far the cancer has spread.

• Genetic Testing

Genetic testing may be advised if you have:

• A family history of pancreatic or related cancers
• Young age at diagnosis
• Multiple cancers in the family

It helps identify hereditary cancer syndromes (e.g., BRCA1/BRCA2, PALB2, Lynch syndrome), and may also guide targeted therapy options.

• Molecular and Biomarker Testing

If cancer is confirmed, advanced molecular testing can identify specific mutations in the tumor that may respond to targeted therapies or immunotherapy, such as:

• KRAS, CDKN2A, TP53 mutations
• Mismatch repair (MMR) deficiency or microsatellite instability (MSI)

Resectable vs. Unresectable Pancreatic Cancer: What’s the Difference?

The key difference is whether the tumor can be removed with surgery.

• Resectable means the cancer is only in the pancreas and can be safely removed through surgery. This gives the best chance for a cure.
  
• Unresectable means the cancer has spread too far to be removed safely, either to nearby blood vessels or other parts of the body. In this case, treatment like chemotherapy or radiation is used to control the disease and relieve symptoms.

Treatment of Pancreatic Cancer

If you’re diagnosed with cancer, your doctor may advise you on the treatment options based on several factors, including the stage of the cancer, location of the tumor, overall health of the patient, and whether the cancer can be surgically removed.

The following are the treatment options for pancreatic cancer:

1. Surgery

It’s considered the best option to cure the cancer, only if the tumor is detected early and has not spread extensively.

• Whipple Procedure (Pancreaticoduodenectomy): It involves the removal of the head of the pancreas, part of the stomach, duodenum, gallbladder, and bile duct.
• Distal Pancreatectomy: Removal of the body and tail of the pancreas, often along with the spleen.
• Total Pancreatectomy: Removal of the entire pancreas, though rarely performed.

2. Chemotherapy

Chemotherapy uses drugs to kill cancer cells or stop them from dividing. It may be used:

• Before surgery (neoadjuvant): To shrink tumors and increase the chance of successful surgery
• After surgery (adjuvant): To destroy remaining cancer cells and reduce recurrence risk

3. Radiation Therapy

Radiation uses high-energy beams to destroy cancer cells. This is often combined with chemotherapy to enhance its effectiveness.

4. Targeted Therapy

These therapies target specific genetic or molecular changes in cancer cells.

5. Immunotherapy

While not standard for most pancreatic cancers, immunotherapy may help some patients, especially those with microsatellite instability (MSI-high) or mismatch repair deficiency (dMMR).

Also Read:- Immunotherapy cost in India

Recovery from pancreatic cancer varies depending on the stage at diagnosis and treatment type. Early-stage patients who undergo surgery, often followed by chemotherapy, have a better chance of long-term survival.

Can I Prevent Pancreatic Cancer?

There is no guaranteed way to prevent pancreatic cancer, but you can lower your risk by:

• Quitting smoking
• Maintaining a healthy weight
• Eating a balanced diet low in processed meats
• Managing diabetes and blood sugar levels
• Avoiding excessive alcohol
• Exercising regularly

Key Takeaways

Pancreatic cancer is a silent and aggressive disease, often detected in advanced stages. Symptoms like unexplained abdominal pain, weight loss, or jaundice should not be ignored. While early diagnosis is difficult, timely medical attention can significantly improve outcomes.

With advancements in surgery, chemotherapy, and targeted therapies, treatment options are evolving. Accessing care at top hospitals for cancer treatment in India can greatly enhance survival and quality of life. Awareness, early detection, and expert care remain the strongest tools in the fight against pancreatic cancer.