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Pancreatic Cancer: Why It's Mostly Silent And Ways To Detect It Early
Pancreatic cancer is one of the rarest cancers worldwide. It occurs when the cells in the pancreas, an organ in the abdomen that plays a role in digestion and hormone production, start to grow uncontrollably, forming a tumour. According to the World Cancer Research Fund (WCRF), pancreatic cancer is the 12th most common cancer. In 2022, pancreatic cancer accounted for 5.11 lakh new cases and 4.67 lakh deaths, making it the sixth leading cause of cancer-related deaths globally, responsible for nearly 5% of all cancer fatalities.
A study published in CA: A Cancer Journal for Clinicians highlights that pancreatic cancer has one of the poorest prognoses, which could be largely attributed to delayed diagnosis and the silent nature of the disease. Speaking with the OnlyMyHealth team, Dr Krishna Kiran Kannepalli, Surgical Oncologist and Advanced Laparoscopic and Robotic Surgeon at the American Oncology Institute (AOI), Hyderabad, provided detailed insights into the factors contributing to the disease's silent progression, its consequences, and strategies to improve outcomes.
Also Read: Pancreatic Cancer Is Not Always Fatal: Doctor Debunks Common Myths About Pancreatic Cancer
Why Is Pancreatic Cancer Mostly Silent And What Are The Consequences?Reportedly, up to 80% of pancreatic cancer cases are diagnosed late, when the cancer has spread and is more difficult to treat.
According to Dr Kannepalli, pancreatic cancer is difficult to detect in the early stages due to various factors.
He explained, "First, the pancreas is located deep within the abdomen, making it hard for doctors to feel tumors during routine physical exams. Second, early-stage pancreatic cancer typically does not cause noticeable symptoms, or the symptoms are vague and can be mistaken for other gastrointestinal issues, such as nausea, weight loss, or abdominal discomfort. Additionally, pancreatic tumours may not produce elevated levels of tumour markers that can be easily detected through blood tests. By the time symptoms become apparent, the cancer is often at an advanced stage, which significantly reduces treatment options and survival rates."
According to the American Cancer Society (ACS), the 5-year relative survival rate for localised pancreatic cancer, which is confined to the pancreas, is 44%, while it drops to 16% for regional cancer, which has spread to nearby structures or lymph nodes. Unfortunately, the survival rate is 3% for distant cancer, which has spread to organs like the lungs, liver, or bones. The overall survival rate across all stages is 13%.
Early Warning Signs Of Pancreatic CancerWhile pancreatic cancer often presents with no symptoms in its early stages, some subtle warning signs may include:
"These symptoms can easily be attributed to other conditions, so it's essential for individuals experiencing them, especially those with risk factors, to consult a healthcare professional for further evaluation," said Dr Kannepalli.
Also Read: Doctor Shares TWO Main Warning Signs Of Pancreatic Cancer To Watch Out For
Screening Methods That Can Help Detect Pancreatic Cancer EarlyCurrently, there are no standard screening tests for pancreatic cancer in the general population due to the lack of effective methods for early detection. However, for individuals at high risk, such as those with a family history of the disease or genetic predispositions, the following methods may be considered:
Before searching for ways to reduce one's risk of pancreatic cancer, it is important to understand and assess your risk factors.
"Genetic predispositions and family history play a significant role in the risk of developing pancreatic cancer. Approximately 10% of pancreatic cancer cases are hereditary, linked to genetic mutations in specific genes such as BRCA2, PALB2, CDKN2A, and STK11," said Dr Kannepalli.
He added, "Individuals with a family history of pancreatic cancer or related conditions, such as familial atypical multiple mole melanoma syndrome, are at a higher risk. Genetic counseling and testing can help identify individuals with these mutations, allowing for enhanced monitoring and early detection strategies, which can improve outcomes."
Regarding lifestyle changes, which may not prevent the disease but can reduce the risk, here are some strategies:
Pancreatic cancer is not as common as breast or lung cancer. However, it can also be life-threatening if not detected early and treated on time. In most cases, pancreatic cancer is silent due to its asymptomatic nature in the early stages and also due to its location in the human body. It is hidden deep within the abdomen behind the stomach, which makes it difficult to catch abnormalities even through screening tests. However, there are warning signs that can help indicate the condition and tests that can identify abnormalities.
"Consultation with a specialist is recommended for individuals at increased risk to determine the most appropriate screening strategy," concluded Dr Kannepalli.
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Understanding Pancreatic Cancer: Symptoms, Diagnosis, And Treatment Options
Pancreatic cancer is the result of abnormal cells in the pancreas growing and dividing out of control to form a tumour.
The pancreas is a gland that is situated behind the stomach and surrounded by the duodenum, liver and spleen in the abdomen. It produces hormones regulating blood sugar levels and enzymes aiding digestion. It is essential for the regulation of blood sugar levels and the preservation of normal digestion.
Pancreatic cancer is of two types:There are a few factors that can lead to a higher risk of pancreatic cancer:
In the early stage, patients are asymptomatic. Most pancreatic cancer patients present with symptoms in stage 3 & stage 4, where the disease has locally advanced or disseminated to other organs, respectively.
You should contact a doctor for further evaluation if any of these symptoms persist for you, especially if you have risk factors for pancreatic cancer (such as smoking, family history, or chronic pancreatitis). The outcomes of early intervention can vary greatly.
An oncologist and gastroenterologist treat pancreatic cancer disease.
Diagnosis of Pancreatic Cancer:Pancreatic cancer may be detected by one or more of the following tests. These examinations can also be used to determine whether the cancer has spread and whether the treatment is effective.
