Pancreatic Cancer Awareness Month isn’t just a period on the calendar; it’s a call to action against one of the most deadliest cancers - Pancreatic cancer. As this type of cancer does not show any noticeable symptoms at initial stages, it has a high mortality rate. What’s equally concerning is that nearly 100,000 new cases of pancreatic cancer are reported in India every year, highlighting the need for increasing awareness around it. This November, it’s time to learn about the often-ignored signs of pancreatic cancer, potential risk factors, and preventive steps.
What is Pancreatic Cancer Awareness Month?
Every year, November is observed as the Pancreatic Cancer Awareness Month, to raise awareness about pancreatic cancer. The month aims to educate the public about the symptoms and risk factors of pancreatic cancer, importance of early detection, and how to support those affected by this disease. Moreover, various organisations around the world use this time to raise funds for research around pancreatic cancer, share survivor stories, and encourage communities to engage in discussions about pancreatic cancer. By increasing awareness, the goal is to improve diagnosis rates, enhance treatment options, and ultimately save lives.
History of Pancreatic Cancer Awareness Month
Pancreatic Cancer Awareness Month was initiated in November 1999 by the Pancreatic Cancer Action Network (PanCAN) in the United States. The establishment of this month aimed to bring attention to pancreatic cancer, which had historically been overshadowed by other cancers in terms of public awareness and funding. The initiative started as a grassroots effort to educate communities about the disease, promote early detection, and encourage donations for research. Over the years, various organisations and advocates worldwide have joined the movement.
Understanding Pancreatic Cancer
Pancreatic cancer is a type of cancer that begins in the tissues of the pancreas, a gland located behind the stomach, responsible for producing digestive enzymes and hormones such as insulin. It is often diagnosed at an advanced stage, due to its unclear symptoms that not only come and go on, but may also point towards other health disorders.
Symptoms of Pancreatic Cancer
In most cases, pancreatic cancer has unclear and nonspecific symptoms, which can make early detection challenging. Common symptoms include:
Abdominal Pain: Discomfort or pain in the upper abdomen that may radiate to the back.
Jaundice: Yellowing of the skin and eyes due to bile duct obstruction, which can occur as the tumour grows.
Weight Loss: Unexplained weight loss can occur, often accompanied by a loss of appetite.
Digestive Issues: This includes nausea, vomiting, and changes in stool, such as pale or greasy stools, indicating problems with fat digestion.
New Onset Diabetes: Sudden development of diabetes in older adults can be a sign, as pancreatic cancer may disrupt insulin production.
Fatigue: Persistent tiredness and weakness are common as the body battles the disease.
Note: As the symptoms of pancreatic cancer can be easily confused with symptoms of other conditions, if you or someone you know is experiencing several of these symptoms, it is strongly recommended to consult a doctor.
Types of Pancreatic Cancer
Boradly, there are two types of pancreatic cancer, classified based on the cells in which they originate:
Pancreatic Adenocarcinoma: This is the most common type, accounting for about 95% of all pancreatic cancer cases. Adenocarcinoma develops in the exocrine cells that produce digestive enzymes. It can be quite aggressive and generally diagnosed at an advanced stage.
Pancreatic Neuroendocrine Tumours (NETs): These tumours develop in the hormone-producing cells of the pancreas. Besides being less common, they can vary significantly in terms of aggressiveness and response to treatments. In addition, NETs may produce hormones that can lead to insulinomas (excessive insulin production).
Other Rarer Types of Pancreatic Cancer
Acinar Cell Carcinoma: This cancer type arises from acinar cells and is quite rare, accounting for less than 5% of pancreatic cancers.
Pancreatic Sarcoma: Another rare type of pancreatic cancer, which originates in the connective tissues of the pancreas.
Cystic Neoplasms: These are fluid-filled sacs that can be benign or malignant, and include intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms (MCNs).
Risk Factors of Pancreatic Cancer
Several risk factors are known to be associated with an increased risk of pancreatic cancer. These include:
Age: The risk of pancreatic cancer increases with age, with most cases diagnosed in individuals over 65 years of age.
Smoking: Tobacco use is a significant risk factor, with smokers being two to three times more likely to develop the disease compared to non-smokers.
Obesity: Obesity is linked to an increased risk of pancreatic cancer, as it can lead to chronic inflammation and changes in hormone levels, which may promote cancer development.
Family History: A family history of pancreatic cancer or genetic syndromes such as BRCA2 mutations increases the risk. Individuals with immediate relatives who have had pancreatic cancer are also at a higher risk.
Chronic Pancreatitis: Long-term inflammation of the pancreas, often due to heavy alcohol use or genetic factors, can increase the risk of pancreatic cancer.
Diabetes: A sudden or unexplained diagnosis of diabetes, especially in older adults, can be a warning sign of pancreatic cancer.
Diet: A diet high in red and processed meats, refined sugars, and low in fruits and vegetables may increase the risk. Conversely, diets rich in fruits, vegetables, and whole grains are believed to lower the risk.
Exposure to Chemicals: Certain occupational exposures, such as pesticides, dyes, and chemicals used in the metal and petroleum industries, may increase the risk.
