Pancreatic cancer is also known as pancreatic duct adenocarcinoma. Other types of pancreatic cancer arise from hormone producing cells called endocrine cells or digestive juice producing cells called exocrine cells. Pancreas cancer arising from endocrine cells is known as pancreatic neuroendocrine cancers.
Patients with pancreatic cancer may complain of
- weight loss
- poor appetite
- abdominal pain
- yellow skin and eyes (jaundice)
- tea-coloured urine
- light coloured stool
However, patients with early pancreatic cancer often do not have symptoms.
The cause of pancreas cancer is not clear. Known risk factors include:
- patients who are male
- age more than 60 years
- heavy smokers
- history of chronic pancreatitis
- strong family history of pancreas cancer
Following the doctor’s interview and physical examination, the doctor may perform some laboratory tests (full blood count, renal panel, liver function tests, blood glucose test, blood tumour markers) and imaging studies. Imaging studies may include:
- CT scan of the abdomen with pancreatic protocol and angiogram
- Endoscopic ultrasound of the pancreas (EUS) with biopsy
- Percutaneous transhepatic cholagiography (PTC)
- Endoscopic retrograde cholangiopancreatography (ERCP)
Through tests and imaging, the doctor will assess the stage and extent of the cancer. Treatment will be based on the stage of the cancer. Fine needle aspiration biopsies (FNAC) may not be necessary if the likelihood of a pancreatic cancer is high.
When the cancer is confined to the pancreas and has not spread to other vital structures and organs, surgery is recommended to remove the cancer. The type of surgery will depend on the location of the cancer. Whipple's procedure is for cancer in the head of pancreas while distal pancreatectomy is for cancer in the body or tail of pancreas. The spleen is commonly removed along with the pancreas. This is to facilitate removal of lymph nodes in a cancer operation.
After a successful pancreatic cancer operation, additional treatment by radiation therapy and chemotherapy are recommended.
When the pancreas cancer is too advanced for a curative operation, and if the cancer is causing blockage to the small intestine or the flow of the bile in the bile duct, a bypass operation is recommended to restore the flow of the bile in the duct and food in the intestines. Such operations are palliative in nature. Alternatively, a plastic or metallic stent can be inserted through an endoscope.