Pancreatic cancer can be treated with surgery, endoscopic procedures, chemotherapy, radiation therapy, or a mix of these.
Surgery:
• With early detection, surgery is the only way to possibly cure pancreatic tumour.
Common surgical procedures are:
◦ Whipple Procedure (Pancreaticoduodenectomy): The procedure involves removing the head of the pancreas and portions of the stomach, small intestine, and bile duct.
◦ Distal Pancreatectomy: The procedure involves removing the tail and body of the pancreas.
◦ Total Pancreatectomy: Removes the entire pancreas, requiring lifelong insulin and enzyme replacement.
Other treatment methods include:• Chemotherapy - Generally given to downstage borderline respectable tumors and increase chances of resectibility. In stage 4, chemotherapy is administered to control the tumour, palliate the symptoms and prolong the survival of the patient.
• Radiation Therapy - Radiation therapy employs high-energy X-rays or other radiations to either prevent the development of tumours or eliminate cancer cells. Radiation therapy is administered to specific patients to reduce the size of their tumours before surgery.
• Targeted Therapy - Targeted treatment is a cancer care strategy that uses medications or other agents to specific target molecules and processes associated with the growth, progression, and dissemination of cancer cells.
• Immunotherapy - Immunotherapy is a new type of cancer therapy that strengthens the immune system's ability to identify and fight cancerous cells, using the patient's immunity to combat the disease.
• Palliative Care - By controlling symptoms and pain, giving emotional and spiritual support, and nursing patients and families to negotiate anxiety and despair, palliative care enhances the quality of life for people living with pancreatic cancer.
Complications: Following pancreatic surgery, anastomotic leaks, delayed gastric emptying, pancreatic fistulas, hemorrhage, and infection are all possible postoperative consequences.
Conclusion:Pancreatic cancer requires early awareness, prevention, and treatment for good results, which can improve the prognosis of this condition. This vigilance empowers patients and deepens understanding of the disease, aiding in the prevention and effective treatment strategies.
Dr. Ch Mohana Vamsy MBBS, MS, DNB(SURG), MCH (SURG. ONCO), FRCS(EDIN), DIP. LAP.SURG.(FRANCE)
Oncologist & Cancer Specialist
Omega Hospitals
"This is a company press release that is not part of editorial content. No journalist of The Hindu was involved in the publication of this release."
Published - November 26, 2024 06:20 pm IST
Why Is Pancreatic Cancer So Under-Diagnosed?
The pancreas is situated deep in the abdomen, making it difficult to detect tumours
Pancreatic cancer is a type of cancer that originates in the tissues of the pancreas, an organ located behind the stomach that plays vital role in digestion and helps in blood sugar regulation. It most commonly arises in the pancreatic ducts (exocrine tumours) however may also occur in hormone-producing cells (endocrine tumours). Pancreatic cancer is notoriously hard to diagnose because it can often present with vague or no symptoms in its early stages. By the time symptoms such as abdominal pain, jaundice, or weight loss become noticeable, the disease has progressed to the advanced stages, making treatment more challenging. Additionally, the pancreas's deep location within the abdomen can make early detection through physical examination nearly impossible. In this article, we cover some common reasons why pancreatic cancer may be hard to diagnose.
10 Reasons why pancreatic cancer is so under-diagnosed 1. Lack of early symptomsIn its early stages, pancreatic cancer often causes no noticeable symptoms or only nonspecific signs like fatigue, indigestion, or mild discomfort. These are easily attributed to less serious conditions, delaying a diagnosis.
2. Non-specific symptoms in advanced stagesEven as the disease progresses, symptoms such as abdominal or back pain, nausea, and weight loss can mimic more common gastrointestinal issues like ulcers or gallstones, leading to misdiagnosis or late diagnosis.
3. Deep location of the pancreasThe pancreas is situated deep in the abdomen, making it difficult to detect tumours through routine physical exams or imaging without targeted investigations. This anatomical location hinders early diagnosis.
4. Lack of screening testsUnlike breast or cervical cancer, there are no routine screening protocols or reliable biomarkers for pancreatic cancer in asymptomatic individuals. This absence significantly contributes to its under-diagnosis.
5. Rapid progressionPancreatic cancer tends to grow and spread quickly, often reaching an advanced stage before it is detected. This aggressive nature leaves little window for early diagnosis through regular health check-ups.
6. Overlap with common conditionsSymptoms like jaundice, nausea, and loss of appetite are often mistaken for benign liver or gastrointestinal issues. Misattribution to common illnesses delays specialised diagnostic procedures.
7. Low awareness among the publicPancreatic cancer lacks the awareness campaigns and funding that cancers like breast or prostate cancer receive. Many people are unaware of its risk factors or warning signs, leading to delayed medical attention.
8. Challenges with imaging testsStandard imaging techniques like ultrasounds may miss small pancreatic tumours due to the organ's location and surrounding structures. Advanced imaging tools like CT scans or MRIs may not be utilised unless specific symptoms are present.
9. Rare nature of the diseasePancreatic cancer is relatively less common than other cancers, so healthcare providers may not immediately suspect it. This rarity leads to delays in pursuing specialised diagnostic procedures.
10. Misinterpretation of diagnostic resultsEven when tests are conducted, small tumours or subtle changes in the pancreas can be overlooked or misinterpreted as benign abnormalities, especially if the physician is not specifically looking for pancreatic cancer.
Addressing these challenges requires a multifaceted approach, including increasing awareness, developing better screening tools, and improving healthcare access to ensure timely diagnosis and intervention.
Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.
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