For many people, the pancreas is an unfamiliar organ, however, once the pancreas has a problem, it can often be fatal. Pancreatic cancer is one of the most malignant tumors in the body, it is the most difficult to treat and the most inconspicuous of all cancers. It is characterized by “three highs and three lows”, i.e. high incidence rate, high postoperative recurrence rate and high mortality rate, and “three lows”, i.e. low early diagnosis rate, low surgical resection rate and low drug efficiency. The International Agency for Research on Cancer (IARC) of the World Health Organization released the latest global cancer burden data for 2020 not long ago, and this data report shows that the number of new cases of pancreatic cancer in China in 2020 is about 125,000, ranking eighth in the number of new cancer cases in China in 2020, and among the top 10 cancer deaths in China in 2020, the number of pancreatic cancer deaths is about 122,000, ranking sixth. Here we will take you to learn about the pancreas and pancreatic cancer.
Normal Pancreatic Tissue
The pancreas is the second largest gland in the body after the liver. It is located deep in the upper abdomen of our body, between the stomach and the spine, usually at the height of the 1st lumbar vertebra and the 2nd lumbar vertebra. The pancreas is surrounded by other organs (small intestine, liver, spleen) and it is also relatively small, so its location is very hidden. The pancreas can be divided into three parts: head, body and tail. Although small, the pancreas performs an important function in the body. The pancreatic gland is divided into two parts: the exocrine part and the endocrine part, in which the exocrine part consists of ducts and alveoli, and the pancreatic juice secreted by the alveoli is discharged through the ducts and eventually released into the small intestine to break down sugar, protein and fat in food, which helps the body digest and break down food. These cells can secrete glucagon, which has an elevating effect on blood sugar, insulin, which has a lowering effect on blood sugar, and many other essential hormones such as growth inhibitory hormone and pancreatic peptide. Most pancreatic cancers originate in the ducts of the pancreas.
The development of pancreatic cancer
Cancer begins in the cells. Cancer occurs when the cells in the pancreas stop working properly and grow out of control. These cancer cells collect and form a mass called a tumor. Pancreatic cancer is malignant and as the tumor cells grow, the tumor grows larger and grows into nearby blood vessels and organs, eventually spreading to other parts of the body in a process called metastasis. Cancer cells can flow through blood vessels to the liver and lungs, or through lymphatic vessels to nearby lymph nodes. After spreading, cancer cells may attach to other tissues and form new tumors that destroy those tissues.
Causes of pancreatic cancer
The cause of pancreatic cancer is not fully understood and is thought to be related to the following factors.
Long-term heavy smoking: smokers are more likely to develop pancreatic cancer compared to non-smokers, and heavy smokers have the highest risk; their risk can be reduced to the same as the normal population after quitting smoking for more than 20 years
Diet: a diet high in fat, animal protein and cholesterol has also been found to be associated with pancreatic cancer
Environmental factors: long-term exposure to certain compounds such as β-naphthylamine, benzidine and hydrocarbons are carcinogenic to the pancreas
Obesity: people with BMI>35kg/m² have a 50% increased risk of the disease. Note: BMI = weight (kg)/height² (m).
Diabetes mellitus: a 50% increased risk of developing the disease in people with diabetes mellitus for more than 10 years compared to normal people
Chronic pancreatic inflammation: pancreatitis is an inflammation of the pancreas that is very painful. Chronic pancreatitis increases the risk of pancreatic cancer.
Family history: individuals with parents or siblings who have pancreatic cancer have a higher probability of developing the disease.
Alcohol abuse: Alcohol abuse significantly increases the risk of pancreatic cancer, especially when combined with tobacco.
People who have these causes in their lifestyle and have genetic factors for pancreatic cancer are accordingly at high risk.Common clinical symptoms of pancreatic cancer
Pancreatic cancer usually does not cause symptoms in its early stages and as the cancer grows, patients may experience the following symptoms.
Discomfort in the stomach area, which is the main reason why many people mistake pancreatic cancer for stomach disease for a very long time.
Prolonged abdominal discomfort of unknown origin.
absence of appetite, weight loss, weakness, low fever.
The appearance of symptoms of jaundice: the skin and sclera begin to turn yellow, accompanied by itching of the body, darkening of the urine to tea-colored, and vitriol-colored stools.
Some patients also show mental symptoms such as anxiety, impatience, depression, and personality changes.Many people are alarmed to find a lump on the pancreas during physical examination and think they have pancreatic cancer. In addition to pancreatic cancer, there are also pancreatic cancer neuroendocrine tumors and possibly benign tumors on the pancreas. How to determine which kind of tumor it is requires a puncture biopsy or surgical resection for pathological examination to be clear.
High risk groups for pancreatic cancer
People over 40 years old with any of the following
- family history of pancreatic cancer, history of diabetes mellitus.
- a history of long-term smoking, alcohol consumption, high fat and high protein diet
- symptoms such as fullness and discomfort in the upper and middle abdomen without obvious causes, abdominal pain, loss of appetite, weakness, diarrhea, wasting or back pain.
- recurrent episodes of chronic pancreatitis, especially when combined with pancreatic duct stones.
- patients with diseases such as mucinous papilloma of the main pancreatic duct type, mucinous cystic adenoma or solid pseudopapillary tumor with elevated serum CA19-9.
- patients with recent onset of sudden onset diabetes without family history of the disease.
Screening of pancreatic cancer
- screening means: blood test results of CA19-9 and other tumor markers combined with abdominal CT and MRI for screening, B ultrasound can also provide corresponding help.
- Screening interval: For high-risk groups, especially those with family history and those with existing pancreatic lesions, annual CT or MR examination is recommended.
Prevention of pancreatic cancer
Surgical resection is currently the main method to cure pancreatic cancer, but the probability of recurrence and metastasis after surgery is high. The best way to fight against cancer is prevention. We advocate the prevention of pancreatic cancer through the following methods.
- Quit smoking and alcohol. Smoking and alcohol are the triggering factors of many tumors, so it is important to quit smoking and alcohol and maintain a healthy lifestyle.
- advocate a light diet and try to consume easily digestible, low-fat foods.
- Eat more poultry, fish and shrimp, more fruits, and promote the consumption of “ten” flower vegetables, such as bok choy, cabbage, radish, broccoli, etc.
- Do more exercise, more than 3 times a week, more than 30 minutes each time, advocate a combination of outdoor aerobic activities and strength exercise.
- To prevent the deterioration of benign lesions, patients with benign pancreatic lesions such as pancreatic duct stones, intraductal mucinous papilloma and cystic adenoma should seek timely medical attention.
Pancreatic cancer, the king of cancers, is extremely malignant, so its incidence and mortality rate should be reduced through prevention and early treatment. First of all, we should maintain a healthy lifestyle and improve immunity to prevent pancreatic cancer; secondly, early detection is very helpful to its later treatment, so we should not let go of any signs and symptoms of pancreatic cancer and go to hospital for examination in time; finally, if pancreatic cancer is diagnosed, we should keep a positive attitude and cooperate with doctors actively to overcome the “King of Cancer”. Finally, if you are diagnosed with pancreatic cancer, you should keep a positive attitude and actively cooperate with your doctor to overcome the “King of Cancer”.
