We make a distinction between tumors that are non-cancerous (called benign*Mass of non-cancerous cells that develops locally without producing metastases.), precancerous*Mass of abnormal cells that can transform into cancer if not properly treated. and malignant*Mass of cancerous cells that can cause metastases if not properly treated. A malignant tumour is a group of cancerous cells that can spread beyond the tissue where they have developed and cause satellite tumours in other parts of the body ([metastasis*). Precancerous tumors have their name because their growth is still controlled and does not produce metastases. However, they can become cancerous.
In the vast majority of cases, pancreatic cancer starts in the cells of the pancreatic canal, whose function is to transport pancreatic secretions to the digestive system. This type of cancer is called ductal adenocarcinoma of the pancreas.
Symptoms of Pancreatic Cancer
Pancreatic cancer rarely causes symptoms at the beginning. When symptoms do appear, the disease is often at an advanced stage. The main signs suggestive of pancreatic cancer are:
- sudden yellowing of the skin and the whites of the eyes (jaundice),
- dark urine and/or diarrhea,
- diffuse abdominal pain forming a kind of belt around the back,
- nausea and/or vomiting,
- a loss of appetite and weight,
Causes of Pancreatic Cancer
In most cases, the origin of the disease is unknown. A genetic predisposition is implicated in some cases.
Le principal paramètre associé au cancer du pancréas est le tabagisme, qui serait responsable de plus de 20 % des cas. Le risque augmente avec le nombre de cigarettes fumées et d’années de consommation.
The main factor associated with pancreatic cancer is smoking, which has a causal role in over 20% of cases. The risk increases with the number of cigarettes and years smoked.
This disease is also more common in people with diabetes. Diabetes*A disease that affects the way the body regulates blood sugar levels. Diabetes is referred to as type 1 when the person is born with it, and type 2 when it is acquired. is evidence of a dysfunction in the way the body responds to insulin, a hormone secreted by the pancreas that regulates blood sugar levels. A third of the people diagnosed with pancreatic cancer also have diabetes.
Other risk factors include:
- old age (more than half of people diagnosed are over the age of 70),
- a family history of the disease (one or more close relatives have had pancreatic cancer),
- excessive alcohol consumption,
- recurrent inflammation of the pancreas (chronic pancreatitis potentially due to alcohol),
- being overweight.
Diet plays an important role. Eating too much red meat and fatty food is associated with pancreatic cancer, and the risk increases if the person is also overweight and does not do enough exercise.
Treating Pancreatic Cancer
Surgical removal of the tumor and adjacent tissues is the main treatment for pancreatic cancer with, in addition, chemotherapy*A drug treatment that targets cancer cells. combined with radiotherapy*A medical treatment that uses radiation to destroy cancer cells and block their ability to multiply. (chemoradiation).
Several factors, namely the size, location, and stage of the disease, help determine whether it is possible to remove the tumor surgically. There are three types of tumor: resectable*A tumor is deemed resectable if it can be removed surgically. Inversely, it is deemed non-resectable if it is impossible to operate on, for example because it is too large or it has metastases., borderline resectable, and non-resectable.
In very advanced cases of pancreatic cancer, palliative surgery can sometimes be performed. The aim of such surgery is to relieve the painful symptoms by removing the part of the tumor that is resectable.
Progression and Possible Complications
The main risk is that cancer cells will spread to other parts of the body (metastases). When this happens, it most commonly affects the liver, abdomen, and lungs.
Cancer is referred to as localized when the tumor, whether it is the original tumor or a recurrent one, has not spread past the point that it can be removed.
Chances of recovery are clearly best if the cancer is diagnosed at an early stage and the tumor is therefore still resectable.
Preventing Pancreatic Cancer
The general medical advice for prevention and staying healthy apply to pancreatic cancer. This simple advice includes eating healthily, not smoking, limiting alcohol consumption, and moving enough.
For smokers, the risk of developing pancreatic cancer reduces as soon as they stop consuming tobacco. The longer they go without smoking, the further the risk falls.
When Should You Contact the Doctor?
The following signs and symptoms could indicate pancreatic cancer:
- sudden yellowing of the skin and the eyeballs (jaundice),
- localized pain in the upper part of the abdomen or back,
- bloating, gas, the feeling of having eaten too much after a light meal, nausea, and/or vomiting,
- diarrhea, constipation, and oily stools that float on the surface of the toilet water,
- unexplained weight loss or loss of appetite, tiredness.
Care at Hôpital de La Tour
An ultrasound scan*A medical imaging technique that uses ultrasound to “see” the inside of the body. an MRI*A medical imaging technique used to obtain 2D or 3D images of the inside of the body., and an endoscopy*A medical examination performed using a probe (endoscope) equipped with a camera that is slid down the throat into the digestive system. are normally performed to diagnose pancreatic cancer.
The ultrasound takes snapshots of certain parts of the body using high-frequency sound waves. Magnetic resonance imaging (MRI) uses magnetic and radio waves to produce 3D images of organs and tissues.
Finally, an endoscopy is used to examine the pancreas and neighboring organs using a flexible probe (endoscope) equipped with a camera that the physician slides down the throat into the digestive system. Blood tests can also be done.