Pancreatic tumor

The pancreatic tumor is caused by the uncontrolled growth of pancreatic cells.
The pancreas (pancreas) produces the hormone insulin, which regulates blood sugar.
This organ also secretes some enzymes that play an important role in the digestion of food in the gastrointestinal tract.

When the tumor mass forms in the ducts that carry the pancreatic juices, the tumor is called an exocrine pancreatic tumor or adenocarcinoma.
If the neoplasia develops in the cells that produce the insulin, the tumor is called endocrine tumor or islet cell carcinoma.
This particular type spreads through the lymphatic system to other areas of the body such as the liver, lungs, bones, etc. and is the fifth leading cause of death from tumors.

Rarely, the tumor occurs in children or adolescents.
The incidence in Europe is around 10 cases per 100,000 inhabitants.


Classification of pancreatic tumor

Non-endocrine tumor
These tumors represent 95% of all pancreatic tumors.
Adenocarcinoma forms in the glandular cells.
These tumors can grow so large that they invade the nerves, causing back pain, or into the arteries (visceral, common liver and spleen arteries) and veins (portal vein).
Often the tumor spreads (metastasizes) to the liver or lymph nodes.
If this happens, the tumor must be considered inoperable.

Endocrine tumor
This tumor is much less common than the non-endocrine tumor.
Endocrine tumors can produce active hormones and thereby cause very serious symptoms.

There are different types:

  1. Insulinoma: produces large amounts of insulin, which can lead to hypoglycemia (too little sugar in the blood).
  2. Glucagonoma: produces glucagon, which can lead to a rash.

Benign and precancerous tumors of the pancreas
Not all tissue growths of the pancreas are cancers.
Some tumors are simply benign (non-carcinogenic), while others can degenerate into cancer over time if left untreated (precancerous).

  • Serous cystadenoma (serous cystic neoplasia, SCN) is a tumor that forms cysts filled with aqueous fluid. These cysts are usually benign and do not require treatment.
  • Mucinous cystadenoma (MCN) is a tumor consisting of a cyst filled with gelatinous fluid called mucin. This cyst is benign, but over time it can degenerate into cancer.
  • Intraductal papillary-mucinous neoplasia (IPMN) is a benign tumor that grows in the pancreatic ducts and can degenerate into cancer over time.

Causes of pancreatic tumor

The exact cause of pancreatic cancer is unknown, but several risk factors have been identified that increase susceptibility to developing the disease. Risk factors include:

  1. Genetic factors
  2. Age (mainly affects the elderly)
  3. Ulcers
  4. Overweight
  5. Smoke
  6. Pancreatitis

Symptoms of pancreatic tumor

Symptoms vary depending on the area where the gland is affected: head, body or tail.
Early diagnosis is difficult because the symptoms appear only at an advanced stage of the disease.
Thus, this cancer is often referred to as a silent disease.

Jaundice (jaundice) is one of the main signs and symptoms in which the white of the patient’s eyes (sclera) and skin turn yellow.
This could be a symptom of the tumor affecting the head of the pancreas (about 60% of tumors are located in the head of the pancreas).

If the tumor spreads, it completely or partially closes the bile duct. This slows down the flow of bile and causes bilirubin in the blood to rise, resulting in yellowing of the eyes and skin.
Other symptoms include impaired digestion and diarrhea.

Another sign is severe abdominal pain in the upper part of the stomach, which slowly radiates to the back. This happens when the tumor presses on nerves. The pain increases especially 3-4 hours after eating or sometimes lying down.
Abdominal pain is typical for cancer of the pancreatic tail or body of the pancreas.
Loss of appetite is another symptom of the pancreatic tumor, although it is common in other diseases and infections. Usually it indicates that there might be a problem with the stomach. Therefore, it is important to talk about it with the doctor.
If the pancreatic cancer affects the head of the gland, it can cause serious unwanted weight loss. Together with the abdominal pain, this is one of the first symptoms in women and men.
Another symptom is the change in stool and urine color.
If the tumor closes the bile duct, the stool becomes bright, mainly clay-colored.
The chair also has a strong and strong smell.
Excessive fat is excreted in the stool.
This disease is called steatorrhea.
On the other hand, the urine becomes much darker.

The patient may suddenly develop diabetes.
This happens because the pancreas loses the ability to produce insulin.
Rarely, there may also be an increase in lipase levels in the blood.
You may feel skin itching, although this is a rare symptom. If it occurs together with stomach pain and jaundice, one should immediately consult a doctor.

