pancreas cancer

Definition

Pancreatic cancer affects, as the name suggests, the pancreas (read below to learn more about this organ). It is an increasingly common cancer, especially in high-income countries, and it is very difficult to treat. It is one of the deadliest cancers, with a 5-year survival rate of approximately 9% in 2020 in the United States. Note that there are important differences depending on the stage of development of the disease. For example, if the cancer is located in the pancreas, the 5-year survival rate is 37%, but it drops to 3% if the cancer has spread to distant parts of the body like the lungs, liver or bones.

The pancreas
– The pancreas is a digestive gland located deep in the abdomen about 15 cm long. We can divide the pancreas into 4 parts: head, isthmus, body and tail.
– At the physiological level, there are two types of tissues in the pancreas, according to their functions, that is, whether they have endocrine secretion or exocrine secretion. Endocrine secreting cells make up a small portion of the pancreas of about 2% (the so-called islets of Langerhans), and play an important role in regulating glucose by producing insulin.
– Most of the pancreas is composed of exocrine secretion cells, responsible for the formation of pancreatic juice. This particular juice contains lipids, proteins and sugars. Each day the pancreas produces 1.5 liters of digestive juices that help the digestion process.

Pancreatic cancer affects, in about 95%, the exocrine pancreatic secretion. The most common form of pancreatic cancer is adenocarcinoma. In most cases, the head of the pancreas is the part affected by the cancer.

Pancreatic cancer rarely causes symptoms before a very advanced stage. Therefore, most patients at the time of diagnosis have advanced-stage disease (eg, metastasis formation).

Why is this cancer so dangerous?
Scientists believe that pancreatic cancer cells grow extremely fast, unlike, for example, prostate tumor cells in men that grow very slowly. Pancreatic tumor cells also have the ability to separate early in the course of the disease and spread to other organs (eg the liver) and form metastases. Another aspect is that tumor cells in the pancreas form scar tissue , which seems to serve as a barrier to the entry of therapeutic agents. Other factors also make the treatment of this cancer particularly complex, this tumor seems to evade the immune system, as well as chemotherapy or radiotherapy treatments.

Are there medical centers or institutions specializing in this cancer?
Yes, we can mention in the United States in New York and region NYU Langone Health , which has a cancer research center called the Pancreatic Cancer Center .

Epidemiology

Worldwide, about 330,000 people are diagnosed with pancreatic cancer each year, according to a CBSNews article published in June 2018.
In the United States, about 55,000 people are diagnosed with pancreatic cancer each year, according to the CBSNews.

Forecast to 2030
In the United States, projections dating back to 2017 cited by NYU Langone Health estimate that pancreatic cancer will be the 2nd cancer that causes the most deaths per year by 2020. One of the reasons is that the cure rate of Very common cancers, such as breast or prostate cancer, always get higher, which is not the case with pancreatic cancer. Pancreatic cancer accounts for about 3% of all cancers in the United States and about 7% of all cancer deaths, according to the American Cancer Society .

Pancreatic Cancer Survival Index
– The American Cancer Society also spoke on their website, accessed September 13, 2020, of an average 5-year survival rate of 9%.
– In Great Britain, a survey released in 2015 indicated a 5-year survival rate of around 3%. This index would have practically not changed over the last 40 years.

Causes

According to a study by Johns Hopkins University in Baltimore, United States, which was based on a mathematical model, the causes of pancreatic cancer are 77% due to errors in DNA copying during cell division, 18% due to environmental factors such such as smoking and 5% heredity. Note that errors in cell division are purely random. That’s why American researchers define the cause of this type of cancer as “pure bad luck”. This study, which also analyzed other types of cancer such as pancreatic cancer, was published on March 24, 2017 in the American scientific journal Science .

The environmental risk factors that favor this type of cancer are, as we have already seen, smoking, but also obesity, pancreatitis and diabetes . A diet rich in animal fats (especially fried and grilled meat) and a significant consumption of alcohol can also be risk factors.

Pancreatitis increases the risk of suffering from pancreatic cancer by about 15 times, as reported by the German German Cancer Research Center  (Deutsches Krebsforschungszentrum, DKFZ) in Heidelberg, Germany, in a press release dated 2016.

Symptoms

The symptoms of pancreatic cancer often appear in advanced stages of the disease, which makes early diagnosis difficult, as they are often not very specific. In 2015, a British study found that in more than 80% of patients the cancer had already spread by the time of diagnosis.

The main symptoms of pancreatic cancer can be weight loss, fatigue, abdominal pain or loss of appetite. A dark urine color can also be a sign of pancreatic cancer, characteristic of jaundice. The skin and eyes may also turn yellow and the stool very pale.

In an advanced stage of this cancer, significant weight loss unexplained for reasons other than cancer is a significant symptom, such as diarrhea, indigestion, or blood clots. The onset of diabetes and jaundice are also signs of the disease.

In more than half of cases, metastases are formed in the liver and often quite quickly.

