Pancreatic Cancer Serum and Plasma

Pancreatic Cancer Overview

Pancreatic cancer is a disease in which malignant (cancer) cells form in the tissues of the pancreas. Pancreas is an organ in the abdomen that lies behind the lower part of the stomach. The pancreas releases enzymes that aid digestion and produces hormones that help manage the blood sugar.

The pancreas is a gland about 6 inches long that is shaped like a thin pear lying on its side. The wider end of the pancreas is called the head, the middle section is called the body, and the narrow end is called the tail. The pancreas lies between the stomach and the spine. The pancreas has two main jobs in the human body, to make juices that help digest and break down food and to make hormones, such as insulin and glucagon, that help control blood sugar levels. Both of these hormones help the body use and store the energy it gets from food. The digestive juices are made by exocrine pancreas cells and the hormones are made by endocrine pancreas cells. About 95% of pancreatic cancers begin in exocrine cells.

Several types of growths can occur in the pancreas, including cancerous and noncancerous tumors. The most common type of cancer that forms in the pancreas begins in the cells that line the ducts that carry digestive enzymes out of the pancreas is called pancreatic ductal adenocarcinoma. Pancreatic cancer is seldom detected at its early stages when it’s most curable. This is because it often doesn’t cause symptoms until after it has spread to other organs.

Types of Pancreatic Cancer

There are several types of pancreatic cancer, depending on whether the cancer began in the exocrine or endocrine component. Rarely, other types of cancer can begin in the pancreas, such as lymphoma and sarcoma.

Exocrine tumors: These are the most common type of pancreatic cancer. The most common type of exocrine tumor is adenocarcinoma. These tumors usually start in the ducts of the pancreas, called ductal adenocarcinoma. Much less commonly, if the tumor begins in the acini, it is called acinar adenocarcinoma.

An increasingly common diagnosis is called intraductal papillary mucinous neoplasm (IPMN). An IPMN is a tumor that grows within the ducts of the pancreas and makes a thick fluid called mucin. IPMN is not cancerous when it begins but could become cancerous if not treated. Sometimes, an IPMN has already worsened and become a cancer by the time it is diagnosed.

Much rarer types of exocrine pancreatic tumors include: acinar cell carcinoma, adenosquamous carcinoma, colloid carcinoma, giant cell tumor, hepatoid carcinoma, mucinous cystic neoplasms, pancreatoblastoma, serous cystadenoma, signet ring cell carcinoma, solid and pseudopapillary tumors, squamous cell carcinoma, and undifferentiated carcinoma.

Endocrine tumors: These are also called pancreatic neuroendocrine tumors (PNETs) or islet cell tumors. They are much less common than exocrine tumors, making up about 7% of all pancreatic cancers. A pancreatic neuroendocrine tumor can be functioning or nonfunctioning. A functioning tumor makes hormones. A nonfunctioning tumor does not make hormones. A functioning neuroendocrine tumor is named based on the hormone the cells normally make. These include:

• Insulinoma
• Glucagonoma
• Gastrinoma
• Somatostatinoma
• VIPomas
• PPomas

Signs and Symptoms of Pancreatic Cancer

Pancreatic cancer is a “silent disease” because there are not many noticeable symptoms early on in the disease. When pancreatic cancer  patients do develop symptoms, they are often similar to the symptoms of other medical conditions, such as an ulcer or pancreatitis. Following are the common signs and symptoms of pancreatic cancer as the cancer grows:

• Yellow skin and eyes, darkening of the urine, itching, and clay-colored stool, which are signs of jaundice caused by a blockage of the bile ducts
• Upper abdominal pain radiates to upper back pain 
• Blood clots
• Diabetes
• Painful swelling of an arm or leg due to a blood clot
• Burning feeling in stomach or other gastrointestinal discomforts
• Stomach bloating
• Floating stools with a particularly bad odor and an unusual color due to the body not digesting fats well
• Fatigue
• Headaches
• Loss of appetite
• Nausea and vomiting
• Chills and sweats
• Fever
• Unexplained weight loss

Pancreatic Cancer Causes

Exact causes of how pancreatic cancer develops are unknown. Researchers have identified some factors that may increase the risk of developing pancreatic cancer, including smoking and having certain inherited gene mutations.

Pancreatic Cancer Risk Factors

Following are the known factors that may increase the risk of developing pancreatic cancer:

• Smoking
• Diabetes
• Chronic inflammation of the pancreas (pancreatitis)
• Family history of genetic syndromes that can increase cancer risk, including a BRCA2 gene mutation, Lynch syndrome and familial atypical mole-malignant melanoma (FAMMM) syndrome
• Family history of pancreatic cancer
• Obesity
• Older age, as most pancreatic cancer patients are diagnosed after age 65

Studies have demonstrated that the combination of smoking, long-standing diabetes and a poor diet increases the risk of pancreatic cancer beyond the risk of any one of these factors alone.

Pancreatic Cancer Complications

As pancreatic cancer progresses, it can cause complications for patients, such as:

• Weight loss: A number of factors may cause weight loss in patients with pancreatic cancer. Weight loss might happen as the cancer consumes the body’s energy. Nausea and vomiting caused by cancer treatments or a tumor pressing on your stomach may make it difficult to eat. Or your body may have difficulty processing nutrients from food because the pancreas isn’t making enough digestive juices.
• Jaundice: Pancreatic cancer that blocks the liver’s bile duct can cause jaundice. Signs include yellow skin and eyes, dark-colored urine, and pale-colored stools. Jaundice usually occurs without abdominal pain. It may be recommend that a plastic or metal tube (stent) be placed inside the patients bile duct to hold it open. This is done with the help of a procedure called endoscopic retrograde cholangiopancreatography (ERCP). During ERCP an endoscope is passed down the throat, through the stomach and into the upper part of your small intestine. A dye is then injected into the pancreatic and bile ducts through a small hollow tube (catheter) that’s passed through the endoscope. Finally, images are taken of the ducts.
• Pain: A growing tumor may press on nerves in the abdomen, causing pain that can become severe. Pain medications can help the patient feel more comfortable. Treatments, such as radiation and chemotherapy, might help slow tumor growth and provide some pain relief. In severe cases, your doctor might recommend a procedure to inject alcohol into the nerves that control pain in the abdomen (celiac plexus block). This procedure stops the nerves from sending pain signals to the brain.
• Bowel obstruction: Pancreatic cancer that grows into or presses on the first part of the small intestine (duodenum) can block the flow of digested food from the stomach into the intestines. Your doctor may recommend that a tube (stent) be placed in your small intestine to hold it open. In some situations, it might help to have surgery to place a temporary feeding tube or to attach your stomach to a lower point in your intestines that isn’t blocked by cancer.

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