Pancreatic cancer is a malignant neoplasm originating from transformed cells arising in tissues forming the pancreas. The most common type of pancreatic cancer, accounting for 95% of these tumors, is adenocarcinoma (tumors exhibiting glandular architecture on light microscopy) arising within the exocrine component of the pancreas. A minority arise from islet cells, and are classified as neuroendocrine tumors.
The signs and symptoms that eventually lead to the diagnosis depend on the location, the size, and the tissue type of the tumor, and may include abdominal pain, lower back pain, and jaundice (if the tumor compresses the bile duct), unexplained weight loss, and digestive problems. Pancreatic cancer is the fourth most common cause of cancer-related deaths in the United States[1] and the eighth worldwide.
[2] Pancreatic cancer has an extremely poor prognosis: for all stages combined, the 1- and 5-year relative survival rates are 25% and 6%, respectively;[3] for local disease the 5-year survival is approximately 15% [3][4] while the median survival for locally advanced and for metastatic disease, which collectively represent over 80% of individuals,[4] is about 10 and 6 months respectively. [5] Individuals vary, however – some are only diagnosed when they are already terminally ill and therefore only have a few days or weeks.
Others have slower progression and may live a couple of years even if surgery is not possible. Men are 30% more likely to get pancreatic cancer than are women. Early pancreatic cancer often does not cause symptoms,[6] and the later symptoms are usually nonspecific and varied. [6] Therefore, pancreatic cancer is often not diagnosed until it is advanced. [6] Common symptoms include: Pain in the upper abdomen that typically radiates to the back[6] (seen in carcinoma of the body or tail of the pancreas) Heartburn – acid stomach
Poor appetite or nausea and vomiting[6] Diarrhea, loose stools. Significant weight loss (cachexia) Painless jaundice (yellow tint to whites of eyes (sclera) or yellowish skin, possibly in combination with darkened urine)[6] when a cancer of the head of the pancreas (75% of cases)[7] obstructs the common bile duct as it runs through the pancreas. This may also cause pale-colored stool and steatorrhea. The jaundice may be associated with itching as the salt from excess bile can cause skin irritation.
Trousseau syndrome, in which blood clots form spontaneously in the portal blood vessels, the deep veins of the extremities, or the superficial veins anywhere on the body, may be associated with pancreatic cancer. Pulmonary embolisms due to pancreatic cancers producing blood clotting chemicals. Diabetes mellitus, or elevated blood sugar levels. Many patients with pancreatic cancer develop diabetes months to even years before they are diagnosed with pancreatic cancer, suggesting new onset diabetes in an elderly individual may be an early warning sign of pancreatic cancer.
[8] Clinical depression has been reported in association with pancreatic cancer, sometimes presenting before the cancer is diagnosed. However, the mechanism for this association is not known. [9] Symptoms of pancreatic cancer metastasis. Typically, pancreatic cancer first metastasizes to regional lymph nodes, and later to the liver or to the peritoneal cavity and, rarely, to the lungs;[10] it rarely metastasizes to bone or brain. [11] Risk factors for pancreatic cancer may include:[6][12] Family history: 5–10% of pancreatic cancer patients have a family history of pancreatic cancer.
The genes have not been identified. Pancreatic cancer has been associated with the following syndromes: autosomal recessive ataxia-telangiectasia and autosomal dominantly inherited mutations in the BRCA2 gene and PALB2 gene, Peutz-Jeghers syndrome due to mutations in the STK11 tumor suppressor gene, hereditary non-polyposis colon cancer (Lynch syndrome), familial adenomatous polyposis, and the familial atypical multiple mole melanoma-pancreatic cancer syndrome (FAMMM-PC) due to mutations in the CDKN2A tumor suppressor gene. [13][14] There may also be a history of familial pancreatitis. [13] Age.
The risk of developing pancreatic cancer increases with age. Most cases occur after age 60, while cases before age 40 are uncommon. Smoking. Cigarette smoking has a risk ratio of 1. 74 with regard to pancreatic cancer; a decade of nonsmoking after heavy smoking is associated with a risk ratio of 1. 2. [15] Diets low in vegetables and fruits. [16] Diets high in red meat. Processed meat consumption is positively associated with pancreatic cancer risk, and red meat consumption was associated with an increased risk of pancreatic cancer in men. [17] Diets high in sugar-sweetened drinks (soft drinks).
[18] In particular, limited epidemiological studies link the common soft drink sweetener fructose with growth of pancreatic cancer cells. [19] Obesity[20] Diabetes mellitus is both risk factor for pancreatic cancer, and, as noted earlier, new onset diabetes can be an early sign of the disease. Chronic pancreatitis has been linked, but is not known to be causal. The risk of pancreatic cancer in individuals with familial pancreatitis is particularly high. Helicobacter pylori infection[21][22] Gingivitis or periodontal disease[23] Partial gastrectomy[24][25].