Cancer of the pancreas

Health and Nutrition > Diseases > C Written by Dr Paul Klenerman, consultant physician

What is cancer of the pancreatic gland?

The pancreas is an oblong-shaped organ located deep in the middle of the upper stomach region. Cancer of the pancreas is the result of malignant cell changes, usually in the head of the gland.

Over the last 20 years the number of new cases of pancreatic cancer has remained steady. The incidence in the UK is estimated at 9 cases per 100,000.

The disease is more common in the elderly, and men are more prone to it than women. It is the fifth most common cause of cancer mortality in the UK.

What causes pancreatic cancer?

The precise cause is not known, but smoking and diets rich in red meat and cholesterol are suspected.

Other theories suggest that exposure to petroleum products and certain other chemicals may also cause the disease.

What are the symptoms of cancer of the pancreas?

Because the initial symptoms are very faint, cancer of the pancreas is detected usually only at a late stage.

The first symptoms include loss of appetite, a loathing of food and weight loss, though these symptoms may be caused by other factors. Other symptoms that may appear include fatigue, jaundice, vomiting and diarrhoea. Abdominal pain may also be present.

A deep, piercing pain in the top part of the stomach, radiating to the back, may stem from the pancreas, though such pain is often due to much more benign conditions.

Finally, some individuals develop diabetes as a first symptom.

How is it diagnosed?

The diagnosis is usually made with an ultrasound examination or by a CT scan. Special biopsy techniques are also used; an ERCP may also be performed.

Prognosis

The five-year survival rate is only about 2 per cent. Most patients do not survive the first year after the diagnosis.

An operation can be performed if the tumour is detected at a very early stage, but even this technique has a five-year survival rate of only about 10 to 20 per cent.

Palliative care, therefore, plays a very important role in this type of cancer.

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