Other common symptoms:

  • Tiredness and loss of energy
  • Bloating and indigestion after meals
  • Nausea and vomiting
  • Depression
  • Fever and chills
  • Constant thirst

Stage IV of pancreatic cancer

This is the tumor form with the highest lethality. Pancreatic tumor has an unfavorable prognosis and is the fourth leading cause of death.
The one-year survival rate is 25% and the five-year rate is only 6% for metastases.
In contrast, the five-year survival rate for localized cancer is about 10-25%.
Metastases can also form in distant organs such as lungs, liver, lymph nodes, bones and brain.

Treatment options for stage IV
pancreatic tumor

Rather, chemotherapy and endovenous injections are given to relieve pain and prolong the patient’s survival time.
Palliative (pain-relieving) surgical interventions can be performed on the patient, and the doctor tries to relieve the symptoms of jaundice, pain, nausea and vomiting caused by the occlusion of the bile ducts.

Palliative surgery includes:

  • Biliary bypass: If the tumor closes the bile duct and bile accumulates in the gallbladder, the doctor connects the gallbladder or bile duct to the small intestine. This allows a new drain for the bile around the blocked area.
  • Endoscopic positioning of a stent: A stent is inserted via a catheter to allow bile to drain from the body or into the small intestine.
  • Gastric bypass: If the tumor closes the food pathway at the level of the stomach, the doctor connects the stomach directly to the small intestine to allow the patient to eat normally.

Diagnosis of pancreatic tumor

The doctor must examine the patient and palpate the abdomen, in case of doubt he orders an apparatus examination. The first proposed examination is echography, which shows an image compatible with the tumor or obstacle on the pancreas.

Endoscopic echography is performed using an endoscope that is inserted through the neck to the intestine. Here, the probe can better detect the inside of the abdomen.
CT is a more accurate examination to detect the size of the tumor and the interference with the surrounding structures.
The doctor orders a cholangiography for jaundice to determine whether there is a blockage of the bile ducts.

Treatment of pancreatic tumor

The form of treatment depends on the location and stage of the tumor. Depending on the age of the affected person, his state of health and personal preferences, the appropriate therapy is determined.

Options include surgery, chemotherapy, and radiation therapy.
Surgery is advised to remove part of the pancreas or the entire organ.
In this way, tumors in the head of the pancreas (pancreatoduodenectomy), tail and body (distal pancreatectomy) can be removed. However, if the cancer spreads to other organs, blood vessels or lymph nodes, surgery is not the right choice.
In this case, one can opt for chemotherapy or radiation treatment.
Quit smoking, maintain a healthy body weight, regular physical exercise, and following a healthy diet are some ways to prevent this disease.

Diet and nutrition

The only possible natural remedy is to follow the guidelines for a tumor diet.

What is the life expectancy? Prognosis for patients with pancreatic tumor

Stage division and survival statistics for pancreatic cancer

  • Stage 1: During the first phase, a very small tumor is formed, occupying only a limited space of the pancreas.
    The tumor can be surgically removed, so this phase has a high survival rate.
    The survival rate increases significantly if the patient undergoes surgery at this stage.
    After surgery, about 10-25% of people survive up to five years.
  • Stage 2: During this phase, neoplasm on the pancreas is operable because the growing tumor mass is still limited to the pancreas.
    The carcinogenic cells can spread to the surrounding lymph nodes.
    Removal of the tumor and lymph nodes is still possible.
    According to some studies by the American Cancer Society, less than 5-7% of people diagnosed with pancreatic tumor live five years.
  • Stage 3: During the third phase, the disease spreads to the surrounding lymph nodes and blood vessels.
    This tumor is defined as locally advanced and can still be removed together with the surrounding lymph nodes, but can no longer be completely eliminated from the body.
  • Stage 4: Phase 4 is the terminal phase that is reached quickly.
    The cancer spreads through the bloodstream throughout the body and bones.
    The last stage of the tumor is inoperable and the doctor tries to minimize the pain.
    Mortality in the fourth stage in pancreatic tumor is very high.
    Life expectancy from diagnosis is about 3-6 months, but survival can last only a few days.

As a rule, the survival rate of the pancreatic tumor is very low.
These survival rates are based on large groups of people and cannot be used to predict what will happen to a particular patient.

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