Pancreas lies in the abdomen between the lower border of the stomach and the upper border of the duodenum, the first part of the small intestine. It produces digestive enzymes which pass into the duodenum by a duct to digest the food. Special type of cells of the pancreas, produce insulin which is absorbed into the blood and helps in keeping in balance the level of the blood sugar.
Cancer of the pancreas occurs in older people of both the sexes.
Cause(s)
It is not known.
Symptoms
· Pain in the upper abdomen, and also sometimes in the back.
· Loss of weight.
· Loss of appetite.
· Jaundice in the later stages.
· There may be no symptoms at all, till the cancer has spread into the adjoining tissues and then produce symptoms because of that.
Diagnosis
· Routine: Blood: Hb, RBC, TLC, DLC may be normal. ESR is raised.
· Special: Barium meal may show narrowing of the duodenum if the pancreas is enlarged and pressing upon it
· Ultrasound examination may show the cancer mass in the region of the pancreas.
· CT scan may show the cancer mass in the region of the pancreas.
· Endoscopy, including ERCP allows direct vision of the pancreatic duct and the bile duct.
Many a time, all the above tests, do not confirm the diagnosis, and opening the abdomen and seeing the organ and the area around and the biopsy examination establishes the diagnosis.
Treatment
Surgery: If the cancer is detected early and is small, confined to the pancreatic duct only, surgical removal is done.
More often the cancer has spread into the adjoining areas and also obstructed the bile duct in the duodenum or the duodenum itself. Then surgery is performed only to remove the obstruction ,o as to remove jaundice.
Radiation: It can only work to the extent that it may reduce the size of cancer and reduce the obstruction, if present.
Chemotherapy: It has only limited role 5-Fluorouracil is the most frequently used drug either singly or along with Adriamycin and Mitomycin C. Most of the patients do not respond favourably; some do.
Prognosis
Cure is only rarely possible in pancreatic cancer because of the advanced stage when detected. Only relief of symptoms is obtained by even the combination of approaches.
Early Detection
Signs & Symptoms
· Pain in the upper abdomen, sometimes going to the back.
· Loss of appetite.
· Loss of weight.
Investigations
· Barium meal may show narrowing of the duodenum if the pancreas is enlarged and pressing against it.
· Ultrasound and CT scan may show the cancer mass in the pancreatic area
· Endoscopy including ERCP allows direct vision of the pancreatic and bile ducts, and may show up the cancer.