Pancreatic Cancer : Definition, Symptoms, and Treatment

Pancreatic cancer is a disease caused by the growth of tumors in the pancreas. The pancreas is a large gland that is part of the digestive system and has a length of about 15 cm. Pancreatic cancer can be experienced by men and women, and usually occurs in people who are elderly or over 75 years old.
The pancreas has an important function for the body because it produces digestive enzymes which function to break down food so that it can be absorbed by the body. In addition, the pancreas also produces hormones, including insulin, which functions to maintain the stability of blood sugar levels in the body.

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Symptoms of Pancreatic Cancer

Pancreatic cancer in the early stages usually does not cause symptoms and therefore diagnosis becomes more difficult to do. Symptoms of pancreatic cancer at an advanced stage depend on the affected part of the pancreas gland because the pancreas has two types of glandular tissue. First is the gland that produces digestive enzymes or is called the exocrine gland. The second is a gland that produces hormones, or also called endocrine glands.
The exocrine gland is the gland most commonly affected by pancreatic cancer with symptoms that commonly occur such as jaundice, weight loss, and back pain or abdominal pain.

In addition to some of the symptoms mentioned above, there are several other symptoms of pancreatic cancer as follows:

• Diabetes
• Fever and chills
• Itchy
• Blood easily clots
• Nausea and vomiting
• Indigestion
• Changes in bowel movements
• Loss of appetite
• Fever

Causes of Pancreatic Cancer

Until now the cause of someone suffering from pancreatic cancer is still not known with certainty, but there are several risk factors that can increase the chances of pancreatic cancer as follows.

• Diabetes can increase a person's risk for pancreatic cancer. Conversely, malignant tumors that grow in the pancreas can also be a cause of diabetes.
• Helicobacter pylori bacteria that cause gastric infection are thought to be able to slightly increase a person's risk of pancreatic cancer.
• Smoking can increase the risk of contracting pancreatic cancer because toxins and harmful chemicals can cause tissues and organs in the body to experience irritation and inflammation.
• Aged over 75 years. 
• People who don't do much physical activity, are overweight or obese, and don't get used to a healthy diet. 
• Have suffered inflammation of the pancreas or pancreatitis . 
• Have a close family member who has pancreatic cancer.

In addition to the risk factors mentioned above, there are also other risk factors that can increase the risk of contracting pancreatic cancer, namely people who consume excessive amounts of alcoholic beverages and people with chronic hepatitis.

Diagnosis of Pancreatic Cancer

Pancreatic cancer diagnosis in the early stages is difficult to do because it often does not cause symptoms in patients. Physical examination to check for pancreatic cancer is difficult to do because the location of the pancreas is quite hidden in the body and surrounded by part of the intestine.
Here are some tests that can be done to diagnose pancreatic cancer:

• Imaging tests of internal organs such as ultrasound scans, CT, MRI , and PET scans . In addition, endoluminal ultrasonography (EUS) can also be done if CT scans or MRI scans that have been done are still unclear. An endoscope or a small camera device will be inserted through the mouth to the stomach to photograph the condition of the pancreas.
• Laparoscopy or 'keyhole' surgery in the abdominal area to insert a small microscope called a laparoscope, to see the organs in the abdominal and pelvic cavities. 
• Endoscopic retrograde cholangiopancreatography (ERCP) is similar to EUS, which is the process of inserting an endoscope through the mouth and into the stomach. However, the endoscope in the ERCP process is used to inject special dyes into the pancreatic and bile ducts to determine the presence of a clogged tumor. This test is done if a person has jaundice. 
• Biopsy or the process of taking samples of cells suspected of being a tumor to be examined under a microscope. Small devices attached to the endoscope can be used for biopsies while performing laparoscopic procedures, ERCP or EUS.

The stages of cancer are divided into four stages or commonly called stages. The doctor will classify the stage of cancer based on the diagnosis that has been made. Below is a classification of pancreatic cancer stages:

• If cancer is only found in the pancreas and has not spread to other parts, it is called stage I.
• If the cancer has spread to tissues and organs close to the pancreas, or may have affected the lymph nodes, called stage II. 
• If the cancer has spread to large blood vessels around the pancreas and may have affected the lymph nodes, called stage III. 
• If cancer has spread widely to other organs such as the lungs, liver, and peritoneum or membrane lining the abdominal cavity, it is called stage IV.

