Pancreatic Cancer is known for its poor prognosis.Nearly more than 25,000 new pancreas cancer patients are diagnosed every year in India. It is 13th most common cancer but 5th most common cause of death due to cancer in India. Without treatment, not more than 15% of patient survive for more than a year. With best treatment possible still less than 15% patient survive more than 5 years.
The pancreas is a vital organ of our body which has got two major functions. Firstly it releases certain enzymes which help in digestion. Second, it releases hormones which maintain blood glucose level.
Pancreas Cancer Risk Factors
Smoking is the most common risk factor. Nearly 75% of patients are chronic smokers and risk equalize to non-smoker after 10 years of quitting it. Alcohol causes the chronic inflammatory condition of the pancreas called chronic pancreatitis which is a risk factor for pancreatic cancer. Recent studies show long term diabetes is also a risk factor. Pancreas cancer in itself can cause diabetes.
Pancreas Cancer Symptoms
During the early stage, the patient is asymptomatic. Pain is a constant feature which is mild to moderate in intensity and localized to the upper abdomen which may radiate to the back. Anorexia and weight loss are common. Cancer located in the head of the pancreas can cause distal CBD obstruction leading to jaundice and Duodenal obstruction leading to vomiting. Tumor located at body and tail region of the pancreas can grow to a large size without any symptom and may present as lump abdomen.
Pancreas Cancer Diagnosis
Ultrasound is the first investigation in patients presenting with an abdominal complaint. When it suggests a mass lesion in the pancreas, CECT abdomen is done to further delineate the mass. Its relation with surrounding structures and any distant lesions.
Pancreas Cancer Treatment
Once CECT abdomen suggests tumor is resectable surgery is the treatment of choice. In the case of a locally advanced tumor, pre-operative chemoradiotherapy is given. The standard surgical procedure done in case of tumor located in the head of the pancreas is Whipple procedure (pancreaticoduodenectomy). If it is located in the distal part distal pancreatectomy with splenectomy is done
Patient with a head tumor can have jaundice. Pre-operative biliary stenting is done if the bilirubin level is very high, the patient has fever and poor general condition with poor nutrition.