Pancreatic cancer is a disease caused by tumor growth in the pancreas. The pancreas is a large gland that is part of the digestive system and has a length of about 15 cm. Pancreatic cancer can be experienced by both men and women, and usually occurs in people who are elderly or above 75 years old. Pancreas has an important function for the body because it produces digestive enzymes that function to break down food to be absorbed by the body. In addition, the pancreas also produces hormones, including insulin, which serves to maintain the stability of blood sugar levels in the body.
Symptoms of Pancreatic Cancer
Pancreatic cancer in the early stages usually does not cause symptoms and therefore the diagnosis becomes more difficult to do. The symptoms of pancreatic cancer in the later stages depend on the part of the pancreas gland that contracts because the pancreas has two types of glandular tissue. First is the gland that produces digestive enzymes or called the exocrine gland. Both are glands that produce hormones, or also called endocrine glands. Exocrine glands are the most commonly acquired pancreatic cancer gland with symptoms that commonly occur such as jaundice, weight loss, and back pain or abdominal pain.
In addition to some of the above mentioned symptoms, there are several other pancreatic cancer symptoms as follows:
- Fever and chills
- Blood easily clot
- Nausea and vomiting
- Changes in bowel pattern
- The loss of appetite
Causes of Pancreatic Cancer
Until now a person's cause of pancreatic cancer is still not known for certain, but there are several risk factors that can increase the chances of pancreatic cancer as follows.
- Diabetes can increase a person's risk of developing pancreatic cancer. Conversely, malignant tumors that grow in the pancreas can also be the cause of diabetes.
- The helicobacter pylori bacterium that causes gastric infections is thought to slightly increase a person's risk of developing pancreatic cancer.
- Smoking can increase the risk of contracting pancreatic cancer because toxins and harmful chemicals can cause tissues and organs in the body to become irritated and inflamed.
- Aged above 75 years.
- People who do not do much physical activity, are overweight or obese, and do not get used to a healthy diet.
- Never have inflammation of the pancreas or pancreatitis .
- Have a close family member who suffers from pancreatic cancer.
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Diagnosis of Pancreatic Cancer
Diagnosis of pancreatic cancer in the early stages is difficult to do because it often does not cause symptoms in patients. Physical examination to check for pancreatic cancer is difficult to do because the location of the pancreas is quite hidden in the body and surrounded by a part of the intestine.
Here are some tests that can be done to diagnose pancreatic cancer:
- Imaging tests of organs in the body such as ultrasound scan, CT, MRI , and PET scan . In addition, endoluminal ultrasonography (EUS) may also be performed if the CT scan or MRI scan has been performed is still unclear. The endoscope or small camera device will be inserted through the mouth to the stomach to photograph the condition of the pancreas.
- Laparoscopy or 'key hole' surgery in the abdominal area to enter a small microscope called a laparoscope, to see the organs in the abdominal and pelvic cavities.
- Endoscopic retrograde cholangiopancreatography (ERCP) is similar to EUS, which enters the endoscope through the mouth and into the stomach. But the endoscope in the ERCP process is used to inject a special dye into the pancreatic and bile ducts to determine the presence of a clogging tumor. This test is performed if a person has jaundice.
- Biopsy or cell sampling process suspected as a tumor for examination under a microscope. Small devices attached to the endoscope can be used for biopsy when performing laparoscopic procedures, ERCP or EUS.
- If the cancer is present only in the pancreas and has not spread to other parts, it is called stage I.
- If the cancer has spread to tissues and organs close to the pancreas, or may have infected the lymph nodes, called stage II.
- If the cancer has spread further into the large blood vessels around the pancreas and may have infected the lymph nodes, it is called stage III.
- If the cancer has spread to other organs such as the lungs, liver, and peritoneum or membranes lining the abdominal cavity, called stage IV.
Treatment of Pancreatic Cancer
Treatment of pancreatic cancer in each patient is different because there are several factors that determine the type of treatment performed as follows:
- The pancreas part of the cancer.
- Broad spread of cancer or stadium suffered.
- Patient age.
- Overall patient's health.
- Choice or preference of patient care.
Treatment or cure of cancer will be much more difficult if the tumor that appears in the body is large or has spread. Discuss with your doctor and family members to choose the type of treatment that suits your condition. Here are some types of treatments that can be done to overcome pancreatic cancer.
The most common type of pancreatic cancer treatment is surgery because it can treat pancreatic cancer until fully healed. But not all patients with pancreatic cancer can perform surgery, only 1 in 5 patients are suitable for surgical removal of the tumor.
There are several factors that can determine the success of surgical removal of tumors, among others:
- The tumor has not spread to other body parts.
- Tumors do not grow around the important blood vessels.
- Patient has good overall health.
- The most widely performed operation is Whipple surgery, which is to lift the head of the pancreas. In this operation, the doctor may also remove the first part of the small intestine, the gallbladder, the bile duct part, and sometimes some of the stomach. About 30 percent of patients who have performed Whipple surgery require enzyme drugs to help digest food. This surgery has a faster recovery time than the total pancreas removal surgery.
- Total pancreatectomy surgery to remove all pancreas. In addition, this surgery also lifts the organ of the spleen, bile ducts, some small intestine, gallbladder, lymph nodes around the pancreas, and sometimes some of the stomach. Patients who have performed this surgery need to consume enzymes to help digest food. The removal of pancreatic organs that function to produce insulin will make the patient suffer from diabetes as well. In addition, patients should take lifelong penicillin antibiotics and routine vaccinations to prevent infection and blood clots due to lymph organ removal.
- Operation of the distal pancreatectomy to remove the pancreatic body and tail but leave the pancreas head. This operation also lifts some of the stomach, part of the large intestine, left liver, left adrenal gland, and possibly the left diaphragm will also be removed.
- If it can not be cured, surgery to relieve symptoms and make patients more comfortable can be done. This operation uses ERCP to place a stent or opening tube in the bile ducts to prevent the buildup of bilirubin elements that cause jaundice. Bile duct-blocking operations may be performed if stent use is unsuitable for the patient. Clogged bile ducts will be cut off the top and reconnected to the intestine in order to channel bile.
- Make sure the pain medication is appropriate and in sufficient doses for postoperative period.
- Patients can not immediately eat or drink after undergoing surgery because the digestive system like the gut takes time to recover.
- Before the patient can eat and drink more regularly, the patient will suck fluid slowly.
- A series of chemotherapy for six months is usually recommended after surgery. This greatly affects the patient's healing opportunities.
To destroy the malignant cancer cells in the body or prevent its growth, patients can perform chemotherapy with anticancer drugs. Chemotherapy may be performed before or after surgery, or if surgery can not be performed. Chemotherapy drugs have two forms, which are consumed directly and are administered by infusion.
Chemotherapy has many side effects because it can attack healthy and normal cells. Side effects that can occur, including thrush, fatigue, nausea, and vomiting. In addition, chemotherapy may also increase the risk of infection. The side effects experienced by patients due to chemotherapy are usually only temporary and will subside once the treatment is done.
The risk of adverse effects will increase if the patient undergoes a combination of chemotherapy treatment, but this may increase the likelihood of controlling or minimizing the cancer suffered.
To help reduce the tumor and relieve the pain suffered, patients can do cancer therapy using a high-energy radiation beam called radiotherapy. For patients who can not perform surgery to treat cancer, doctors usually advise to do combination treatment of chemotherapy and radiotherapy. But this therapy has some side effects, such as loss of appetite, nausea, vomiting, fatigue, diarrhea, and skin rashes . The side effects patients experience due to radiotherapy are usually only temporary and will subside once the treatment is done.