Cancer is a devastating disease not only for the misery it induces, but also when it is lethal and the silent. Pancreatic cancer is one such aggressive form of cancer which develops from the cells of a digestive organ called the pancreas. It has claimed the lives of dynamic personalities like the Late Goa Chief minister and Defence minister Sri Manohar Parrikar and Apple CEO Steve Jobs. The following should shed light on this elusive disease.

What is the Pancreas?
The Pancreas is an elongated digestive organ lying behind the Stomach in the upper abdomen. It secretes digestive juices and also secretes insulin which controls blood sugar.

What is pancreatic cancer? The human body is made of trillions of cells. Each day billions of cells need to be replaced. The process in which a cell divides and replaces another cell is tightly regulated. Occasionally mistakes occur in this process, affecting our genetic code and these are called mutations. This leads to uncontrolled or unregulated cell division and this causes cancer. Cancerous cells lead to tumors which grow rapidly and spread to other organs.

Among cancers affecting the abdominal organs, Pancreatic cancer is particularly lethal. The overall 5 year survival for all stages of the disease after diagnosis is only 6%. The majority of cancers of the pancreas arise from the cells lining the ducts delivering digestive juices and are called Adenocarcinomas.
In spite of all the recent advances in the treatment of other cancers, the survival after diagnosis of Pancreatic cancer has not significantly improved over the past few decades.

What are the Symptoms of Pancreatic cancer ?
The symptoms are non specific and include upper abdominal or back pain, loss of appetite, loss of weight, digestive problems and Jaundice or yellowish discoloration of the eyes. Since the symptoms are non specific there is often a delay before diagnosis is made.

What are the tests required to diagnose Pancreatic cancer ?
The diagnosis of Pancreatic cancer is difficult as it lies deep in the upper abdomen. The tests during staging usually include Blood tests, Ultrasound and frequently require a CT scan of the abdomen. Other tests like tumour markers, MRI and endoscopic ultrasound may be required for further evaluation.

What are the treatment options for Pancreatic cancer ?
Surgery is the only treatment option which can provide a chance for cure. It can only be performed as long as the cancer is confined to the pancreas without spread to the other organs. The surgical procedure which is usually required is called a Whipple’s procedure and is a complex surgery due to the large number of critical structures near the pancreas. Unfortunately after testing only one in five patients are able to undergo surgery. The rest have tumors which have grown too large locally or have spread to other organs.

Other treatment options include Chemotherapy and Radiotherapy. Occasionally it is given before surgery to improve the chances of tumor removal if it is in a borderline stage.

In cases where the tumor has metastasised or spread to other organs then Palliative therapy will be given which includes pain killers and use of endoscopic stents to reduce the jaundice.

What are the risk factors for pancreatic cancer?

Certain risk factors are associated with a higher chance of developing pancreatic cancer. These include smoking, alcohol abuse, obesity, age greater than 40 to 50 years, Diabetes, Chronic Pancreatitis, certain drugs, family history and a fatty diet.
Some of the preventive measures are by stop smoking, a healthy diet, weight reduction and moderation of alcohol intake can reduce the modifiable risk factors of pancreatic cancer.

When should you meet your doctor?
The presence of alarm symptoms such as age more than 40 years with loss of weight and appetite, unexplained upper abdominal or back pain with or without jaundice should prompt you to meet your doctor on priority and get a thorough check up.