Pancreatic Cancer and Diabetes
Unexpectedly developing diabetes, for example in a normal-weight person, can be a precursor to pancreatic cancer, according to a team of Mayo Clinic researchers . Pancreatic cancer is one of the deadliest cancers, with a 5-year US survival rate of less than 10% in 2018. The earlier this cancer is detected, the better the chances of treatment. In fact, the disease usually goes unnoticed until the appearance of an advanced form of cancer with, for example, the formation of metastases. But, as researchers at the Mayo Clinicfound and reported in November 2018, for a small number of pancreatic cancer cases, a clue can help doctors find the tumor early, while it’s still curable. This clue is the unexpected diagnosis of diabetes. General practitioners and family physicians should think more about possible pancreatic cancer when diagnosing diabetes, especially the elderly, those of normal weight and those who smoke. In these rare cases, diabetes is directly caused by pancreatic cancer. It is known that insulin is produced in the pancreas.

Diagnosis

Diagnosis is largely based on imaging methods such as tomography, magnetic resonance imaging or ultrasound of the abdomen and gastrointestinal tract. Blood tests or biopsy may be performed. Identification of cancer is often difficult, as the organ is located in a deep region of the abdomen.

In early August 2015, a British team from the Barts Cancer Institute , Queen Mary University of London, published a study in the journal Clinical Cancer Research showing that a combination of three proteins in the urine seemed to be a good indicator of early stage pancreatic cancer. development stage, with an accuracy greater than 90%. Currently, there is no early detection test for this type of cancer. This discovery should allow low-cost, non-invasive screening tests to be placed on the market.

Treatments

Treatment of pancreatic cancer involves the use of drugs (chemotherapy), radiation therapy, or surgery. The different treatments can be combined. A specific diet also plays an important role.
An effective treatment for this cancer is surgery, but the tumor must be discovered very early, before it spreads to other organs, causing metastases. Surgery is believed to be the only method capable of curing this cancer.
The treatment of this type of cancer can often be painful for the patient, a good follow-up by caregivers and family members is therefore very important.
In the United States, most people with pancreatic cancer die within a year of diagnosis. According to experts, only 4% of patients survive five years after a cancer diagnosis.
Pancreatic cancer can only be cured if it is treated before it spreads to other organs (metastasizes), so the tumor can be completely removed by surgery.

Surgery and Pancreatic Cancer
Only about 20% of patients have a pancreatic tumor that can be removed by surgery, according to Dr. Diane M. Simeone of NYU Langone Health , who spoke in an interview on this topic in 2017. However, among this 20% the cancer reappears in approximately 75% of cases and the 5-year survival rate for these patients goes to just 25% (better than the 5-year survival rate for all patients with pancreatic cancer which is around 9% in 2017 in the United States). According to a CBSNews article published in June 2018, only 15% of patients have a pancreatic tumor that can be treated by surgery.

Radiotherapy and chemoradiation:
Radiation therapy is usually reserved for when the cancer has spread beyond the pancreas. Radiation therapy is only used to treat organs close to the pancreas, not too far away.
In some hospitals in the United States in particular, chemoradiation may be used before surgery to help shrink the tumor mass. Chemoradiation is sometimes used after surgery to reduce the risk of prostate cancer recurrence1.

Tips & Prevention

– The best way to prevent cancer is to stop smoking. Smoking is the main preventable risk factor. A healthy and balanced diet, regular exercise and weight control are other useful measures to prevent the disease.

– It is highly recommended to avoid the consumption of fried and grilled meat, as stated by the American NGO Physicians Committee for Responsible Medicine in a press release on nutrition and cancer risks in June 2014. It is a risk factor for pancreatic cancer .

– Steve Jobs, the famous co-founder of the computer company Apple in California, died of pancreatic cancer in October 2011.
In Brazil, journalist Marcelo Rezende died of pancreatic cancer on September (16th) 2017 in São Paulo . The Record TV presenter had been fighting pancreatic and liver cancer since the end of April 2017.

Severe obesity and obesity surgery
– A 2017 study conducted by the University of Cincinnati showed that severely obese patients (BMI greater than 35) who underwent obesity surgery (bariatric surgery) had a 54% reduction in the risk of developing pancreatic cancer. In other words, everything indicates that severe obesity is a major risk factor for this form of cancer. To reach these conclusions, the researchers examined the medical data of 22,198 people who underwent bariatric surgery and 66,427 patients who did not have bariatric surgery (without bariatric surgery) between 2005 and 2012, with follow-up until 2014. This study did not only focus on breast cancer. pancreas, but took into account other forms of cancer, such as breast and colon cancer. Average, the results of this research showed that patients undergoing bariatric surgery had a 33% reduction in the risk of developing cancer during follow-up. This study was published on October 3, 2017 in the scientific journalAnnals of Surgery (DOI: 10.1097 / SLA.0000000000002525).

News:
Pancreatic Cancer, an interview with a world expert on this imposing cancer

Sources:
The Pancreas Club and Society for Surgery of the Alimentary Tract  (congress held in May 2016),  Physicians Committee for Responsible Medicine , R7.com (about Marcelo Rezende), Technical University of Munich (TUM), Johns Hopkins University , Science , German Cancer Research Center, Annals of Surgery (DOI : 10.1097/SLA.0000000000002525), NYU Langone Health, NYL Langone Health (interview by Dr. Diane M. Simeone, autonomous edition of 2017) and interview conducted by Create health.com.br with Dr. Diane M. Simeone November 2017 , CBSNews, Mayo Clinic

Jeanne Kenney
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I’m a stylist trainer, a content creator, and an entrepreneur passion. Virgo sign and Pisces ascendant, I move easily between my dreams, the crazy world I want, and my feet on the ground to carry out my projects.

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