Pancreatic cancer - symptoms, diagnosis, treatment
Pancreatic cancer is an oncological disease that is difficult to diagnose at an early stage. According to statistics, men get sick more often. Like most tumors, pancreatic cancer affects mainly elderly people, which is associated with a decrease in natural anti-tumor defense mechanisms, the accumulation of various mutations and disorders of cell division. Since the disease has no specific symptoms, patients seek help in advanced cases.
The main causes of pancreatic cancer are
- Smoking;
- diseases of the pancreas;
- diseases of the biliary tract;
- heredity, genetic abnormalities;
- errors in nutrition;
- diabetes mellitus;
- age;
- obesity.
Pancreatic cancer - symptoms, types of disease
Experts distinguish two main types of cancer: adenocarcinoma (exocrine cancer) and endocrine cancer. The former is diagnosed in patients in 90% of cases.
Taking into account the localization, there are
- pancreatic head cancer;
- carcinoma of the body of the gland;
- pancreatic tail cancer.
Most often, the tumor is found in the head of the gland.
Manifestations of pancreatic cancer. The onset of the disease is usually asymptomatic. The first symptoms will be pain under the “spoon” and in the left hypochondrium, weight loss for no apparent reason, heaviness in the stomach after eating, severe fatigue, general weakness, loss of appetite. Later symptoms include:
- severe itching of the skin
- jaundice;
- intolerance to meat;
- nausea, vomiting, diarrhea (foul-smelling stools);
- general exhaustion.
Signs of pancreatic tail or body cancer are somewhat different and in many ways similar to the symptoms of chronic pancreatitis and diabetes mellitus.
Stages of pancreatic cancer, metastasis
According to the TNM classification, the following stages of cancer are distinguished:
- Stage 0 - the tumor is localized in the pancreas, there is no damage to internal organs and lymph nodes;
- Stage IA - the tumor size is not more than 2 mm, there is no spread to internal organs and lymph nodes;
- Stage IB - tumor size is more than 2 mm, no germination;
- Stage IIA - the tumor “goes” beyond the pancreas, there is no damage to the lymph nodes and internal organs;
- Stage IIB - involvement of internal organs and lymph nodes;
- Stage III - lymph node and internal organ involvement, presence of cancer cells in nearby arteries and veins;
- Stage IV - metastasis to distant organs.
Treatment depends on the stage of pancreatic cancer and the general condition of the patient.
Metastases in pancreatic cancer. Regardless of the size of the tumor, cancer is dangerous due to early metastases that can occur in the lungs, stomach, liver, abdomen, intestines, bones, and lymph nodes.
Pancreatic cancer - symptoms of cancer intoxication: mechanical jaundice, intense progressive pain, severe exhaustion, ascites, and dysfunction of internal organs.
Diagnosis
In the early stages, due to the absence of specific symptoms, the diagnosis of pancreatic cancer causes some difficulties. To confirm the diagnosis, after examining the patient and taking anamnesis, the doctor will prescribe a number of necessary examinations, namely
- general blood and urine test, blood chemistry, coagulogram;
- blood test for tumor markers;
- determination of blood levels of insulin, C-peptide, gastrin;
- determination of pancreatic amylase in urine and blood;
- determination of alkaline phosphatase in blood and pancreatic elastase in feces.
Instrumental examinations: Abdominal ultrasound, CT, MRI (MRI with contrast agent), PET, endoscopic retrograde cholangiography, laparoscopy, biopsy. If metastasis is suspected, CT of the abdominal lymph nodes, liver, kidneys and spine, CT and MRI of the brain are prescribed.
These studies will help determine the type of tumor, its size, as well as find out the stage of cancer and make the correct diagnosis.
Important: if pancreatic cancer is suspected, histological verification of the diagnosis is mandatory.
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Treatment of pancreatic cancer
Treatment depends on the stage of the disease, the size of the tumor and the patient's condition. The main methods are surgery, chemotherapy (monochemotherapy, polychemotherapy), radiation therapy, targeted therapy.
Types of surgical operations:
- complete resection of the pancreas;
- distal resection of the gland;
- segmental resection;
- Whipple's operation;
- palliative surgery (indicated for unresectable tumors).
Treatment of pancreatic cancer is radiation therapy. Two types are used - internal and treatment with external radiation.
Chemotherapy is performed with the following drugs: gemcitabine, paclitaxel, oxaliplatin, capecitabine, docetaxel. Polychemotherapy with the use of several drugs is most effective (FOLFIRINOX regimen, combination of gemcitabine with cisplatin or capecitabine).
The prognosis for pancreatic cancer depends on the location of the tumor, the degree of atypical cell proliferation, the presence (absence) of metastases, and the general condition of the patient. The prognosis for exocrine cancer is disappointing - the survival rate is only 6%.
Prevention. Smoking cessation, a healthy diet, regular medical examinations, weight control, and timely treatment of inflammatory diseases will help maintain health for a long time and avoid oncology.
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