Diagnosis and treatment of pancreatic cancer is difficult, but it can be intervened with various treatment methods. Early diagnosis is very important in the treatment of the rapidly progressive disease. Successful results can be obtained with Whipple surgery when the disease, which is mostly seen after the age of 60, is diagnosed at an early stage. So what is the pancreas? The organ, which is one of the most important organs of the body, is in the back of the abdomen. In terms of its location, it is close to the large intestine and duodenum. It ensures the digestion of the foods consumed during the day and the normal levels of the glucose taken from the foods. Therefore, a minor damage to this organ can cause serious health problems.
This organ, located in the abdominal cavity and measuring 15 cm in length, is a bifunctional gland. This organ is surrounded by the liver, stomach, spleen and small intestine. The organ, which has endocrine and exocrine functions, performs these tasks with 2 separate cell groups. The exocrine part secretes the enzyme that facilitates digestion and transmits it to the small intestine. Thus, protein, fat and carbohydrates in food are stored as energy. Endocrine, on the other hand, secretes insulin and glucagon hormones, keeping the glucose in the blood at a certain level.
“What is pancreatic cancer?” It is one of the most frequently asked questions. This type of cancer is the uncontrolled proliferation of cells in the pancreas. This type of cancer mostly occurs in the region of the exocrine cells surrounding the channels of the organ. Malignant masses, which tend to proliferate in any part of the organ, develop in all parts of the organ, but most often spread to the head region. Therefore, a doctor should be consulted at the presentation of first symptoms.
This type of cancer develops as a result of mutational changes in the DNA of the organ. With these mutations, cells grow uncontrollably, normal cells die, and mass formation occurs. Although the causes of this cancer have not been clearly determined, there are some risk factors. Age is the most important of these factors. Because the disease usually affects people between the ages of 50 and 70.
Another important risk factor is genetics. Cancer is inherited in one out of every 10 cases of this condition. So some genes can cause pancreatitis. This increases a person's risk of developing cancer. If there are 2 or more close first-degree relatives with this cancer in their family, if there is a hereditary disease such as Peutz-Jeghers syndrome or Lynch, these people should be checked more frequently as the risk of pancreatic cancer will increase.
Other risk factors are as follows:
- Smoking habit
- Obesity
- Family history of cancer
- Diabetes (diabetes)
- Chronic pancreatic inflammation
Resectable: It is suitable for surgical intervention. If the tumor can be removed, the only solution to cure the cancer is surgery. However, even if the tumor is surgically removed, the situation may recur. Recurrence of the condition can be delayed by administering chemotherapy treatment with 5-FU or gemcitabine (gemzar) after surgery.
Regionally advanced: If the condition progresses locally, the tumor has spread to tissues and blood vessels, but not to other organs. These tumors are not suitable for surgical intervention, but rather clogged bile ducts are opened or the small intestine blocked by cancer is intervened by bypass.
Metastatic (wide spread): If it has spread to a large area such as the abdomen, bones, brain and lungs, surgical intervention or radiotherapy alone will not be sufficient. One of the appropriate treatment methods for cancer that has spread is chemotherapy. With this treatment, it is aimed to extend the life expectancy of the patient by shrinking the cancer cells.
Recurrent (recurrent) pancreatic cancer: Cancer that recurs in or near the same area after surgery is called recurrent. If the cancer is to recur to a distant point, it will first occur in the liver. In case of recurrence, it is aimed to extend the life expectancy of the patient by shrinking the cancer cells with chemotherapy.
“What causes pancreatic cancer?” It is one of the most frequently asked questions. However, the causes of pancreatic cancer are not fully known, but there are certain pancreatic cancer risk factors. The main risk factors are as follows:
- Age
- Genetics
- Smoking
- Wrong eating habits (Protein weight nutrition and low consumption of fruits and vegetables)
- Obesity
- Exposure to chemicals and petroleum substances
- Diabetes
Pancreatic cancer symptoms may not be seen in the first stage. However, when the condition started to show symptoms, it may have already spread. Therefore, it is extremely important to detect the condition at an early stage. Symptoms include weight loss, loss of appetite, gastric outlet obstruction, pain, nausea, and slowly developing jaundice. In cancer that is located in the head of the organ, stool is light in color and jaundice is seen in the mouth. Pain in the back is also a sign of regional spread of the disease. Rare symptoms include depression, diarrhea, and diabetes. In addition, increased abdominal pain after meals, bloating, gas pains, loss of appetite, vomiting, general weakness, bloody or dark urine, varicose veins, enlargement of the gallbladder and liver, itching are among the serious symptoms. If these symptoms are observed, a doctor should be consulted without delay.
