A diagnosis of pancreatic cancer can indeed be overwhelming and stressful, and often requires you to undergo multiple life changes. The disease can lead to difficult physical, as well as emotional symptoms and require various decisions to make regarding management and care.
Trying to educate yourself about the disease, how it progresses, the available options of treatment, and the long-term impact makes a difference. This article aims to explore pancreatic cancer and its related aspects in detail, including different coping mechanisms to practice in daily life.
Pancreatic Cancer – A Quick Overview
The pancreas refers to a small organ present near the top part of the small intestine, just behind the stomach. With a length and width of six inches and two inches, respectively, it consists of three parts: the head, body, and tail. The pancreas is chiefly responsible for the following two functions:
- Synthesis of digestive juices that assist the intestines in the breakdown of food
- Production of hormones, such as insulin, that regulate the blood sugar levels
Pancreatic cancer happens when the cells comprising the pancreas undergo changes or mutations in their DNA. The DNA content in each cell includes codes that instruct it about growth and functionality. When it undergoes a mutation, the DNA signals the cell to grow uncontrollably and continue living beyond its death date. As a result, the cells can start accumulating rapidly, giving rise to cancer or a tumor.
Pancreatic cancer is broadly classified into two types:
- Adenocarcinoma (Exocrine cancer) which begins in the cells lining the ducts of the pancreas.
- Neuroendocrine cancer which affects the cells responsible for hormone production.
How to Detect Pancreatic Cancer
Pancreatic cancer is often referred to as the silent disease as it does not produce any identifiable symptoms in the early stages. The symptoms, if any, are too mild to raise the suspicion of cancer. As a result, patients are usually unaware of the grave nature and seriousness. Additionally, because the pancreas is present deep in the abdomen, a tumor growing inside it may continue to persist for years without causing any pain or pressure.
Some common pancreatic cancer symptoms that may surface at later stages of the disease include:
- Abdominal pain radiating to the back
- Yellow-colored stools
- Jaundice (yellowing of skin and whites of eyes)
- Unintentional weight loss
- Loss of appetite
- Dark-colored urine
- Blood clots
- Itchy skin
- Increased fatigue
- Newly-diagnosed diabetes or poor control of diabetes
Who is at Risk?
The exact causes of pancreatic cancer are not fully understood yet. However, experts relate its incidence to certain inherited, personal, health, and environmental factors that increase the risk of a person developing this disease. These risk factors are briefly discussed below:
Ethnicity: Pancreatic cancer tends to affect African Americans and Ashkenazi Jews more than other ethnicities
Old Age: Pancreatic cancer usually hits people after 50 and is commonly diagnosed after the age of 65
Hereditary Risk: Up to 15 percent of the cases of pancreatic cancer are related to a positive family history
Previous Health Conditions: Chronic inflammation of the pancreas (chronic pancreatitis) and diabetes significantly add to the risk of pancreatic cancer
Diagnosing Pancreatic Cancer
Pancreatic cancer is a life-changing diagnosis and to confirm it, multiple diagnostic steps are used by physicians. These include:
The first step of forming a diagnosis of pancreatic cancer involves a detailed history-taking session with your doctor. A doctor may enquire about your past medical history and ask questions focused on your symptoms, such as:
- Any unintentional weight loss
- The color of your stool and urine
- Your daily energy levels
- Any pain (along with its severity, duration, and location)
The next step is performing a physical exam of your abdomen and the rest of the body during which the doctor may:
- Check the color of your eyes and skin to detect jaundice
- Check for any fluid accumulation or any masses in areas surrounding your pancreas
- Check for any lumps in different locations of the body, particularly above the collarbones
At present, there is no lab test specific to diagnosing early cases of pancreatic cancer. However, the doctor may order the following blood tests in order to support the diagnosis and determine suitable treatment:
- Liver Function Tests
- Ca 19-9
- Carcinoembryonic Antigen (CEA)
These tests are ordered to look at the pancreas and its surrounding structures more closely. They can also help diagnose tumors and monitor their growth with time. Some of the most commonly performed imaging tests include:
CT Scan: It uses x-rays of high resolution to provide a 3D model of the pancreas.
