Pancreatic cancer

Symptoms and causes

What is it?

The pancreas is made up of two types of glands: the exocrine glands and the endocrine glands. In most cases, the pancreatic tumour develops in the exocrine glands (adenocarcinoma), but it can also develop in the endocrine glands (neuroendocrine or hormone-producing tumours).

The cause for pancreatic cancer is still not known. It is known that diabetics and smokers have a slightly increased risk for developing pancreatic cancer.

Pancreatic cancer is most common in people older than 60 years old.

Symptoms

In the early stage, pancreatic cancer barely causes any symptoms. As the tumour grows, the symptoms increase. The following complaints or symptoms may indicate pancreatic cancer:

pain in the upper or middle of the abdomen or back
yellow colouring of the skin and eyes, due to jaundice
weight loss
digestive problems
decreased appetite
nausea and vomiting
light-coloured ('white') stool and dark urine
itching
development of diabetes

Diagnosis and treatment

Diagnosis and staging

Once the diagnosis of pancreatic cancer has been made, it is important to gain the best possible insight into the extent of the disease, particularly by determining the stage of the illness as correctly as possible. This information determines the choice of treatment and prognosis. Disease staging is determined by the size of the tumour and whether or not is has spread outside of the pancreas. When cancer cells become detached from the original tumour and penetrate deep enough to reach the blood and lymph vessels, they can escape and colonise glands. If a detached clump of cancer cells nests within another part of the body, the cancer is said to have spread or ‘metastasised’. Pancreatic cancer cells sometimes end up in other organs.

The stage is determined based on a globally used classification, the TNM classification (Tumor Nodus Metastasis classification), which looks at to what degree the tumour has passed through the pancreas wall (T), whether or not the lymph nodes are affected (N) and whether or not it has metastasised (M).

Treatment

The treatment of pancreatic cancer is complex and entails a specialised team. The most commonly used treatments are oncological surgery, radiotherapy and chemotherapy. Clinical trials sometimes offer a solution and provide access to the very latest treatments.