Unfortunately, most cases of pancreatic cancer are diagnosed at a stage when the tumor has progressed and spread to nearby tissues. The position of the pancreas in the body is such that it is difficult to identify the tumor in the early stages.
On the other hand, malignant pancreatic cancer has no obvious or significant symptoms; undoubtedly, early detection of pancreatic cancer provides the possibility of appropriate treatment and longer survival for patients. Is early detection of pancreatic cancer possible?
How to diagnose pancreatic cancer early?
In the following, our doctors will answer this question
Pancreatic cancer is called silent cancer because it is not usually diagnosed until the tumor has progressed and spread.
what you will read next :
- Where is the pancreas?
- What is the function of the pancreas?
- What are malignant tumors and cancers of the pancreas?
- Symptoms of pancreatic cancer
- Who is most at risk for pancreatic cancer?
- What can we do to detect pancreatic cancer early?
- What can be done to detect pancreatic cancer early in people at high risk?
- Performing a test for early detection of pancreatic cancer in high-risk individuals
- What are the new tests for early detection of pancreatic cancer?
Where is the pancreas?
An adult human pancreas is fifteen centimeters long and five centimeters wide and is located behind the stomach and near your bladder.
What is the function of the pancreas?
The pancreas has two important parts and two functions:
- The part that produces digestive enzymes and flows into the small intestine (the exocrine or exocrine part) that make up most of the pancreatic tissue
- The part that is active in the production and secretion of important hormones such as insulin (endocrine or endocrine part)
What are malignant tumors and cancers of the pancreas?
Malignant cancers can be present in both endocrine and exocrine segments. Most pancreatic cancers are found in exocrine segments.
- Malignant tumors of the exocrine part of the pancreas (in order of prevalence):
- Adenocarcinoma (pancreatic cell wall cancer in the pancreas)
- Acinar cell carcinoma
- Ampullary cancer (cancer at the junction of pancreatic secretory ducts to the small intestine)
- Adenosquamous carcinoma of the pancreas
- SCC pancreas
- Giant cell pancreatic carcinoma
- Tumors of the endocrine part of the pancreas:
Endocrine or endocrine tumors are rare and are in order of prevalence:
- Insulinoma (insulin-producing cell cancer)
- Glucagonoma
- Somatosatinoma
- Gastrinoma
- Vipoma
Symptoms of pancreatic cancer
Unfortunately, in the early stages, the symptoms of pancreatic tumors overlap with a large number of diseases. In other words, pancreatic tumors do not initially have specific signs and symptoms, which makes this diagnosis difficult.
The following symptoms are not specific to pancreatic cancer, but if you have several of the following symptoms in yourself or those around you for a long time, be sure to see your doctor for diagnostic tests for early detection of pancreatic cancer:
- the pain:
The pressure of the tumor on the adjacent nerves causes intermittent pain in the upper abdomen
The pain can spread to your back and even cause back pain
- Jaundice of the skin and cross of the eye:
This symptom occurs when pancreatic cancer has reached the bile ducts of the liver and caused them to become blocked.
Clear stools with dark urine and generalized itching may also be present.
- Feeling full
- Early satiety !!
- Excessive weight loss
- Decreased appetite
- nausea and vomiting
- Fatty stools
- depression
- Blood clots in the arteries spontaneously
- Tumors of the endocrine pancreas can have their own symptoms:
- Insulinoma
- Anxiety
- Sweat
- Vertigo
- Frequent weakness and fainting
- Blood sugar drop
- Glucagonoma:
- Diarrhea
- Feeling thirsty all the time
- urinary frequency
- weight loss
- Gastrinoma:
- Ulcers
- Gastric bleeding
- weight loss
- stomach ache
- Abdominal pain
- Gastric acid reflux into the esophagus
- Somatostatinoma:
- Fatty and smelly stools
- Diarrhea
- weight loss
- Abdominal pain
- Vipoma:
- Abdominal pain
- Facial hot flash
- Watery diarrhea
Who is most at risk for pancreatic cancer?
Risk factors for pancreatic cancer include:
- Tobacco users (the most important risk factor for pancreatic cancer)
- Being overweight
- People with diabetes
- People with a history of chronic pancreatitis
- Age (people over forty-five years)
- Men more than women
- African American race
- People with a family history of pancreatitis in their father, mother, sister, brother or children
- People with specific genetic syndromes
- People with hereditary breast and ovarian cancers:
- BRCA1 and BRCA2 mutations
- People with hereditary breast cancer:
- PALB2 mutation
- Familial atypical multiple mole melanoma or FAMMM syndrome
- P16 / CDKIN2A gene mutation
- Familial pancreatitis:
- Mutation in PRSS1
- Lynch syndrome or hereditary non polyposis colorectal cancer or HNPCC for short
- Defects in MLH1 and MLH2 genes
- Peutz Jeghers Syndrome:
This syndrome is also associated with other cancers and has a defect in the STK11 gene
The effects of alcohol, diet, coffee, inactivity, and some infections, such as hepatitis B or Helicobacter pylori, have not yet been proven.
What can we do to detect pancreatic cancer early?
It is difficult to diagnose pancreatic cancers due to the non-specificity of their symptoms in the advanced stages. On the other hand, most malignant pancreatic tumors form in a place that is behind the stomach and out of reach, so they cannot be detected until the tumor grows too large.
Tumors in advanced stages with metastases and overgrowth and progression to surrounding tissues, it is clear that unfortunately the treatment in these stages will not be satisfactory.
In medicine, for some cancers such as breast, intestine, etc., there are tests for screening and early diagnosis of diseases, but unfortunately, there is no valid screening program for early detection of pancreatic cancer in people at moderate risk.
What can be done to detect pancreatic cancer early in people at high risk?
People at high risk for pancreatic cancer are in the following groups:
- People with a history of first-degree relatives with pancreatic cancer and other related cancers
- People with specific genetic changes that lead to a group of inherited syndromes associated with pancreatic and gastrointestinal cancers
- People with specific genetic mutations mentioned in the previous section:
These people are more likely to develop pancreatic cancer than the general population. For these people, tests for early detection of pancreatic cancer may be performed. It is difficult to identify high-risk individuals
The American Cancer Society recommends that people at high risk seek guidance from a medical team, including a geneticist, before having a genetic test. Because it is important to know what the test result is helpful in diagnosing and what it is not used to diagnose.
Performing a test for early detection of pancreatic cancer in high-risk individuals
New tests for early detection of pancreatic cancer could help people with genetic or familial backgrounds (people at risk)
What are the new tests for early detection of pancreatic cancer?
- Endoscopic ultrasounds:
Endoscopic ultrasound will be much more accurate than routine abdominal ultrasound. Endoscopic ultrasound is one of the methods that can be very helpful in the early diagnosis of pancreatic cancer.
In this procedure, a small ultrasound probe is attached to the tip of a thin, flexible endoscopic tube and is routed from the mouth to the esophagus, into the stomach, and into the small intestine.
We said that the pancreas is behind the stomach, so this method is very good for early evaluation of pancreatic cancer.