Pancreatic cancer (pancreatic cancer)

Pancreatic cancer or Pancreatic cancer is a rarely occurring cancer. Unfortunately, it is currently still considered to be very difficult to cure. In most cases, pancreatic cancer cannot be cured because the disease is often diagnosed and treated too late.The earlier the disease is recognized, the higher the chances of survival. Pancreatic cancer can be prevented by abstaining from smoking and alcohol consumption, as well as eating a healthy diet and plenty of exercise and sport.

What is pancreatic cancer?

Pancreatic cancer or pancreatic cancer is relatively rare with a statistical probability of 3% of all cancers. The corresponding tumor is usually found in the so-called exocrine part of the pancreas on the back wall of the abdomen below the diaphragm.

In most cases, the duct cells at the gland outlets are malignantly changed (exocrine tumor). In rarer cases, pancreatic cancer begins in the hormone cells of the islets of Langerhans in the glandular lobules (endocrine tumor).

Due to the deceptive freedom from pain in this disease, pancreatic cancer is considered very insidious, and when the risk is recognized, the patient and his doctor often run out of time during treatment due to the formation of metastases.

Therefore, the chances of survival in the case of pancreatic cancer diagnosed late are unfortunately not that high so far.

causes

The basic causes for the development of pancreatic cancer are still unknown. However, there are a number of factors that have a positive effect on the negative development of pancreatic cancer. Smokers are three and a half times more likely to develop pancreatic cancer. High alcohol consumption also promotes the development of the disease. In particular, the connection between excessive tobacco and alcohol consumption has a dangerous effect.

Previous illnesses such as stomach ulcers or chronic pancreatitis, but also changes in the genetic material, can lead to pancreatic cancer. In addition, environmental pollution is currently suspected of promoting pancreatic cancer.

These include poisons such as herbicides (pesticides), pesticides (insecticides) and fungicides (fungus killers), but also electromagnetic fields, exhaust gases, chromium and chlorine. But mind you, these factors are not causally responsible for pancreatic cancer or are scientifically proven.

Symptoms, ailments & signs

In the first phase of pancreatic cancer, there are no or only very weak symptoms. However, these can also occur with other diseases, so that those affected do not perceive the danger in time and consult a doctor. Only when the cancer is more advanced and no treatment has taken place, severe symptoms can occur.

Above all, these include: fatty stools, upper abdominal pain and feeling of pressure, weight loss and loss of appetite, as well as vomiting and nausea. However, these symptoms also occur in a similar form in pancreatitis and can therefore be easily confused.

The first symptoms appear in the advanced stage, in which a cure is usually no longer possible. Then, as with pancreatitis, pain in the left upper abdomen occurs. They radiate into the back and can wrap around the body like a belt. It is increasing dull and excruciating pain that is especially worse at night.

Unclear indigestion and a feeling of pressure can also occur. These often manifest themselves in the form of a feeling of fullness, gas and stool irregularities. If fewer digestive juices are produced, so-called fatty stools and diarrhea can occur because the fat digestion no longer functions properly. The chair turns clay-colored.

Furthermore, loss of appetite, nausea and possibly depression occur. There follows a severe weight loss, which can be more than ten percent of the body weight. Diabetes can also occur suddenly. If the tumor is in the head of the pancreas, jaundice will increase because the bile duct narrows.

When the tumor expands into the abdomen, leg vein thrombosis and changes in skin pigmentation occur. In the later stages, metastases spread in the liver. They lead to liver enlargement, liver dysfunction, ascites and extreme weight loss. After the first symptoms of pancreatic cancer, death occurs within a few months.

course

Typical for the development of pancreatic cancer is the dangerous and completely painless freedom from symptoms. As an exocrine tumor, pancreatic cancer spreads unnoticed after the tumor has grown, initially to the surrounding body regions via the bloodstream and the lymphatic system.

In most cases, the liver is affected, but the lungs and even the skeleton are also at risk. This almost inevitably leads to a rather unfavorable prognosis. In the case of an endocrine tumor, the growth of the nodule initially displaces the surrounding tissue, while the formation of metastases progresses rather slowly and thus a more successful treatment can be hoped for even if pancreatic cancer is diagnosed late. However, the majority of pancreatic cancer that is not recognized in time is fatal in the short or long term.

Complications

Cancer of the pancreas (pancreatic cancer) is fraught with numerous complications. For example, due to the anatomical proximity, there is a disruption of the bile outflow. As a result, the bile backs up to the gall bladder (cholestasis) and can lead to inflammation of the gall bladder (cholecystitis) or an abscess in the liver.

In the worst case, the inflammation can spread over the entire body and lead to dangerous sepsis, which, if left untreated, can quickly lead to death. Pancreatic carcinoma can also lead to a blockage of the intestine (ileus), which leads to constipation and metabolic disorders. In addition, the intestinal section can become inflamed and die off as the blood supply is also throttled.

