What is Pancreatic Carcinoma?

 

The pancreas is situated posterior to the lower section of the stomach. It makes enzymes and hormones that help in the digestion of food and help regulate blood sugar [1]. Pancreatic carcinoma refers to the uncontrolled growth of the pancreatic duct cells. According to NIH, it is the fourth leading cause of death in the United States [2].

 

Pancreatic cancer is difficult to diagnose at its early stages. It is because it does not cause symptoms until it has spread to other organs.

 

 

 

What are the Symptoms of Pancreatic Carcinoma?

 

The initial symptoms of pancreatic carcinoma are non-specific and often misinterpreted. In pancreatic carcinoma, the patient presents with the following symptoms [3]:

 

• Considerable weight loss for no apparent reason
• Loss of appetite
• Mid-epigastric pain often radiating to the mid back or lower back region
• Painless Obstructive Jaundice
• Dark colored urine
• Pruritus 
• Night time pain
• The onset of Diabetes Mellitus within two years
• Lethargy
• Palpable Gallbladder
• Migratory Thrombophlebitis
• Ascites
• Palpable abdominal mass
• Hepatomegaly from liver metastases
• Splenomegaly from portal vein obstruction
• Para umbilical subcutaneous metastases

 

 

 

What are the Causes of Pancreatic Carcinoma?

 

About 53670 cases of pancreatic carcinoma occur yearly in the U.S [4]. The following risk factors increase the chances of pancreatic carcinoma:

 

• People above age 60 are at a greater risk of developing pancreatic carcinoma.

 

• Familial Syndromes are uncommon, but it is important to explain to the doctor if the patient has a cancer history in their family.

 

• Tobacco use increases the risk of developing pancreatic cancer.

 

• Obesity, a sedentary lifestyle, diabetes, pancreatitis, and a fatty diet increase the risk of developing pancreatic carcinoma.

 

• Prior stomach surgery due to hepatitis B or H.pylori, increases the risk of pancreatic carcinoma.

 

• Certain drugs that treat diabetes such as metformin and sitagliptin are associated with an increased risk of pancreatic carcinoma.

 

 

 

What are the Treatment Options for Pancreatic Carcinoma?

 

The following treatment options are available for pancreatic carcinoma [5]:

 

• Surgery
• Radiation therapy
• Chemotherapy
• Chemo-radiation therapy
• Targeted therapy

 

The three surgical treatment options are usually opted for pancreatic carcinoma:

 

• Whipple procedure: in this technique, only the head of the pancreas along with most of the duodenum, bile duct, gall bladder, and associated lymph nodes are removed. Enough of the pancreas is left to carry out its function.

 

• Total pancreatectomy:  This procedure involves the removal of the whole pancreas.

 

• Distal pancreatectomy: This surgery removes the body and the tail of the pancreas.

 

 

 

References:

1. https://www.mayoclinic.org/diseases-conditions/pancreatic-cancer/symptoms-causes/syc-20355421
2. https://www.ncbi.nlm.nih.gov/books/NBK518996/
3. https://emedicine.medscape.com/article/280605-overview
4. https://www.medicinenet.com/pancreatic_cancer/article.htm
5. https://www.cancer.gov/types/pancreatic/patient/pancreatic-treatment-pdq

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