Pancreatic cancer: symptoms to look out for
Pancreatic cancer is one of the most deadly forms of the disease.
Less than 1% of patients are still alive a decade after their diagnosis, with survival rates not improving at all over the past 40 years, according to Cancer Research UK.
The “brutal disease” often goes unnoticed, with around 60% of tumours only being spotted after they have spread, MedStar Georgetown Cancer Institute reports.
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While its symptoms may be vague, pancreatic cancer does cause some warning signs that could help patients get diagnosed sooner.
This Pancreatic Cancer Awareness Month, Yahoo UK looks at why pancreatic cancer is so aggressive and the symptoms to look out for.
What is the life expectancy for a patient with pancreatic cancer?
Pancreatic cancer is the eleventh most common form of the disease in England, with around 8,500 people being diagnosed every year, according to Pancreatic Cancer UK.
In the US, an estimated 55,450 will be struck down with the condition this year, Cancer.net statistics show.
Life expectancy varies depending on when the patient is diagnosed.
Those aged 15-to-49 are the most likely to beat the disease, according to Cancer Research UK.
Sadly, survival rates are poor, with pancreatic cancer having the highest mortality of all common forms of the disease.
Less than a quarter of patients (23.7%) diagnosed in England make it through the next year, while five-year survival is just 6.9%, Pancreatic Cancer UK statistics show.
In the US, the overall five-year survival rate is 9%, according to the American Cancer Society.
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Pancreatic cancer is thought to be particularly aggressive due to its location in the middle of the abdomen, close to other vital organs.
Malignant cells can therefore easily spread from the pancreas to other important tissues via the bloodstream or lymphatic system.
Pancreatic cancer cells typically go on to invade the liver, lungs or abdominal cavity, which may be impossible to remove.
The pancreas’ location also makes it hard to access.
And a lot of the time, the tumour may lie too close to blood vessels to be safely removed.
The MedStar Georgetown Cancer Institute claims up to a quarter of cases are inoperable even when the disease has not spread, with just 10-to-20% of patients being able to go under the knife.
And with the disease tending to be aggressive, more than 70% of cases that are “successfully” operated on still end up being fatal.
What are the symptoms of pancreatic cancer?
Pancreatic cancer often does not cause any symptoms in its early stages, which also makes it hard to diagnose, Pancreatic Cancer UK reports.
And any warning signs that do develop tend to be vague, and come and go.
They could also be confused for more common conditions like irritable bowel syndrome or inflammation of the pancreas (pancreatitis).
Nonetheless, look out for abdominal pain that spreads to the back. This may present as tenderness or just general discomfort.
Unexplained weight loss or continuously not feeling hungry should also raise alarm bells.
Patients may also notice a difference to their bowel habits, including diarrhoea, constipation or pale faeces that float.
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Indigestion, nausea, vomiting and difficulty swallowing can also occur. These tend to come about due to the pancreas’ role in digesting food.
Jaundice - itchy skin, and yellowing of the skin and eyes - is another symptom to look out for.
Some cancer sufferers may also have recently been diagnosed with diabetes. The pancreas produces the hormone insulin, which helps to control the amount of sugar in the blood.
If the pancreas becomes cancerous, it may stop producing insulin, leading to diabetes.
Jaundice is a medical emergency, with patients being required to go to A&E immediately.
For all the other symptoms, see your GP if they do not ease after four weeks.
If your symptoms worsen - or new ones appear - after you have been discharged, see your GP again.
How is pancreatic cancer treated?
Once diagnosed, treatment depends on a patient’s age and how advanced their cancer is.
Surgery is usually the only way to cure pancreatic cancer completely, according to the NHS.
The operation is long and complex, with a drawn out recovery.
It is therefore typically only suitable for relatively young people.
Most undergo the “Whipple procedure”, which involves removing the head of the pancreas.
Part of the bowel, gallbladder, bile duct and even stomach may also have to be taken out.
Some patients then require enzymes to help them digest their food.
More complex cases require a distal pancreatectomy, where the tail and body of the pancreas is removed.
The spleen, as well as part of the stomach, bowel, left kidney and left diaphragm, may also have to go.
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In some cases, a total pancreatectomy is required.
As well as the entire pancreas being taken out, the bile duct, gallbladder, spleen and surrounding lymph nodes are removed. Part of the small intestine and stomach also have to go.
After the procedure, patients are required to take enzymes that help them digest food.
They also become diabetic due to them losing their pancreas.
Having their spleen, which helps fight infections, taken out means they need to be on antibiotics for the rest of their life and have regular vaccinations.
The spleen also plays a role in stopping blood clotting. Patients may therefore require tablets that prevent their blood “sticking”.
Even if surgery cannot cure a patient’s disease, they may still go under the knife.
Inserting stents into the bile ducts helps keep them open to prevent the build of the chemical bilirubin, which causes jaundice.
A blocked bile duct may also be “cut” to allow bile to drain away.
Chemo may be given before surgery to help shrink the cancer or after to stop it coming back.
If the patient cannot go under the knife, chemotherapy may shrink the tumour to minimise symptoms and extend their life.
Radiotherapy can also help halt cancer growth and ease any pain.