Diagnosing pancreatic cancer at an early stage may not be easy. Because pancreatic cancer does not give any signs and symptoms necessary for its diagnosis at an early stage. In addition, the fact that the symptoms are the same as the symptoms of many other diseases is also effective in not being able to diagnose the disease early. Diagnosis is usually made by detailed imaging of the organ and its surroundings with various tests. Tests that measure the extent to which cancerous cells have spread inside and outside the organ are called staging. In addition, tests can be applied at the same time during the diagnosis phase. These tests are as follows:
- Taking the person's health history and physical examination
- Blood test
- Tumor markers
- Magnetic resonance imaging
- Computed tomography
- Positron emission tomography
- Abdominal ultrasound
- Endoscopic ultrasound
- Endoscopic retrograde cholangiopancreaticography
- Subcutaneous transhepatic cholangiography
- Laparoscopy
- Biopsy
“How long does pancreatic cancer patients live in the 4 stages and what are these stages?” It is one of the topics of interest. Cancer-causing cells spread into the body through the blood, tissue and lymphatic system. However, these cells can break away from the tumor and pass to other parts of the body through lymph channels and blood vessels and cause different tumors to form. Tumors that have spread or are in the secondary group exhibit the same characteristics as the main tumors. These stages are often difficult to distinguish with imaging tests. For this reason, it should be well decided whether the entire cancerous tumor will be removed before the surgical procedure is decided.
The stages of pancreatic cancer are as follows:
0: It is the stage where there is no spread, and at this stage the cancer is limited to only one layer of cells. In addition, cancer can be easily seen on imaging tests.
Stage I: Cancer seen in this stage shows local growth.
Stage II: The cancer grows outside the pancreas or approaches the lymph nodes.
Stage III: Cancer seen in this stage shows a wide spread. The tumor has spread to nearby major vessels or nerves.
Stage IV: At this stage, the cancer has spread to distant organs.
Pancreatic cancer treatment is carried out with surgical procedures, radiotherapy and chemotherapy methods. Therefore, the intervention and control of different specialists may be required in the treatment planning and process. The treatment is applied together with all the specialist doctors in radiation oncology, gastroenterology, surgical procedure, medical oncology and other fields in a multidisciplinary manner.
“What is Whipple surgery?” The answer to the question is one of the topics that researchers wonder about the disease and its treatment. Whipple surgery; It is a life-saving surgical procedure in the treatment of tumors of the duodenum, pancreatic head and biliary tract. This surgery is ideal for completely cleaning the area of tumors formed in 3 organs that are close and connected to each other.
In this surgical method, the pyloric Whipple procedure is applied to protect the gastric valve. Thus, there are no complaints about the digestive system after the surgery. The most important aspect of this process is the correct and re-establishment of the coordination of these organs with each other. For this reason, the Whipple surgery method should be applied by a doctor who is an expert in the field.
Radiotherapy: The most preferred type of radiotherapy is rxternal-beam radiotherapy. Due to the effect it will show, it is usually applied simultaneously with radiation therapy and chemotherapy. With this simultaneous operation, tumors shrink and disappear.
Chemotherapy: Drug treatment is applied to stop the growth and division of cancer cells.
Targeted therapy: This form of therapy targets proteins, particularly certain genes, or the tissue environment that contributes to the development and survival of cancer.
Although the life expectancy of pancreatic cancer differs from person to person, successful results can be achieved with the right treatment method and post-treatment process. Especially with early diagnosis, the success rate of treatment can increase.
In addition, anticancer drugs and radiation therapy given in the treatment can increase the rate of recovery. However, this rate is low after surgeries with cancer cells left behind or in cases where it has spread to neighboring organs. In order to increase this rate, prevention methods can be applied after treatment. To be protected, smoking should be stopped and attention should be paid to a balanced diet. In addition, since the symptoms of pancreatic cancer can present with back pain, regular exercise should be done and excess weight should be lost in the post-treatment period.