In rare cases, the cancer leads to metabolic disorders, as insufficient enzymes and hormones are no longer produced. For example, diabetes can develop over time. Too many hormones can also be produced, such as in an insulinoma, which leads to hypoglycaemia.

The opposite is the glucagonoma, which leads to an excess of sugar. A gastrinoma increases the risk of developing a stomach ulcer. Overall, however, pancreatic carcinoma has a very poor prognosis and can only be treated completely if it is detected early. The 5-year survival rate at diagnosis is less than one percent.

When should you go to the doctor?

The pancreas is located in the back of the abdomen. Symptoms therefore appear very late and when the diagnosis is made, the tumors have often outgrown the organ borders. Early symptoms are usually unspecific and diffuse. Malaise, flatulence, fatty stools and pain in the upper abdomen often indicate diseases of the pancreas. If you then add weight loss and back pain in the waist area, this should be viewed as a warning sign.

Jaundice can also be an indicator of pancreatic cancer. The bile duct and pancreatic duct flow together into the duodenum. If the tumor is at this point, it closes the bile duct and the bile secretion builds up and turns yellow. A new onset of diabetes can also be a warning sign. In rare cases, an acute pancreatitis occurs beforehand. If alcohol addiction or gallstones are excluded, a tumor can be the cause.

In all cases - with the exception of pancreatitis, which is part of clinical treatment - the family doctor is the first point of contact. A blood count with the pancreas lipase and amylase values ​​as well as the liver values ​​can provide an initial clue. Also an ultrasound examination, which is difficult due to the location of the pancreas. Intestinal gases often overlap this area. If the findings are unclear, we recommend a computer or magnetic resonance tomography as soon as possible for an exact clarification.

Doctors & therapists in your area

Treatment & Therapy

Treatment for pancreatic cancer depends on the type of disease, the stage it has already reached, and the patient's age and general health. An operation in the course of which the tumor and the surrounding lymph nodes are removed is, however, an unavoidable measure. The success of such an operation, however, presupposes that the progress of the disease is still limited to the pancreas.

The following long-term treatment for pancreatic cancer may vary depending on the stage of the disease. You can choose between chemotherapy or radiation therapy, as well as a combination of both.

In addition to radiation therapy, Erlotinib is also used to treat pancreatic cancer. This is a metastasis blocker, but it is usually only suitable for patients in whom the disease has progressed so far that an operation appears hopeless from the outset. In terms of treatment, pancreatic cancer is a lengthy affair that can often only be completely cured if detected early.

Outlook & forecast

Pancreatic cancer has a very high mortality rate. Initially, the tumor only affects the pancreas itself. However, in later stages it quickly spreads to surrounding tissue and organs. These include the spleen, duodenum, stomach, liver or large intestine. In addition, the malignant tumor also forms distant metastases via distribution through the lymph nodes in the lungs or the bones.

Due to the massive space requirement, liver function is impaired in many cases due to congestion of the bile duct. An additional inflammation of the pancreas can result from a blockage of the drainage of the glands. In some cases, the release of hormones is considered to be greatly reduced, and as a result, an insulin deficiency develops with diabetes.

The chances of survival depend on when the cancer was diagnosed. Rapidly spreading adenocarcinoma has an unfavorable prognosis due to the aggressive nature of the tumor cells. The mortality rate for the rare cystadenocarcinoma is significantly lower. This does not spread over a long period of time and grows relatively slowly. A pure infestation of the endocrine segment even allows the successful removal of the entire tumor in later stages.

If surgical intervention is not possible, the average life expectancy is a maximum of five months after the diagnosis has been made. After five years, only 0.2% to 0.4% of those affected are still alive. In general, pancreatic carcinoma is therefore one of the most dangerous tumor diseases of the gastrointestinal tract.

You can do that yourself

Patients with pancreatic cancer can optimize their diet to improve their health. There are already various research approaches according to which the regular consumption of vegetables from the cruciferous family can be supportive of the initiated cancer therapy.

Consuming broccoli, cauliflower, or Brussels sprouts can therefore help and strengthen the patient. The overall diet should be balanced and healthy. The intake of vitamins and trace elements is particularly important in order to support the own immune system and to achieve an improvement in wellbeing.

Despite existing complaints and discomfort, the patient should ensure that there is sufficient exercise. Daily stays in the fresh air support the supply of oxygen, relieve the cardiovascular system and strengthen the organism. Consumption of harmful substances such as nicotine or alcohol should be avoided as a matter of principle. On the other hand, techniques that contribute to mental strengthening are helpful. Daily exercises and training sessions that lead to internal stabilization and the building of new confidence are highly recommended.

In addition to autogenic training, meditation or yoga, cognitive behavioral therapies can promote optimism or a positive attitude towards life. An exchange between the affected person in self-help groups or forums can give new impulses. In addition, sick and recovered patients can give each other assistance in dealing with the disease in everyday life.