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Pancreatic cancer

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Pancreatic cancer refers to any malignancy originating in the pancreas. The pancreas is a glandular organ located behind the stomach.

Blausen 0699 PancreasAnatomy2
Blausen 0699 PancreasAnatomy2

This disease begins when pancreatic cells multiply uncontrollably to form a mass. These cancerous cells possess the ability to invade nearby tissues. They can also spread to distant parts of the body. Because it is difficult to detect early, it is a very deadly disease.

Pancreatic cancer death rate, World, 2023 (cropped)
Pancreatic cancer death rate, World, 2023 (cropped)

Most pancreatic cancers are classified as exocrine cancers. These account for approximately 95% of all cases. The most dominant type is pancreatic adenocarcinoma. This specific cancer represents about 85% to 90% of all diagnoses. Adenocarcinomas typically begin in the ductal part of the pancreas. These ducts are the tubes that carry digestive enzymes and bicarbonate away from the organ. About 60% to 70% of these adenocarcinomas occur in the head of the pancreas.

Pancreas adenocarcinoma (4) Case 01
Pancreas adenocarcinoma (4) Case 01

Other exocrine types exist within the pancreas. Acinar cell carcinoma arises in the cell clusters that produce digestive enzymes. This type represents about 5% of exocrine cancers. Cystadenocarcinomas account for 1% of cases and often have a better prognosis. A rare form called pancreatoblastoma mostly affects children. There are also rarer types like solid pseudopapillary tumors. These rare tumors mainly affect younger women and generally have a very good prognosis.

Histopathology of solid pseudopapillary tumor
Histopathology of solid pseudopapillary tumor

A smaller group of cancers is called pancreatic neuroendocrine tumors, or PanNETs. These arise from the hormone-producing cells of the pancreas. They represent only about 1% to 2% of all pancreatic cancer cases. PanNETs are divided into functioning and nonfunctioning types. Functioning tumors secrete hormones like insulin, gastrin, or glucagon into the blood. This over-production can cause symptoms like low blood sugar. Nonfunctioning tumors do not secrete enough hormones to cause obvious symptoms. These are often only discovered after the cancer has already spread.

Relative incidence of pancreatic neoplasms
Relative incidence of pancreatic neoplasms

Detecting pancreatic cancer is challenging because early stages often show no symptoms. By the time specific symptoms appear, the disease is often at an advanced stage. One common sign is jaundice, which is a yellow tint in the eyes or skin. Jaundice occurs when a tumor in the pancreatic head obstructs the bile duct.

Jaundice08
Jaundice08

Other symptoms include abdominal or back pain and unexplained weight loss. Pain may be worse at night or relieved by bending forward. Patients may also experience dark urine or light-colored stools. At least 50% of people with adenocarcinoma have diabetes at the time of diagnosis.

Ultrasonography of pancreatic cancer
Ultrasonography of pancreatic cancer

Medical professionals use several methods to diagnose the disease. They combine medical imaging, such as ultrasound or computed tomography, with blood tests. Doctors also perform a biopsy to examine actual tissue samples. The disease is categorized into stages ranging from Stage I to Stage IV. While screening the general population has not been effective, certain risk factors are known. Tobacco smoking is linked to about 25% of cases. Inherited genetic conditions are linked to 5% to 10% of cases.

Adenocarcinoma of Pancreas, FNA (5558060087)
Adenocarcinoma of Pancreas, FNA (5558060087)

Treatment options depend heavily on the stage of the cancer. Surgery is the only method that can cure pancreatic adenocarcinoma. This may include a Whipple's operation to remove parts of the organ.

Diagram showing the parts removed with a Whipple's operation CRUK 337
Diagram showing the parts removed with a Whipple's operation CRUK 337

Other treatments include radiotherapy, chemotherapy, or a combination of these. Palliative care is often used to manage pain and improve quality of life. Pancreatic cancer is a major global health issue. In 2021, it caused 508,532 deaths worldwide. This was a significant increase from 411,600 deaths in 2013.

Diagram showing pancreatic cancer that has spread (M staging) CRUK 179
Diagram showing pancreatic cancer that has spread (M staging) CRUK 179
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🖼️ Images & Media (22)
File:2424 Exocrine and Endocrine Pancreas.jpg
2424 Exocrine and Endocrine Pancreas.jpg
File:Relative incidence of pancreatic neoplasms.png
Relative incidence of pancreatic neoplasms.png
File:Jaundice08.jpg
Jaundice08.jpg
File:Secondary tumor deposits in the liver from a primary cancer of the pancreas.jpg
Secondary tumor deposits in the liver...
File:Pancreas adenocarcinoma (4) Case 01.jpg
Pancreas adenocarcinoma (4) Case 01.jpg
File:Pancreas neoplasia carcinoma sequence.png
Pancreas neoplasia carcinoma sequence.png
File:Progression of pancreatic intraepithelial neoplasia.png
Progression of pancreatic intraepithelial...
File:Blausen 0699 PancreasAnatomy2.png
Blausen 0699 PancreasAnatomy2.png
File:MBq cystic-carcinoma-pancreas.jpg
MBq cystic-carcinoma-pancreas.jpg
File:Ultrasonography of pancreatic cancer.jpg
Ultrasonography of pancreatic cancer.jpg
File:Adenocarcinoma of Pancreas, FNA (5558060087).jpg
Adenocarcinoma of Pancreas, FNA (5558060087).jpg
File:Histopathology of pancreatic ductal adenocarcinoma.jpg
Histopathology of pancreatic ductal...

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