Treatment of Pancreatic Cancer

Treatment of pancreatic cancer in each patient varies because there are several factors that determine the type of treatment performed as follows:

• The pancreas that has cancer.
• Extensive spread of cancer or stage
• Patient age.
• Overall patient health.
• Choice or patient care preferences.

Treatment for pancreatic cancer patients aims to remove tumors and other cancer cells in the body. But if this is not possible to do, then the doctor will carry out treatments that aim to prevent the tumor from growing bigger because it can cause further danger. In addition, the treatment that is done is useful to relieve the symptoms experienced, and make the patient feel comfortable.

Treatment or healing process of cancer will be much more difficult if the tumor that appears in the body is large or has spread. Discuss with your doctor and family members to choose the type of treatment that suits your condition. Here are some types of treatments that can be done to treat pancreatic cancer.

Operation

The most common type of treatment for pancreatic cancer is surgery because it can treat pancreatic cancer until it is fully healed. But not all pancreatic cancer patients can perform surgery, only 1 of 5 patients is suitable for tumor removal surgery.

There are several factors that can determine the success of tumor removal surgery, including:

• The tumor has not spread to other parts of the body.
• The tumor does not grow around important blood vessels.
• Patients have good overall health.

The following are some surgical procedures that can be performed to treat pancreatic cancer:

• The most common operation is Whipple surgery, which is to remove the head of the pancreas. In this operation, the doctor may also remove the first part of the small intestine, gallbladder, part of the bile duct, and sometimes part of the stomach. About 30 percent of patients who have had Whipple surgery need an enzyme drug to help digest food. This operation has a faster recovery time than total pancreatic removal surgery.
• Total pancreatectomy surgery to remove the entire pancreas. In addition, this operation also removes the organs of the spleen, bile duct, part of the small intestine, gallbladder, lymph nodes around the pancreas, and sometimes part of the stomach. Patients who have performed this surgery need to consume enzymes to help digest food. The removal of the pancreatic organ that functions to produce insulin will make the patient suffer from diabetes as well. In addition, patients must take penicillin antibiotics for life and regular vaccinations to prevent infection and blood clots due to removal of the spleen organ. 
• Distal pancreatectomy surgery to remove the body and tail of the pancreas but leave the head of the pancreas. This operation also removes a portion of the stomach, part of the large intestine, left kidney, adrenal gland on the left side, and the possibility of a left diaphragm being removed. 
• If it cannot be cured, surgery to relieve symptoms and make the patient more comfortable can be done. This operation uses ERCP to place an opening stent or tube in the bile duct to prevent buildup of bilirubin which causes jaundice. Bypass surgery that blocks the bile duct can be done if the use of stents is not suitable for patients. The blocked bile duct will be cut off the top and reconnected to the intestine so that it can channel bile.

Postoperative pancreatic cancer recovery process must be considered because it requires a long time. The following are some of the things that should be noted in the postoperative recovery process of pancreatic cancer:

• Make sure the pain medication is appropriate and in sufficient doses for the postoperative period.
• The patient cannot eat or drink immediately after surgery because the digestive system like the intestine needs time to recover.
• Before the patient can eat and drink more regularly, the patient will sip the liquid slowly.
• A series of chemotherapy for six months is usually recommended after surgery. This has a great impact on patients' chances of recovery.

Chemotherapy

To destroy malignant cancer cells in the body or prevent their growth, patients can do chemotherapy with anticancer drugs. Chemotherapy can be done before or after surgery, or if surgery cannot be performed. Chemotherapy drugs have two forms, which are consumed directly and given by infusion.

Chemotherapy has many side effects because it can attack healthy and normal cells. Side effects that can occur include thrush, fatigue, nausea, and vomiting. In addition, chemotherapy can also increase the risk of infection. Side effects experienced by patients due to chemotherapy are usually only temporary and will subside as soon as treatment is complete.

The risk of side effects will increase if the patient is undergoing a combination of chemotherapy treatments, but this can increase the possibility of controlling or minimizing the cancer suffered.

Radiotherapy

To help minimize the tumor and relieve the pain suffered, the patient can do cancer therapy using high-energy radiation rays called radiotherapy. For patients who cannot perform surgery to treat cancer, doctors will usually recommend combination chemotherapy and radiotherapy.

However, this therapy has several side effects, such as loss of appetite, nausea, vomiting, fatigue, diarrhea, and skin rashes . Side effects experienced by patients due to radiotherapy are usually only temporary and will subside once the treatment is complete.

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