By: Prof. Dr. Seyed Saeid Zamanieh Shahri, MD  and  Prof. Dr. Sonia Sayyedalhosseini, MD

The pancreas is a pear-shaped gland about 15 centimeters (six inches) long in the abdomen, surrounded by the stomach, small intestine, liver, spleen, and gallbladder. The enzymes produced by the pancreas helps in digesting food and the hormones of the pancreas help control our blood sugar.

What is pancreatic cancer?

Cancer is the uncontrolled growth of body cells. Normally, cells divide to form new cells as needed by the body. Old cells die and new cells take their place. Sometimes this process is disrupted. In this case, new cells are formed without the need of the body or old cells do not die. This accumulation of extra cells forms a mass called a tumor.

Uncontrolled growth and division of abnormal cells in the pancreas leads to the formation of a mass and cancer in it. This cancer is the 12th most common cancer worldwide. The most common type of pancreatic cancer is formed from the cells lining the ducts that exit digestive enzymes from the pancreas (pancreatic ductal adenocarcinoma).

Cancer is less common in the hormone-producing cells or nerve cells of the pancreas. These types of cancer are pancreatic neuroendocrine tumors and pancreatic endocrine tumors. Pancreatic cancer is rarely diagnosed in the early stages when it is treatable; Because it often does not cause symptoms until it has spread to other organs.

Signs and symptoms of pancreatic cancer:

Signs and symptoms of pancreatic cancer often do not appear until the disease is advanced.

These symptoms may include:

Heartburn radiating to the back, loss of appetite or unwanted weight loss, yellowing of the skin and whites of the eyes (jaundice), light-colored stools, dark urine, itchy skin, diabetes or uncontrolled diabetes, abnormal blood clots, and excessive fatigue.

What causes pancreatic cancer?

The exact cause of pancreatic cancer is unknown. Scientists have identified factors that may increase the risk of developing this type of cancer, including smoking and certain hereditary factors.

Risk Factors of Pancreatic Cancer:

Factors that may increase the risk of pancreatic cancer include:

Smoking, diabetes, chronic inflammation of the pancreas (chronic pancreatitis), family history of certain genetic syndromes that can increase the risk of pancreatic cancer, family history of pancreatic cancer, obesity, diet rich in red meat and processed food, normal aging (pancreatic cancer is diagnosed more often after the age of 65). A broad spectrum study has shown that the combination of smoking, long-term diabetes, and poor diet increases the risk of pancreatic cancer more than either of these factors alone.

Prevention of pancreatic cancer:

We can reduce the risk of pancreatic cancer by observing the following:

Quit smoking: If you smoke, you should try to quit. You can talk to your doctor about ways to help, including support groups, medications, and nicotine replacement therapy.

Fitness: If we have a healthy body weight, we should try to maintain it, and if we are overweight or obese, consider a plan to lose weight slowly and continuously. Daily exercise combined with a diet rich in vegetables, fruits and whole grains will help you lose weight.

Healthy diet: A diet low in fat, sugar, red meat and processed food and diet rich in fruits and vegetables and whole grains may help reduce the risk of cancer.

Consultation with your doctor:

If you have a family history of pancreatic cancer, it is better to consult a genetic counselor. By examining the family history, the doctor can determine the need for genetic testing to check the risk of pancreatic cancer or other cancers.

How is pancreatic cancer diagnosed?

The pancreas is located deep in the abdomen, so it is not easy to see or touch the tumor with the help of physical examination. Also, the symptoms of pancreatic cancer are not always clear and usually develop over time. The doctor may use several tests to diagnose, but there is no standard test to diagnose pancreatic cancer. This complicates the diagnosis. If there are symptoms of pancreatic cancer, the doctor will usually do the following:

Review of medical and family history, complete physical examination, request for blood, urine and stool tests, request for imaging tests, such as ultrasound, computed tomography scan, magnetic resonance scan or imaging, tissue sampling (biopsy)

Complications of pancreatic cancer: As pancreatic cancer progresses, the following complications may occur:

Weight loss: Some factors may cause weight loss in pancreatic cancer patients.

Weight loss may be for the following reasons: High metabolism of cancer cells, nausea and vomiting caused by treatment or tumor pressure on the stomach, disturbance in digestion and absorption of nutrients due to insufficient secretion of digestive juices from the pancreas.

Jaundice: Pancreatic cancer can cause jaundice by blocking the bile ducts of the liver. Symptoms of blockage of this duct include yellowing of the skin and eyes, dark urine and pale stools.

Pain: A growing tumor may cause severe pain by pressing on the abdominal nerves. Radiotherapy and chemotherapy may provide pain relief by slowing tumor growth.

Bowel obstruction: Pancreatic cancer growth may put pressure on the first part of the small intestine (duodenum) and block the bowel. The doctor may place a tube (stent) in the small intestine to keep it open.