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The pancreas is an important and complex mixed gland of the digestive system. It is about 15 cm long, located behind the stomach and consists of four anatomical parts: head, neck, body and tail. It releases digestive enzymes to break down food, hormones to store energy from food, and hormones to manage blood sugar.

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What is pancreatic cancer?

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Pancreatic cancer is considered one of the most aggressive cancers, with relatively low survival rates. It is a disease in which certain pancreatic cells proliferate uncontrollably and autonomously compared to healthy cells. These 'defective' cells are called cancer cells, are immortal and form a tumour in the pancreas.

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What forms of pancreatic cancer are there?

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The pancreas is made up of two different types of cells: exocrine cells, which regulate the digestion of food, and endocrine cells, which regulate blood sugar. Depending on the cells that become cancerous, we have 2 main types of pancreatic cancer:

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Adenocarcinoma, which involves the exocrine cells and is the most common form of pancreatic cancer
Neuroendocrine carcinoma involving the endocrine cells

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There are other, very rare tumours of the exocrine cells.

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Epidemiological data

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Pancreatic cancer has the highest mortality rates of all cancers. Based on international statistics, only 7% of patients survive five years. According to records, about 30% of patients lose their lives within 2 to 6 months of diagnosis.

A key reason is that pancreatic cancer does not show symptoms in the early stages. Although surgery is considered the main way of treating pancreatic cancer, in 80% of cases it can be so late that doctors cannot use a scalpel. This is why it is often described as a "silent killer".

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What causes pancreatic cancer?

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To date, the cause of pancreatic cancer is not known. However, certain factors that increase the risk have been identified. In particular:

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Smoking
High alcohol consumption
Age
Obesity
Chronic pancreatitis
Long-term diabetes mellitus
Certain rare inherited conditions
Inherited gene mutation

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What are the symptoms of the disease?

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Unfortunately, usually pancreatic cancer remains asymptomatic for a long time, while the first symptoms are mild and non-specific, misleading and delaying diagnosis. The most common symptoms are:

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Anorexia
Indigestion
Nausea or vomiting
Unexplained weight loss
Unexplained fatigue
Pain in the upper abdomen, waist or back
Icteros
Sudden development or deregulation of diabetes mellitus
Sudden onset of pancreatitis

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Is there a risk of metastasis?

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If the cancer is not diagnosed early, there is a high risk of metastasis through the bloodstream or lymphatic system. Also, the disease can spread and directly affect surrounding tissues.

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How is the diagnosis made?

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To diagnose pancreatic cancer, the following tests are performed:

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Clinical examination
Specialised haematological testing
Ultrasound (US)
Computed tomography (CT)
Magnetic Resonance Imaging (MRI)
Endoscopic palindromic cholangiopancreatography (ERCP)
Magnetic resonance cholangiopancreatography (MRCP)
Endoscopic ultrasound (EUS)
Biopsy of a tissue sample
PET scan

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Is there a cure?

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The appropriate treatment for pancreatic cancer emerges through the Oncology Council consultation. This is a multidisciplinary team of doctors, which consists of a specialist gastroenterologist, oncologist, radiologist and surgeon. They will take into account all the available data and each will contribute to ensure that the patient receives appropriate treatment and holistic care.

The only option for treating pancreatic cancer is surgical removal of the tumour, usually assisted by chemotherapy and radiotherapy. Unfortunately, however, the majority of pancreatic cancer patients cannot undergo surgical treatment due to the extent of the disease and metastases. In inoperable pancreatic neoplasms, radiotherapy and chemotherapy are used as a means of delaying the development of the disease and thus prolonging survival.

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The multidisciplinary team is also responsible for improving patients' quality of life. Therefore, they have to take care of the management of the following:

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