In the Netherlands, there are approximately 2,200 people who have been diagnosed with pancreatic cancer. This form of cancer occurs in both men and women. When looking at age, people over the age of sixty are mainly affected by the disease. It is very important for treatment that pancreatic cancer is detected at an early stage. Unfortunately, the symptoms often reveal themselves quite late: when the tumor has already grown to another organ.
Pancreas or pancreas
A soft gland about twelve to fifteen centimeters long that lies behind the stomach, against the back wall of the abdominal cavity. Horizontally, the pancreas lies from the duodenum to the spleen. The thickest part, the head , lies next to the duodenum and the thinnest part, the tail , lies near the spleen. The pancreas secretes digestive juices into the intestine. The islets of Langerhans are scattered throughout the pancreas. These are groups of cells that ensure that insulin and glucagon (hormones) are secreted into the blood.
Pancreatic cancer
Pancreatic cancer is a malignant tumor in the pancreas, also called the pancreas. There are different types of pancreatic cancer: adenocarcinoma (originates in the ducts of the pancreas), the cancer originates in the head of the pancreas: pancreatic head carcinoma. Tumors can also develop near the head of the pancreas that do not originate from the tissue of the pancreas itself. For example, a tumor may have its origin in the papilla of Vater, the bile duct, the small intestine. If it cannot be determined which type of tissue is involved (in or around the head of the pancreas), the term periampullary tumor is used.
Growth of the tumor to other parts of the body
If a tumor continues to grow in the pancreas, it mainly goes to the duodenum (upper part of the small intestine), nerves, blood vessels, and abdominal cavity. If the tumor grows larger, cells may detach and end up in the lymph nodes around the pancreas and form tumors there (pancreatic cancer metastases). Metastases can develop in other organs by spreading through the blood, such as the lungs and the liver.
Who gets pancreatic cancer?
People over the age of sixty are particularly affected by pancreatic cancer. In some cases it occurs at a younger age. Gender does not matter, the disease occurs equally in men and women.
Cause
It is not known what exactly causes pancreatic cancer. However, there are factors that may increase the risk of pancreatic cancer, such as smoking (it has been proven), excessive use of alcohol, fatty diet, chronic inflammation of the pancreas, diabetes. Heredity plays a role in approximately five percent of people with pancreatic cancer.
Symptoms
It often takes quite a long time before someone notices anything about the tumor. This is because the symptoms usually only occur when the tumor grows to another organ or when the nerve pathways around the pancreas are reached by the tumor. The type of complaints someone has depends on the size of the tumor, its location and the influence of the tumor on any other organ that is affected.
Complaints that often occur:
- Less cravings for food.
- Loss of weight.
- A nauseous feeling.
- Pain, which you can describe as nagging, in the middle of the abdomen or back.
- The stool pattern is different than normal.
- Jaundice: with a tumor near or in the head of the pancreas.
Jaundice in pancreatic cancer
If the tumor is located near or in the head of the pancreas, it can block the large bile duct. Bile then accumulates in the liver, gallbladder and bile ducts. The person will feel tired and not feel like doing anything because the liver cannot get rid of the bile. The digestion of food will no longer proceed properly because the bile no longer flows to the duodenum. If the large bile duct is blocked, you will see that the stool becomes light in color or even white, and the consistency also changes: a lot thinner than normal. The whites of the eyes and skin can turn yellow because a large part of the bile pigment that has accumulated is absorbed into the blood (and ends up in the eye and skin). It can also lead to itching all over the body. The urine becomes darker in color.
Diagnosis
Always contact your doctor if you recognize some of the above symptoms in yourself or a loved one. Physical examination and blood tests will be done. If diabetes or jaundice is found during blood tests, this may indicate pancreatic cancer. Follow-up examinations may include: ultrasound, CT scan, ERCP examination (keyhole examination: contrast fluid, cells from the tumor can be removed for examination), MRCP (MRI scan of the pancreas and bile ducts), laparoscopy (keyhole surgery).
Therapy
It depends on the stage of the disease, but also the form of pancreatic cancer, the location and size of the tumor. The person’s physical condition also plays a role. This may involve curative treatment, which means that the goal is to cure the disease. If additional treatment such as chemotherapy is required after surgery, the term adjuvant treatment is used for this. If the cancer can no longer be treated curatively, treatment is aimed at inhibiting or reducing the disease or preventing symptoms: palliative treatment.
Treatments applied:
- Operation;
- Applying a tube (also called a stent or endoprosthesis);
- Chemotherapy;
- Radiotherapy.
What else should you pay attention to?
- Ask the doctor for good painkillers.
- It is important to keep nutritional status and body weight stable. Ask for advice from a dietitian.
- Drink enough.
- Eat small amounts more often throughout the day (not so quickly feel full).
- Discuss fears about the disease or other matters, don’t worry.
- Physiotherapy: Relaxation exercises can reduce pain and tension.
Prognosis
With pancreatic cancer, it is very important that the disease is detected at an early stage. The type of pancreatic cancer and the stage of the disease determine the chance of surviving the disease.
