Pancreatic Cancer

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Exocrine Pancreatic Cancer Symptoms & Diagnosis

Symptoms

Pancreatic cancer is hard to diagnose due to the lack of early warning signs. The disease has often advanced and spread to other parts of the body by the time it is found.

One of the most pronounced symptoms is pain in the upper abdomen and back. At times the cancer may also cause the gallbladder to swell. Because 80 percent of pancreatic cancers occur in the head of the pancreas, where they can block the bile duct, jaundice (a yellowing of the skin, or whites of the eyes, and darkening of the urine) is often another sign. Weight loss often occurs when the cancer interferes with the food-processing functions of the pancreas, especially the digestion of fatty foods. This interference can cause stool to be pale and greasy. It can also cause vomiting and nausea after eating.  

Diagnosis

No screening tests are available for cancers of the pancreas. CA 19-9, a molecule that is released into the blood cells by some pancreatic tumor cells, can be useful in tracking the progression of the disease, but it is only 80 percent accurate in diagnosing pancreatic cancer. 

Traditionally, patients with pancreatic cancer need exploratory surgery to determine whether removal of the pancreas is necessary. Often times this surgery needs six to eight weeks of recovery time, so doctors often opt for less invasive means. If pancreatic cancer is suspected, certain imaging tests (pictures of the inside of the body) can be taken in order to make a diagnosis.

The following is a list of imaging tests used to find pancreatic cancer:

  • Computed Tomography Scan (CT Scan). Shows cross-sectional pictures of the body. This test can help a doctor see if there is an abnormal growth on the pancreas.

  • Laparoscopy. A specialized telescope with an attached camera is sent into the abdomen to view the pancreas and surrounding organs. This procedure can allow a doctor to directly view a tumor and help determine the next step. 
  • Magnetic Resonance Imaging (MRI). For patients whose major blood vessels are compressed, or invaded by cancer, this special type of MRI allows the physician to get a picture of the pancreas ducts. 
  • Endoscopic Retrograde Cholangiopancreatography (ERCP). A flexible tube is sent down the throat, through the stomach, and into the small intestine. ERCP can also be used to look at the pancreas; the doctor can inject dye into the tube, allowing the area to be seen more clearly on an X-ray. During an ERCP, the doctor may also put a fine needle or brush into the pancreas in order to take out cells for a biopsy. A stent inserted through the tube can also be used to alleviate jaundice.

Risk Factors

Very little is known about the exact cause of pancreatic cancer. Many studies have drawn links between the disease and various types of behaviors and genetic groups. There are many studies currently underway that are investigating what causes the DNA of a cell to suddenly tell it to become cancerous.

The following is a list of some of the behaviors and genetic groups that are prone to pancreatic cancer more than others:

  • Smoking – Adenocarcinomas, the most common form of pancreatic cancer, is two to three times more common in heavy smokers than in nonsmokers.
  • Age – While pancreactic cancer is sometimes found in young people, the majority of cases are found in people over 60. 
  • Gender – Men are more often diagnosed than women. 
  • Ethnicity – African Americans, Ashkenazi Jews (Jews of European descent), and Native Hawaiians have been found to have the highest rates of pancreatic cancer. Asians and Hispanics have been found to have the least. 
  • Diet – A diet high in meats and fats has been linked to an increased risk of pancreatic cancers. 
  • Diabetes mellitus – Pancreatic cancer has been found to be more common in people with diabetes. 
  • Environment – Studies have shown that people with prolonged exposure to pesticides, dyes, petrochemicals, and other carcinogens are more likely to contract pancreatic cancers. 
  • Family history – People who have immediate family (mother, father, or siblings) that have been diagnosed with pancreatic cancer are three times more likely to also be diagnosed. A family history of colon or ovarian cancer also increases the risk of pancreatic cancer.