What is Pancreatic Cancer?
Pancreatic cancer is a malignant abnormal growth of cells, called a neoplasm. Pancreatic cancer has a very poor prognosis with less than 5% of individuals diagnosed alive after 5 years.
Causes of Pancreatic Cancer
DNA that has mutated or become damaged is the primary cause of any cancer including pancreatic cancers. The mutations can be inherited or they can occur over time. Usually causes that occur over time are due to certain behaviors such as smoking, obesity, or excessive drinking. In some situations there are no known causes of pancreatic cancer so it has to be chalked up to chance.
Medications for Pancreatic Cancer
The primary chemotherapeutic agent is a gemcitabine such as Gemzar. In 2005 the FDA recommended the use of an erlotinib called Tarceva in combination with Gemzar. Currently the use of an oxaliplatin is being investigated in conjunction with Gemzar. Other chemotherapy drugs that may be used include the bevacizumab, Avastin, and the methotrexate Trexall. Xeloda (capecitabine), Adrucil (fluorouracil) and Zanosar (streptozocin) are other possible medications that can be used. Because the pancreas is diseased it does not produce the enzymes necessary for digestion. Drugs are available to replace these enzymes including Pan-2400, Pancreatin 4X, and Hi-Vegi-Lip.
Prevention of Pancreatic Cancer
Like many other diseases, one of the primary ways to prevent cancer is to adopt healthy practices:
- Quit smoking as this will get rid of a major carcinogen.
- Maintain a healthy body weight and if weight loss is required aim for a slow loss of only 1 to 2 pounds a week.
- Try to exercise at least 30 minutes seven days a week.
- Eat a diet rich in fibers, fruits and vegetables. Dark leafy vegetables and berries have been shown to fight off cancers.
- Do not drink alcohol in excess.
- Maintain vitamin D levels as it may help prevent pancreatic cancer although there is no scientific evidence.
- If there are family members that have had pancreatic cancer it is important to be checked early and often. If caught quickly enough surgical intervention and chemotherapeutic treatments may prevent further spread of the cancer.
Risk Factors for Pancreatic Cancer
There are several factors that can lead to pancreatic cancer:
- Individuals over the age of 60 are more likely to develop pancreatic cancer.
- Men are 30% more likely to get pancreatic cancer than women
- Smoking increases the risk for all cancers.
- Poor diets including those low in fiber, fruits and vegetables, and diets high in red meat and sugary soft drinks.
- Chronic pancreatitis
- Helicobacter pylori
- Genetic inheritance
- Periodontal disease including gingivitis.
- Excessive alcohol consumptions
Symptoms of Pancreatic Cancer
One of the problems with pancreatic cancers is they do not have any symptoms during the early stages. Over time symptoms will appear and can include:
- Pain in the abdomen that moves toward the back.
- Nausea, vomiting, appetite loss
- Extreme weight loss.
- Jaundice, seatorrhea, pale stool.
- Spontaneous formation of blood clots in portal veins and arteries, known as Trousseau sign.
- Diabetes can be an early warning sign
Treatment of Pancreatic Cancers
Treatment for pancreatic cancer depends on how far the disease has progressed. The most common treatment is the Whipple procedure where the head of the pancreas and the curving portion of the duodenum are removed. This procedure is done only when the cancer has not metastasized. If cancer is localized in the tail of the pancrease it can be resected and removed. Once surgery is completed the patient will undergo chemotherapy treatments. Radiation therapy is used as well in the United States.
Types of Pancreatic Cancer
Most exocrine type pancreatic cancers (95%) are adenocarcinomas. An adenocarcinoma is epithelial cancer that begins in the glands. This does not mean the cells must be part of a gland, only that they have excretion features. The rest of the pancreatic cancers include adenosquamous carcinomas, hepatoid cancer, signet ring cell cancer, colloid cancer, and undifferentiated cancers including some with giant cells resembling osteoclasts. Endocrine pancreatic tumors only make up 1% of cases.