Pancreatic cancer

Pancreatic cancer is a disease in which cancerous cells are found within thetissues of the pancreas. The pancreas is a pear-shaped gland that lies behindthe stomach, surrounded by other digestive organs, such as the liver, gallbladder, and small intestine. It has two main functions, to produce digestive juices that help break down food, and to produce hormones (like insulin) thatcontrol how the body stores and uses the food.

The part of the pancreas that produces the digestive juices is called the exocrine pancreas, and almost 95% of pancreatic cancers occur in the tissues ofthe exocrine pancreas.

Although the exact cause for pancreatic cancer remains unknown, several riskfactors, such as smoking and diets rich in red meat and fat, have been shownto increase the susceptibility to this particular cancer. It has been observed that a third of pancreatic cancer cases occur among smokers. Therefore, smoking is regarded as the single greatest risk factor for this cancer. The disease is more common among diabetics. Conditions such as chronic pancreatitis (long-term inflammation of the pancreas) have also been associated with an increased risk for pancreatic cancer.

The most common signs and symptoms of the disease are abdominal pain; digestive problems, diarrhea, and nausea,. Weight loss that is not due to drastic dieting or exercising is a common occurrence in pancreatic cancer patients. Gallbladder enlargement and jaundice (a yellowish discoloration of the whites of the eyes and the skin) may sometimes occur.

The first step in diagnosing pancreatic cancer is a thorough medical historyand a complete physical examination to check for fluid accumulation, or any lumps, or masses, in the abdomen. The skin and the whites of the eyes will bechecked for jaundice. Blood tests will be performed to rule out the possibility of liver diseases that can also contribute to jaundice. Imaging tests suchas CT scans, MRI imaging, or ultrasonography may be ordered in order to geta detailed picture of the internal organs. This will also help to check whether the cancer has spread to other organs beyond the pancreas. The most definitive test for pancreatic cancer is a biopsy, where a sample of the tumor is removed and examined microscopically.

Pancreatic cancer can be treated by any of the three standard modalities: surgery, radiation therapy, or chemotherapy.

If the imaging studies show that the cancer is contained within the pancreas,the doctors will attempt surgery to remove all the cancer. Depending on thelocation of the tumor, different types of surgery can be performed, where either the whole pancreas or only parts of the pancreas are removed. If the tumor is too widespread to be removed by surgery, radiation therapy in combination with chemotherapy is used.

The disease is often fatal. Once diagnosed with this cancer, 95% of patientswill die within five years. More than 80% of the patients will not survive the first year after initial diagnosis. The poor prognosis is because of late diagnosis; the pancreas is a small gland located deep within the abdominal cavity, and, hence, cannot be seen or felt during routine physical examination.There are no early symptoms, and by the time the symptoms are manifested, thecancer has already spread to other organs and is in an advanced stage.

Since the exact cause of pancreatic cancer is not known, there are no guidelines for prevention. The wisest approach would be to avoid all the risk factors for pancreatic cancer. Quitting cigarette smoking will certainly reduce the risk for many cancers, including pancreatic cancer. In countries where the diet is low in fat, the incidence of pancreatic cancer is much lower. The American Cancer Society recommends a diet rich in fruits, vegetables, anddietary fiber in order to reduce the risk of pancreatic cancer.

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