What's It Called When Your Cancer Comes Back
The pancreas is a bodily organ that few people think about. In fact, most people don't even know what it does. Despite this, pancreatic cancer is among the deadliest types of cancer, which is why it's extremely important to know and recognize the typical signs and symptoms of this disease.
What Is Pancreatic Cancer?
As the name suggests, pancreatic cancer is a type of cancer that first develops in the tissues of the pancreas. The pancreas is an organ located in the right side of the abdomen behind the lower part of the stomach. This organ's purpose is to secrete enzymes that help your body digest food. It also secretes hormones that are responsible for regulating your blood glucose levels.
Pancreatic cancer is often associated with a very poor prognosis because it is rarely detected in its early stages and the signs and symptoms of the disease aren't always apparent until it's too late. Additionally, it is a very aggressive form of cancer that spreads rapidly, making it difficult to treat. Unfortunately, the incidences of pancreatic cancer continues to rise.
Types of Pancreatic Cancer
There are many types of pancreatic cancer, but the majority of cases can be categorized into two main types. Based on the type of cells from which the cancer originates, most patients exhibit one of these types of pancreatic cancers:
Exocrine (Nonendocrine) Pancreatic Cancer: This type of pancreatic cancer originates from the exocrine cells that form the exocrine gland and pancreatic ducts. The exocrine gland produces the enzymes that help break down food, whereas the pancreatic ducts carry these enzymatic juices to the common bile duct. There are various types of exocrine pancreatic cancer. The most common type is adenocarcinoma or ductal carcinoma, which affects the pancreatic ducts. Other more rare types of exocrine pancreatic cancer include squamous cell carcinoma, adenosquamous carcinoma, and colloid carcinoma.
Neuroendocrine Pancreatic Cancer/Pancreatic Neuroendocrine Tumors (PanNETs): This type of pancreatic cancer is less common and occurs when tumors develop from the cells of the pancreatic endocrine gland, which is responsible for producing and secreting the hormones that regulate blood glucose levels (i.e. glucagon and insulin).
Symptoms Associated With Pancreatic Cancer
One of the most dangerous things about pancreatic cancer is that tumors in the pancreas can often grow for some time without any symptoms. However, there are a few indicators that pancreatic cancer may be developing, including:
- Dark-colored urine
- Pale-colored stools that float
- Nausea
- Vomiting
- Loss of appetite
- Bloating
- Indigestion
- Diarrhea
- Unintentional weight loss
- Jaundice (skin or eyes that become yellowish in color)
- Pain or discomfort in the upper abdomen
- Back pain
- Blood clots
- Fatigue
These symptoms may be indicators of any number of diseases, so it's important to see a doctor if you find that you are experiencing any of these symptoms.
Causes & Risk Factors
Pancreatic cancer occurs in response to genetic mutation in the cells of the pancreas. The mutations allow the cells to divide and grow at unusually rapid rates. In addition, the mutations allow the cells to stay alive under conditions in which normal cells would die. Often, the accumulating cells will turn into a mass that forms a tumor.
There are several factors that can increase a person's risk for pancreatic cancer, including:
- Age: The risk of pancreatic cancer increases with age. This is particularly true once a person surpasses the age of 50.
- Assigned Sex at Birth: Pancreatic cancer is slightly more common in people assigned female at birth.
- Race: Black folks are more susceptible to developing pancreatic cancer than people of other races.
- Family History and/or Genetics: Having a family history of pancreatic cancer increases your risk for the disease. In addition, the presence of certain genetic variations/mutations or syndromes, including BRCA1/2 or PRSS1 gene mutations, Lynch syndrome, and Peutz-Jeghers syndrome, increases a person's risk of pancreatic cancer.
- Tobacco Use: Tobacco use is linked to an increased risk of pancreatic cancer.
- Other Health Conditions: People with pancreatitis (chronic inflammation of the pancreas) or diabetes and those who are overweight or obese have a higher risk of pancreatic cancer.
Pancreatic Cancer Diagnosis
Pancreatic cancer is very difficult to diagnose because the pancreas is located behind other organs deep within the body. However, if an individual is suspected of having the disease, several diagnostic tests can be performed.
Various imaging techniques, including computerized tomography (CT) scan, positron emission tomography (PET) scan, magnetic resonance imaging (MRI), ultrasound, and endoscopic retrograde cholangiopancreatography (ERCP), are often used to determine if a pancreatic tumor is present. Blood tests for circulating tumor markers as well as liver function tests and chemistry panels can also help diagnose pancreatic cancer. However, obtaining a biopsy to study the actual tissue is the most accurate method for diagnosing pancreatic cancer.
Are There Ways to Prevent Pancreatic Cancer?
There are no proven ways to prevent pancreatic cancer completely, but many people can reduce their risks by taking the following steps:
- Stopping the use of tobacco products
- Maintaining a healthy weight
- Eating a diet with lots of fruits, vegetables, and whole grains
- Exercising regularly
Prognosis & Treatment
Sadly, pancreatic cancer is one of the most deadly types of cancer. Approximately 95% of patients will not survive five years past diagnosis. Additionally, patients with pancreatic cancer that cannot be surgically removed or that has spread to other parts of the body are generally given one year or less to live. Because of the poor prognosis of the disease, some people do not undergo intensive treatment once they are diagnosed. However, some types of pancreatic cancer may be treatable with the following methods:
- Surgery: When possible, doctors will try to remove as much of the cancer from the pancreas as possible. One common surgical method is the Whipple procedure, which involves removing the head of the pancreas. The body of the pancreas as well as surrounding structures, such as a portion of the small intestine, the gallbladder, or part of the bile duct, may also be removed. Other surgical methods include a distal pancreatectomy, which involves removing the tail of the pancreas, or a total pancreatectomy, in which the entire pancreas is removed. In any case, surgery always involves risks, such as bleeding or infection.
- Ablation or Embolization: These treatment strategies are different ways of removing pancreatic tumors without surgery. During ablation, extreme hot or cold is used to destroy the tumor. Some of these treatments include radiofrequency ablation (RFA), microwave thermotherapy, and cryosurgery. Embolization uses the injection of substances to block the blood flow to the tumor. There are three main types of this treatment: arterial embolization, chemoembolization, and radioembolization.
- Radiation Therapy: With radiation therapy, high-energy beams are used to kill the cancer cells in the pancreas and other areas to which they have spread.
- Chemotherapy: Chemotherapy is the use of drugs to kill off cancer cells. The drugs are administered orally or intravenously.
- Immunotherapy: This treatment involves programming or stimulating the patient's immune system to recognize and destroy the cancer cells. Various medications are used for this technique, including immune checkpoint inhibitors.
- Clinical Trials: Because pancreatic cancer is often accompanied by a poor prognosis, many people join clinical trials to explore new ways to treat their disease. This may involve taking a drug or even getting an experimental pancreatic cancer vaccine.
Next Steps for Survivors
Although rare, it is possible to survive pancreatic cancer. For many patients, the cancer may not completely go away or it may come back in another part of the body. Either way, it is extremely important to remain vigilant when it comes to follow-up care. Even though there will be a lot of changes after surviving pancreatic cancer, it is also important to try to regain personal wellbeing by staying active, eating healthy, reducing stress, and connecting with others, such as through a support group.
Resource Links:
- "What Is Pancreatic Cancer?" via American Cancer Society
- "Pancreatic Cancer Types" via John Hopkins Medicine
- "Epidemiology of Pancreatic Cancer: Global Trends, Etiology and Risk Factors" via World Journal of Oncology, U.S. National Library of Medicine
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What's It Called When Your Cancer Comes Back
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