Pancreatic Cancer

Pancreatic cancer is an uncontrolled proliferation of malignant cells in the pancreas. It is usually an adenocarcinoma, a tumor that originates in the glandular tissue lining the organ.

Depending on where it forms in the organ, there are two main types of pancreatic cancer:

• Pancreatic ductal adenocarcinoma: Originates in the exocrine cells, which form the exocrine glands and pancreatic ducts responsible for producing and releasing the enzymes involved in digestion. It is the most common type.
• Neuroendocrine carcinoma: Less common than the previous type and has a better prognosis. It arises in the endocrine cells of the pancreas, which produce hormones such as insulin and glucagon. Neuroendocrine tumors can be:
• Functioning, if they produce an excess of hormones.
• Non-functioning, if they stop producing hormones.

Pancreatic cancer is one of the most aggressive cancers of the digestive tract and typically has a poor prognosis because it is often diagnosed late. In most cases, it is asymptomatic until it has spread to other organs. Moreover, many of its symptoms are similar to those of non-cancerous conditions.

Symptoms

As the tumor grows, pancreatic cancer may present the following symptoms:

• Jaundice: Yellowish discoloration of the skin and the whites of the eyes due to bile duct invasion, which interrupts bile flow to the intestine.
• Generalized itching caused by the accumulation of bile salts.
• Back and abdominal pain.
• Unexplained weight loss.
• Fatigue.
• Pale-colored stools.
• Dark-colored urine.

Endocrine carcinomas may present additional symptoms:

• Diarrhea.
• Abdominal mass.
• Tachycardia.
• Weakness.
• Dizziness.
• Headaches.
• Blurred vision.
• Sweating and hot flashes.
• Stomach ulcers.
• Acid reflux.
• Skin rashes on the face, stomach, or legs.
• Redness, pain, and swelling in the limbs due to blood clot formation.
• Irritation of the tongue and corners of the mouth.
• Excessive hunger and thirst.
• Frequent urination.

Causes

Uncontrolled growth of pancreatic cells is due to mutations in their DNA. These changes may activate genes that promote cell growth and development or deactivate genes that regulate cell reproduction and programmed cell death. Cancerous cells cluster together, forming a mass (tumor) that grows and invades healthy body tissue. The exact cause of these mutations is unknown, but certain risk factors are believed to increase their likelihood.

Risk Factors

Risk factors for developing pancreatic cancer include:

• Smoking.
• Obesity.
• Alcohol consumption.
• Age: More common in people over 65 years old.
• Personal history of pancreatitis or diabetes.
• Family history of pancreatic cancer.
• Hereditary disorders, such as multiple endocrine neoplasia type 1, Lynch syndrome, Von Hippel-Lindau syndrome, hereditary breast and ovarian cancer syndrome, or familial melanoma syndrome, among others.

Complications

As mentioned earlier, pancreatic ductal adenocarcinoma only presents severe symptoms when metastasis is already present, at which point the prognosis is usually fatal. Additionally, tumor growth can significantly affect the digestive process, hindering food intake and nutrient absorption, as well as causing an obstruction that blocks the passage of food from the stomach to the intestine.

Prevention

It is possible to mitigate risk factors by avoiding tobacco use and maintaining a healthy body weight. Additionally, individuals with a family history of pancreatic cancer are advised to undergo early detection tests to diagnose it before symptoms appear or genetic tests to assess their risk of developing the disease.

Which Doctor Treats Pancreatic Cancer?

Pancreatic cancer is diagnosed and treated in the Digestive System and Gastroenterology and Medical and Radiation Oncology units.