Pancreatic cancer is one of the rarest cancers worldwide. It occurs when the cells in the pancreas, an organ in the abdomen that plays a role in digestion and hormone production, start to grow uncontrollably, forming a tumour. According to the World Cancer Research Fund (WCRF), pancreatic cancer is the 12th most common cancer. In 2022, pancreatic cancer accounted for 5.11 lakh new cases and 4.67 lakh deaths, making it the sixth leading cause of cancer-related deaths globally, responsible for nearly 5% of all cancer fatalities.
A study published in CA: A Cancer Journal for Clinicians highlights that pancreatic cancer has one of the poorest prognoses, which could be largely attributed to delayed diagnosis and the silent nature of the disease. Speaking with the OnlyMyHealth team, Dr Krishna Kiran Kannepalli, Surgical Oncologist and Advanced Laparoscopic and Robotic Surgeon at the American Oncology Institute (AOI), Hyderabad, provided detailed insights into the factors contributing to the disease's silent progression, its consequences, and strategies to improve outcomes.
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Why Is Pancreatic Cancer Mostly Silent And What Are The Consequences?
Reportedly, up to 80% of pancreatic cancer cases are diagnosed late, when the cancer has spread and is more difficult to treat.
According to Dr Kannepalli, pancreatic cancer is difficult to detect in the early stages due to various factors.
He explained, “First, the pancreas is located deep within the abdomen, making it hard for doctors to feel tumors during routine physical exams. Second, early-stage pancreatic cancer typically does not cause noticeable symptoms, or the symptoms are vague and can be mistaken for other gastrointestinal issues, such as nausea, weight loss, or abdominal discomfort. Additionally, pancreatic tumours may not produce elevated levels of tumour markers that can be easily detected through blood tests. By the time symptoms become apparent, the cancer is often at an advanced stage, which significantly reduces treatment options and survival rates.”
According to the American Cancer Society (ACS), the 5-year relative survival rate for localised pancreatic cancer, which is confined to the pancreas, is 44%, while it drops to 16% for regional cancer, which has spread to nearby structures or lymph nodes. Unfortunately, the survival rate is 3% for distant cancer, which has spread to organs like the lungs, liver, or bones. The overall survival rate across all stages is 13%.
Early Warning Signs Of Pancreatic Cancer
While pancreatic cancer often presents with no symptoms in its early stages, some subtle warning signs may include:
- Unexplained weight loss
- Loss of appetite
- Fatigue
- Abdominal or back pain
- Changes in stool (such as greasy, pale, or floating stools)
- New-onset diabetes, particularly if it occurs suddenly
- Sudden worsening of diabetes
- Jaundice (yellowing of the skin and eyes) if the tumour blocks the bile duct
“These symptoms can easily be attributed to other conditions, so it's essential for individuals experiencing them, especially those with risk factors, to consult a healthcare professional for further evaluation,” said Dr Kannepalli.
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Screening Methods That Can Help Detect Pancreatic Cancer Early
Currently, there are no standard screening tests for pancreatic cancer in the general population due to the lack of effective methods for early detection. However, for individuals at high risk, such as those with a family history of the disease or genetic predispositions, the following methods may be considered:
- Magnetic Resonance Imaging (MRI): It offers detailed images of the pancreas.
- Computed Tomography (CT) Scan: It can help identify tumours in the pancreas.
- Endoscopic Ultrasound (EUS): This involves inserting a thin tube with an ultrasound device through the stomach to get close to the pancreas for detailed imaging.
- Blood tests: While not definitive, tests for tumour markers like CA 19-9 may provide some indication of pancreatic abnormalities. However, elevated levels can occur in other conditions as well.
Lifestyle Changes To Reduce Pancreatics Cancer Risk
Before searching for ways to reduce one’s risk of pancreatic cancer, it is important to understand and assess your risk factors.
“Genetic predispositions and family history play a significant role in the risk of developing pancreatic cancer. Approximately 10% of pancreatic cancer cases are hereditary, linked to genetic mutations in specific genes such as BRCA2, PALB2, CDKN2A, and STK11,” said Dr Kannepalli.
He added, “Individuals with a family history of pancreatic cancer or related conditions, such as familial atypical multiple mole melanoma syndrome, are at a higher risk. Genetic counseling and testing can help identify individuals with these mutations, allowing for enhanced monitoring and early detection strategies, which can improve outcomes.”
Regarding lifestyle changes, which may not prevent the disease but can reduce the risk, here are some strategies:
- Maintaining a healthy weight: Obesity is a significant risk factor, so achieving and maintaining a healthy weight through diet and exercise is crucial.
- Eating a balanced diet: A diet rich in fruits, vegetables, whole grains, and lean proteins, while limiting red and processed meats, can support overall health and reduce cancer risk.
- Avoiding tobacco: Smoking is a major risk factor for pancreatic cancer, so quitting or avoiding tobacco products can significantly lower risk.
- Limiting alcohol consumption: Excessive alcohol intake may increase the risk of pancreatic cancer; moderation is key.
- Regular physical activity: Engaging in regular exercise can help maintain a healthy weight and reduce cancer risk.
- Managing diabetes and chronic pancreatitis: Proper management of these conditions is essential, as they are associated with an increased risk of pancreatic cancer.
Conclusion
Pancreatic cancer is not as common as breast or lung cancer. However, it can also be life-threatening if not detected early and treated on time. In most cases, pancreatic cancer is silent due to its asymptomatic nature in the early stages and also due to its location in the human body. It is hidden deep within the abdomen behind the stomach, which makes it difficult to catch abnormalities even through screening tests. However, there are warning signs that can help indicate the condition and tests that can identify abnormalities.
“Consultation with a specialist is recommended for individuals at increased risk to determine the most appropriate screening strategy,” concluded Dr Kannepalli.