Pancreatic Cancer: Causes, Symptoms, and Treatment Options

Pancreatic cancer develops when tumors grow in the pancreas, an essential organ situated behind the stomach that plays a vital role in digestion. The pancreas also produces two vital hormones: glucagon and insulin. These hormones are at the helm of controlling glucose (sugar) metabolism. Due to the pancreas’s deep location in the body, pancreatic cancer is often hard to detect and frequently diagnosed at advanced stages.

Types

Pancreatic cancer is primarily classified into two types, depending on the cells where it originates:

S.No	Type Name	Definition
1.	Pancreatic adenocarcinoma	The most prevalent type of pancreatic cancer originates in the exocrine cells, which secrete enzymes essential for the digestive process.
2.	Pancreatic neuroendocrine tumours	Rarer type of pancreatic cancer in the endocrine cells. It releases hormones that affect everything from mood to metabolism.

Causes

The cause of pancreatic cancer is unclear. However, many risk factors for this illness are known, and some contribute to the development of malignant cells.

• Oncogenes are genes that aid cell growth, division, and survival.
• Tumor suppressor genes help regulate cell division or prompt cells to die at the appropriate moment.
• DNA changes that activate oncogenes or silence tumour suppressor genes can result in cancer.

Inherited Gene Mutations

Your parents can pass along mutations that make you more likely to get pancreatic cancer. Researchers have associated the condition with BRCA1 and BRCA2 genes, which produce proteins involved in repairing damaged DNA, along with genes linked to colorectal cancer and other medical disorders. These mutations cause up to 10% of pancreatic cancer cases.

Acquired Gene Mutations

Many gene changes happen after you’re born. Sometimes, they change because you come into contact with chemicals like those in tobacco or smoke. Other mutations occur at random as your cells copy your DNA and divide.

Risk Factors

The precise cause of pancreatic cancer remains unidentified, but various factors are known to contribute to a higher risk of developing it. These include,

• Sex: The likelihood of developing pancreatic cancer is somewhat higher in men than in women.
• Age: People between 65 and 74 are more likely to be diagnosed with pancreatic cancer.
• Family history: The chance of developing other cancers may be increased by a family history of the disease or by genetic abnormalities associated with pancreatic cancer. It’s advised to note your family’s history of medical issues.
• Tobacco use: Cigarette smoking is estimated to contribute to 20–35% of pancreatic cancer cases.
• Heavy alcohol consumption: Consuming three or more alcoholic drinks daily can raise the risk of developing pancreatic cancer. Excessive alcohol intake may cause pancreatitis, further increasing the risk of pancreatic cancer.
• Chronic and hereditary pancreatitis: This condition involves inflammation of the pancreas. Long-term excessive alcohol consumption is a common cause of chronic pancreatitis. Pancreatitis can also be hereditary.
• Weight: Being overweight or obese, particularly in early adulthood.
• Diet: A diet rich in red and processed meats, fried foods, sugar, or cholesterol may raise the risk of pancreatic cancer, although researchers are still studying the precise connection.
• Workplace exposure: Exposure to specific chemicals, especially in metalworking and pesticide use, may contribute to up to 12% of pancreatic cancer cases.
• Diabetes: People have a higher risk of developing pancreatic cancer if they have type 1 or type 2 diabetes.
• Infections: A history of H. Pylori infection in the digestive system may elevate the risk of pancreatic cancer, although the connection is not fully understood. Additionally, hepatitis B infection can increase the risk by up to 24%.

Symptoms

Most people don’t experience early signs of pancreatic cancer. However, as the disease progresses, people may notice

• Discomfort in the upper abdomen that may extend toward the back
• Depression
• Unintentional weight loss
• Jaundice
• Tiredness
• Loss of appetite
• Light-coloured poop
• Dark-coloured urine
• Weight loss
• Blood clots in the body
• Itchy skin
• New or worsening diabetes
• Nausea and vomiting

Stages

Upon diagnosing pancreatic cancer, doctors typically conduct tests to check if the cancer has spread. These tests can include imaging procedures like PET scans as well as blood tests. Doctors use the findings from these tests to assess the cancer’s stage. Staging reveals how far the tumor has progressed, guiding doctors in selecting the most appropriate treatment.

The stages of pancreatic cancer are

Stages	Definition
Stage 0	A precancerous stage. Abnormal cells in the pancreas become cancerous.
Stage 1	The tumour is only in the pancreas
Stage 2	The tumour has spread to nearby abdominal tissues or lymph nodes
Stage 3	The tumor has extended into major blood vessels and nearby lymph nodes.
Stage 4	The tumour has spread to other organs like the liver. This is also called metastatic cancer.

Symptoms of Pancreatic Cancer Stages

Stage 0

This represents the initial stage of pancreatic cancer, which may not yet involve fully developed cancer. It means that abnormal cells have been detected and could potentially become cancerous. This stage doesn’t include any symptoms.

Stage 1

Pancreatic cancer of stage 1 consists of a tumour only in the pancreas. This stage is further classified into two subcategories based on the tumor’s size.

• Stage 1A: The tumour measures 2 cm or less.
• Stage 1B: The tumour measures more than 2 cm but less than 4 cm.

Stage 1 of pancreatic cancer typically doesn’t cause noticeable symptoms. Pancreatic cancer may be curable with surgery if detected at this stage.

Stage 2

Stage 2 pancreatic cancer describes cancer that mainly remains in the pancreas but has potentially spread to nearby lymph nodes or blood vessels. This stage is categorized into two subtypes based on the tumor’s location and size:

• Stage 2A: The tumour is more significant than 4 centimetres but hasn’t spread to lymph nodes or nearby tissue.
• Stage 2B: The tumor has reached nearby lymph nodes, affecting no more than three.

Stage 2 pancreatic cancer often produces mild symptoms, which may include:

• Jaundice
• Changes in urine colour
• Pain or tenderness in the upper abdomen
• Weight loss
• Loss of appetite
• Fatigue

Treatments may include:

• Surgery
• Radiation
• Chemotherapy
• Targeted drug therapies

Stage 3 & Stage 4

Stage 3 pancreatic cancer involves a tumor in the pancreas that may also extend to nearby areas, including lymph nodes or blood vessels.

Stage 3 pancreatic cancer can present with symptoms such as:

• Pain in the back
• Pain or tenderness in the upper abdomen
• A loss of appetite
• Weight loss
• Fatigue
• Depression

Treatment

Pancreatic cancer treatment aims to kill cancerous cells and prevent cancer from spreading. The best treatment approach is determined by the tumor’s stage. The main treatment options include,

• Surgery: Surgery for pancreatic cancer involves removing part of the pancreas. While this can eliminate the original tumour, it won’t remove cancer that has spread to other areas. Consequently, surgery is generally not advised for pancreatic cancer in its advanced stages.
• Radiation therapy: Radiation therapy uses X-rays and other high-energy beams to destroy cancer cells.
• Chemotherapy: Chemotherapy drugs work by destroying cancer cells and inhibiting their future growth.
• Targeted therapy: Targeted treatments employ drugs and antibodies to selectively attack cancer cells while sparing nearby healthy cells, unlike chemotherapy and radiation.
• Immunotherapy: Various methods trigger your immune system to target and attack cancer cells.

Frequently Asked Questions