Pancreatic cancer – everything you need to know
8th November 2021
Pancreatic cancer is a type of cancer that has seen some improvements in survival rates but continues to be one of the most difficult types of cancer to diagnose and treat. It’s also one of the deadliest cancers, with less than 1 in 10 people in the UK expected to survive 5 years or more after their diagnosis. How can you spot it early on? Does it metastasise, and where to? What are your treatment options if you are diagnosed? And what are we doing to find new cures for pancreatic cancer?
In 2020, nearly half a million people worldwide were diagnosed with pancreatic cancer.
In 2020, over 460,000 people worldwide died from pancreatic cancer.
What is pancreatic cancer?
The pancreas sits just behind your stomach and is an important part of both the digestive and endocrine systems. It produces many important hormones and enzymes. Cancers that develop in the pancreas can usually be split into two groups:
- Exocrine tumours, which start in exocrine cells that produce enzymes to digest food. This includes 96% of all pancreatic cancers, such as pancreatic ductal adenocarcinoma (PDAC) which accounts for 90% of cases.
- Neuroendocrine tumours, which start in neuroendocrine cells that produce hormones.
If left undetected and untreated, it can spread to other parts of the body such as nearby lymph nodes, the lungs, liver, or peritoneum (lining of the stomach). If caught early enough, it may be possible to treat pancreatic cancer. However, early symptoms may not be obvious and they may not appear for some time. This means many people discover they have pancreatic cancer once it is too late to cure.
What causes pancreatic cancer?
Anyone can get pancreatic cancer, but certain things can increase the risk of developing it. More than half of all cases occur in those over 70 – diagnosis before the age of 40 is rare. Certain medical conditions, such as chronic pancreatitis, diabetes, being overweight, or a history of smoking may increase your risk. A strong family history of pancreatic cancer can also increase your risk, however this accounts for less than 10% of cases. More research is needed to understand other possible risk factors.
Dr Alessandro Carrer in Italy is looking for ways to prevent pancreatic cancer by working out how different parts of the cell talk to each other.
What are the signs and symptoms of pancreatic cancer?
Spotting the signs of pancreatic cancer remains one of the biggest challenges to improving outcomes after diagnosis. Many of the symptoms are commonly associated with other, less serious, health problems and so may go ignored. Symptoms can include:
- Unintentional weight loss
- Pain at the top of your stomach and back, which may feel worse when lying down or eating
- Indigestion, bloating
- A recent diabetes diagnosis
- Fatigue, or lack of energy
- Changes to bowel movements or diarrhoea
Many cases of pancreatic cancer are only discovered once it has spread to other parts of the body, when it may be too late to treat successfully. This has led to some referring to pancreatic cancer as a ‘silent killer’ or a silent disease. It is therefore important not to put off seeking help if you have any symptoms that are concerning you.
If you experience any of the above symptoms, or for longer than you usually might, it’s worth speaking to your GP.
Dr Miriam Martini in Italy is trying to understand how a specific protein in our cells could make pancreatic cancers more vulnerable to treatments.
How is it treated?
The success of any treatment depends on how advanced the cancer is, including whether it has spread to nearby organs or other parts of the body. Surgery can be the best option for localised cases, however it is a major operation and patients need to be fit enough. Removing some or all of the pancreas can cause difficulty digesting food, cause diabetes, and generally takes many months to recover from. Chemotherapy, radiotherapy, or a combination (chemoradiotherapy) may be used before surgery to reduce the size of the tumour.
If surgery is not an option, chemotherapy and radiotherapy can also be used to try and reduce the size of the tumour or manage its growth. If the pancreatic cancer is too advanced, stents or bypasses are other options to help manage symptoms like sickness and jaundice.
Once pancreatic cancer has become more advanced or spread, often the stage at which it is discovered, it is very difficult to treat with current methods. This shows why it is so important to do more to understand pancreatic cancer, learn how to spot it earlier, and discover new cures.
Dr Edna Cukierman in the US wants to understand how proteins usually found in nerve cells influence the growth of pancreatic cancer, which could lead to new treatments in the future.
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