MRCP: It is an MRI that focuses on the pancreas as well as the bile ducts.
PET Scan: A test specifically designed to identify cancers in the body.
A biopsy is the most definitive test to confirm pancreatic cancer. It is an invasive procedure that involves taking out a piece of the tumor and examining it under a microscope.
Management of Pancreatic Cancer
The treatment for pancreatic cancer depends on a variety of factors, such as the extent of the cancer, your current health status, and your preferences. In most cases, the treatment plan aims to focus on eliminating cancer from the roots. If it’s not achievable, for example in very advanced stages of cancer, the aim of treatment is to limit further harm while improving the quality of life.
A doctor may advise one or more of the following treatments as a part of the pancreatic cancer management plan.
The following types of surgical procedures are usually carried out to treat cancer of the pancreas:
Whipple Procedure: A process performed if cancer is located in the head of the pancreas.
Distal Pancreatectomy: A surgical procedure to remove cancer from the left side of the pancreas (including the body and tail). In some cases, the spleen may also be removed.
Total Pancreatectomy: A process that involves the removal of the entire pancreas. You can live comfortably without a pancreas but need enzyme replacement therapies and lifelong injectable insulin to compensate for its effects.
Extended Surgery: In advanced stages of pancreatic cancer, the tumor might invade the nearby vessels. In such circumstances, a surgeon may need to remove and reconstruct the affected blood vessels in addition to pancreatic removal.
Chemotherapy involves the use of potent chemicals to kill tumor cells. These drugs might be taken orally or as an injection. The sessions may continue for months or even years depending on how well your body responds to them.
It includes high-energy beams, such as those made with protons, to target and destroy cancer cells. These sessions are often combined with chemotherapy for increased efficiency and are usually suggested in cases where surgical removal isn’t possible.
Palliative care involves providing an extra layer of support with the help of a team of specialists, as well as your family. The aim is to target any discomfort or symptom and manage it so that your quality of life is drastically improved. As a part of palliative care, you might be offered one or more of the following:
Stent placement: This is to remove any blockage of pancreatic juices due to pressure from the tumor.
Surgical bypass: In case the pancreatic cancer is blocking the flow of bile coming from the gallbladder, a surgical bypass is made to ensure smooth supply to the intestines for optimal digestion.
Pain management: This involves controlling pain associated with pancreatic cancer. Sometimes with high-potency painkillers, such as morphine.
Coping with Pancreatic Cancer
Apart from medical management, patients with pancreatic cancer often require additional support in order to cope with the disease in a better way. In this context, the following tips can be followed:
Get support from family and friends
There’s nothing worse than living alone with pancreatic cancer. So always make sure that you have enough support from family and friends. They can help you in different ways, for example helping you with daily chores, taking you to your medical appointments, or simply talking to you when you need someone to vent your emotions.
Find people with similar problems
Who can understand you better than someone suffering from pancreatic cancer themselves? Find support groups, both online and in-person, where you can connect with people having similar issues. Talking to someone who understands your struggles so aptly makes a huge difference in terms of mental health.
Live a healthy life
Getting a diagnosis of pancreatic cancer does not mean you should give up on living a healthy life. In fact, getting some exercise and eating a nutritious meal is what you need, now more than ever. Just make sure not to push yourself beyond your limits.
Maintain a positive mindset
It can be extremely difficult to think positively while you are living with cancer. However, hoping for the best and being optimistic can push you to keep battling the disease, take care of yourself in a better way, and even inspire your fellows fighting a similar way to do the same.
Get spiritual help
Practicing spirituality has been strongly linked to improved healing and overall well-being. Consider taking time to meditate and start appreciating the simplest wonders of nature to discover your spiritual side. You may wish to connect with a faith leader if you follow a religion.
If you are experiencing symptoms similar to those of pancreatic cancer, get in touch with your healthcare professional right away. While the symptoms may not be specifically related to cancer, it is still worth being cautious as pancreatic cancer responds best to treatment if caught and treated in earlier stages.
Living with pancreatic cancer is extremely difficult and full of physical and emotional challenges. While there are several ways to medically manage your health and symptoms, getting emotional and spiritual support from your family, friends, and others with a similar diagnosis is equally important.