Diagnosis of Pancreatic Cancer
Diagnosing pancreatic cancer at an early stage is often challenging, as its early symptoms can be unclear or intermittent. That said, here’s an overview of key diagnostic approaches used to diagnose pancreatic cancer:
Risk Factors Assessment: The doctor checks whether there is a family history of pancreatic cancer, smoking, diabetes, and certain genetic conditions such as BRCA mutations are assessed.
Genetic Testing: For individuals with a family history of pancreatic cancer or genetic syndromes, genetic testing can identify hereditary risks, leading to earlier monitoring and potential interventions.
Imaging Tests: Doctors use imaging techniques such as CT scans, MRIs, and ultrasounds to detect any tumours in the pancreas. These methods can reveal abnormalities even before symptoms become severe.
Blood Tests: Certain blood tests, such as measuring CA19-9 levels, can help in diagnosis. Elevated CA19-9 levels may indicate the presence of pancreatic cancer, though this marker is not specific and can also be elevated in other conditions.
Endoscopic Procedures: Doctors may also use endoscopic ultrasound (EUS) that allows for a closer examination of the pancreas, and can also be used to obtain tissue samples for biopsy.
Screening Recommendations: While there are no standard screening guidelines for the general population, high-risk individuals may benefit from regular surveillance and consultations with a pancreatic cancer specialist.
Treatments for Pancreatic Cancer
The treatment options for pancreatic cancer depend on various factors, such as the stage of the cancer, the patient’s overall health, and the specific characteristics of the tumour. The primary treatment approaches include:
Surgery
If the cancer is localised, surgical procedures can be considered to remove the tumour. The most common surgical procedure is the Whipple procedure (pancreaticoduodenectomy), which is typically used to remove a tumour in the head of the pancreas. If the cancer is in the tail of the pancreas, a distal pancreatectomy may be performed. In cases where the cancer has spread extensively, surgery may not be a suitable treatment option.
Chemotherapy
Chemotherapy uses drugs to kill cancer cells or slow their growth. It is often used before or after surgery (adjuvant therapy) to reduce the risk of recurrence, or as the main treatment for advanced cancer.
Radiation Therapy
Radiation may be used in conjunction with chemotherapy, especially for patients who cannot undergo surgery. It helps shrink the tumour or control symptoms by targeting cancer cells with high-energy rays.
Targeted Therapy
This approach uses drugs that specifically target the molecular abnormalities within cancer cells, without damaging nearby healthy tissues. For example, Olaparib, a PARP inhibitor, is used for patients with BRCA mutations.
Immunotherapy
Although not commonly used to treat pancreatic cancer, immunotherapy aims to stimulate or boost the body’s immune system to fight cancer. Trials are still being conducted to assess the effectiveness of different immunotherapy agents in pancreatic cancer treatment.
Preventing Pancreatic Cancer
While there is no sure way to prevent pancreatic cancer, certain lifestyle changes and awareness of risk factors can help. Here are some preventive tips:
Maintain a Healthy Weight
Obesity is a known risk factor for pancreatic cancer. A balanced diet and regular physical activity can help maintain a healthy weight. Aim for a diet rich in fruits, vegetables, whole grains, and lean proteins while limiting processed foods and sugary beverages.
Quit Smoking
Smoking is one of the most significant risk factors associated with pancreatic cancer. Quitting smoking can dramatically lower the risk of developing the disease and improve overall health.
Limit Alcohol Consumption
Excessive alcohol intake can lead to chronic pancreatitis, which is linked to an increased risk of pancreatic cancer. Moderating alcohol consumption or abstaining altogether is advisable.
Manage Diabetes
There is a strong link between diabetes and pancreatic cancer, especially in individuals diagnosed with diabetes later in life. Managing blood sugar levels through diet, exercise, and medication can help mitigate this risk.
Regular Check-Ups
For individuals with a family history of pancreatic cancer or genetic predisposition, regular check-ups and discussions with healthcare providers about screening options can facilitate early detection and prevention strategies.
Stay Informed About Family History
Understanding family health history and genetic factors can help identify increased risks. Those with a family history of pancreatic cancer should consider genetic counselling for potential screening recommendations.
Avoid Exposure to Chemicals
Occupational exposure to certain chemicals, such as pesticides and industrial solvents, has been linked to an increased risk of pancreatic cancer. Taking precautions to minimise exposure in the workplace can be beneficial.
Exercise Regularly
Engaging in regular physical activity not only helps with weight management but also has been linked to a lower risk of several cancers, including pancreatic cancer. Aim for at least 150 minutes of moderate exercise each week.
Conclusion
Pancreatic Cancer Awareness Month serves as a reminder of the significance of awareness, early detection, and preventive measures. By understanding the risk factors and identifying the early symptoms, significant steps can be taken toward improving outcomes for patients. While we, at Artemis Hospitals, are equipped to provide comprehensive care and support for those affected by pancreatic cancer, we urge everyone to prioritise their health by scheduling regular check-ups and consultations with a doctor.
Article By Dr. Tapan Singh Chauhan
Sr. Consultant - Surgical Oncology, Robotics, GI & HPB, Gynae & Peritoneal Surface Oncology
Artemis Hospitals
