Pancreatic cancer is an adenocarcinoma starting from the pancreas gland. It’s the fourth most common cause of death in terms of cancer conditions. It is very difficult to be diagnosed in an early phase – when it is diagnosed about 50% of patients already have remote metastases, and with 26% of them the cancer has spread regionally. A five year survival is somewhere in the 6% of cases, while 75% of people die within first year of diagnosis.
Ethology of pancreatic cancer can be divided into two categories – environment and genetic factors. Environment factors are smoking, alcoholism, fatty foods, chemicals, chronic pancreatitis and diabetes. Estimates report that about 40% of pancreatic cancer is random at nature, while 30% of them are caused by smoking, with 20% of them being caused exclusively is eating habits. Only 5-10% of pancreatic cancers are hereditary in their nature.
Genetic factors, besides hypermethylation and strong gene expressions are divided into four groups. Accumulation of these four groups of genetic mutations is usually the main reason for the cancer to become so resistant towards chemo and radio therapy. Hereditary disorders who are a predisposition to the cancer are hereditary pancreatitis, hereditary rectal cancer, family polyposis and Gardner’s syndrome – a familiar atypical multiple melanoma. BRCA1 and BRCA2 gene mutations are considered to be critical as well.
80% of all pancreatic tumors are adenocarcinomas with a ductal epithelium. Only about 2% of the pancreatic tumors are benign. Less frequent histological chances for the pancreatic tumor include cancer of the gigantic cells.
Pancreatic cancers can metastases quickly into the regional lymph nodes, followed by liver and possibly lungs. It can infiltrate the stomach and intestines directly, as well as any surface in the abdominal cavity. Since most of the pancreatic tumors localize themselves in the head of the pancreas, gallbladder function is quickly obstructed, which results in digestive issues. If the cancer captures the tail of the gallbladder there is no obstruction so the symptoms are recognized later.
The most characteristic sign of pancreatic cancer is jaundice, which is painless. It can be recognized by a change in the patient’s skin tone. Patients with clinical jaundice can also have palpable gallbladder, which carries its own set of symptoms.
Loss of weight can also be connected to cancer, possibly mistaken by stress or anorexia, while it obviously indicates towards a completely different condition.
Pancreatic cancer is unfortunately a fatal condition, in most cases. Overall average pancreatic cancer survival rate for all patients is about 4-6 months. Relative one year survival was experienced only with 24% of patients, with a total of 5 years in survival being applied only to 5 percent of patients so far. With patients who have had their cancer resected, an average survival rate climbs up to 12-19 months, with a 5 year survival being possible for about 15-20% of patients. The best prediction factor for long term survival is a tumor with a diameter less than 3 centimeters, especially if it doesn’t infect lymph nodes and other negative resection margines.