Pancreatic cancer

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The Role of the Pancreas and Problems Related to Pancreatic Cancer

The pancreas performs both exocrine and endocrine functions. Its enzymes are critical for protein, fat, and carbohydrate digestion in the small intestine. If the pancreas is impaired, as in the case of cancer, these functions cannot be performed optimally. Pancreatic cancer can cause malabsorption syndromes, severe endocrine disorders like diabetes, accelerated breakdown of body systems, and potentially fatal multi-organ decline.

Pancreatic cancer initiates in the pancreas and is one of the deadliest cancers due to its rapid progression and lack of pre-symptomatic signs. It typically arises from disruptions within pancreatic cells that escalate normal functioning cells to mutate into aggressive cancerous cells. While not among the most commonly diagnosed cancers globally, it has one of the highest mortality rates because it is tardily diagnosed and there are no signs for early detection. There is some optimism in regards to risk assessment, education, and awareness about risk factors like chronic pancreatitis, diabetes, and family history aiding in early intervention and improving survival outcomes.

What is Pancreatic Cancer?

Pancreatic cancers have two main classifications:

Primary Pancreatic Cancers: These cancers begin from the pancreas and frequently appear as Pancreatic Ductal Adenocarcinoma (PDAC) which is found most commonly in the ducts of the pancreas. Other forms of Acinar Cell Carcinomas PDACs include NETs, or neuroendocrine tumors. The less common Pancreatoblastomas also fall into this category.

Secondary Pancreatic Cancer: Metastatic pancreatic cancer refers to tumors that spread to the pancreas from other locations such as the lungs, breast, or colon. While more uncommon than primary pancreatic tumors, secondary tumors develop later and contribute to the complexities which arise in the clinical picture during the disease’s progression.

What Causes Pancreatic Cancer?

Chronic pancreatitis
Obesity
Type 2 Diabetes and Hereditary Conditions, such as BRCA2 and Lynch Syndrome
Smoking and alcohol abuse
Industrial and chemical exposure

Pancreatic Cancer Symptoms

In the early stages of the disease, there are no symptoms and thus is regarded as a “silent killer”. With time, and in the more advanced stages, a patient may experience:

Digestive problems (nausea and vomiting)
Putrid exhaustion and overall weakness
Jaundice (skin and eyes turning yellow)
Dietary changes (anorexia)
Marked greasiness or pallor of stools (faeces)
Darkened urine
Onset or worsening of pre-existing diabetes
Significant unexplained weight loss
Skin lightening or losing color
Skin lesions

Pancreatic Cancer Diagnosis

Diagnosing pancreatic cancer involves several steps, including:

Laboratory Tests: The liver’s function as bile duct obstruction gives CA 19-9 necrosis and glucose levels. Positioned behind the stomach, the pancreas is a vital organ.
Imaging Studies: Abdominal ultrasound, EUS, CT and MRI for tumor and metastasis detection, and PET scan for overall body assessment.
Biopsy: Tissue samples can be obtained surgically or by EUS-guided fine needle aspiration to confirm malignancy and subtype.
Staging: It includes evaluating whether the tumor is resectable and its lymph node and organ metastasis as well.

Latest Treatment For Pancreatic Cancer

The management plan for pancreatic cancer is influenced by the patient’s overall status, the tumor type, site, and the extent of spread. The key treatments are:

A. Traditional Treatments

B. Exploration of Treatment Options and Assessment

C. Primary Approach for Treating Pancreatic Cancer

1. Surgical Interventions

Whipple Procedure - Pancreaticoduodenectomy: One of the most frequently done surgical treatments for head of pancreas tumors that are amenable to excision, including removal of parts such as duodenum and bile duct. Complete or partial removal may involve excision from both organs.

Distal Pancreatectomy: Also referred to as Spleen Preserving Surgery, entails removal of both body and tail of pancreas as well as the spleen.

Total Pancreatectomy: Rarely used. Involves complete removal of the pancreas, usually requiring lifelong insulin and enzyme therapy.

2. External Beam Radiation Therapy

Uses modern linear accelerators to target pancreatic tumors with precision. Can shrink tumors prior to surgery or provide palliation when surgery is not an option. Risks include potential damage to intestines or liver.

3. Systemic Chemotherapy

Gemcitabine, FOLFIRINOX (a combination of four drugs), or nab-paclitaxel are commonly used intravenously. Benefits include tumor reduction, symptom relief, increased survival, and improved quality of life. Side effects may include hair loss, nausea, fatigue, and weakened immunity.

B. New Methods for Treating Pancreatic Cancer

1. Microinvasive Therapies and Surgeries

IRE NanoKnife: Useful for cancers close to large blood vessels. Uses electrical pulses, not heat. Tissue-sparing and improves prognosis in unresectable cases.

Cryosurgical Ablation: Freezes tumors to sub-zero temperatures. Often combined with immune-modifying therapy to trigger immune response. Surrounding tissues remain unaffected.

2. Targeted Therapies

Microvascular Interventional Chemo: Transcatheter Artery Infusion (TAI) and Chemoembolization (TACE) deliver drugs directly via catheters.

Targeted Medication Administration: Kinase inhibitors and PARP inhibitors for BRCA mutation carriers target cancer cells while sparing healthy cells.

3. Targeted Radiation Therapy (Radioembolization/Brachytherapy)

Implanting radioactive seeds (Iodine-125, Palladium-103) directly into pancreas. Fewer side effects and faster recovery.

4. Immunotherapies and Stem Cell Treatments

Immune checkpoint inhibitors (anti-PD-1, anti-CTLA-4) and CAR-T therapy help the immune system identify and destroy cancer cells. More effective when combined with microinvasive methods like cryoablation.

Preventative Health Management

Reduce risk factors: avoid tobacco, maintain healthy weight, eat fruits and vegetables, limit alcohol, and treat chronic pancreatitis and diabetes early. High-risk individuals should have genetic counseling and regular screening.

Pancreatic Cancer Survival Rate

Pancreatic cancer has a poor prognosis due to its silent and aggressive nature. Overall 5-year survival is ~11%. Early detection and surgery improve survival to 25-30%. Advanced cases diagnosed late have a median lifespan of 7-11 months. New treatments are improving quality of life and life expectancy.

Conclusion

Pancreatic cancer remains challenging due to its silent onset, rapid progression, and resistance to treatment. Advances in diagnostics, awareness campaigns, microinvasive approaches, and immunological therapies are steadily improving outcomes. Continuous monitoring and risk reduction remain crucial.

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Our Specialties & Procedures

Explore our range of advanced cancer care procedures designed to provide comprehensive treatment and improve your well-being.

Advanced Therapies For Cancer

Innovative and precise cancer treatments combining advanced technology, targeted therapy, and personalized medicine for better recovery outcomes.

Explore More →

Treating Specific Cancer

Specialized treatment plans for different cancer types — including liver, lung, breast, and bone cancers — with a focus on patient comfort and long-term wellness.

Explore More →