Pancreatic Cancer is a very dangerous medical condition with a very high level of mortality. As with all such conditions, it is important to detect the condition early to have a reasonable chance of saving the unfortunate victim of this dreaded disease. Given the importance of its timely detection, greater awareness about this condition can enable an earlier recognition. In many cases, that can be the difference between life and death!
Pancreatic cancer is not a very common disease, thankfully so, given the dreaded nature of this disease and its relatively poor prognosis. More often than not, it is likely to remain undetected in the early stage, with the patient and people around him rarely being aware of the possibility of this disease and seeking medical consultation for it. In view of its potentially fatal nature, awareness of its early signs and symptoms becomes a crucial factor in the survival of the patient.
Even though one may not be very likely to come across cases of this disease frequently enough to test and use their awareness, it potential life saving nature makes it worthwhile knowing about this disease.
Pancreatic cancer arises from pancreas, a small internal organ deep inside the abdomen, about 4 to 6 inches in size. Pancreas has two important roles in the human body. It secretes pancreatic juice into the gut, containing several enzymes that are very important in the digestion of food that we take. Its other function is of no less importance, consisting of secretion of insulin, which maintains and balances the blood sugar level in the body.
These cancers are one of the most fatal malignancies of human body, with probability of death within five years being around 95 percent.
One of the primary reasons for such high mortality is that in early stages, when it could be most amenable to treatment, the pancreatic cancer gives out few signs and is often difficult to diagnose.
Pancreatic cancers are of two types, depending upon the types of cells from which they arise. Endocrine Pancreatic Cancer arises from the tail of the pancreas involving cells that produce insulin. These are much less frequent and much more easily diagnosed. Exocrine Pancreatic Cancer arises from the head and body of the pancreas from where digestive enzymes are produced. It is more difficult to detect in early stages and has a far higher mortality. They are also the commoner form of pancreatic cancer.
Since pancreas is deeply seated in the abdomen and surrounded by many other organs, most symptoms of early pancreatic cancer tend to get overlooked as some minor problem of some other organ, like intestines or stomach. Most of these early signs and symptoms of pancreatic cancer are not very specific and can be similar to those arising from minor ailments in other surrounding organs. Thus, one must understand that none of these signs or symptoms are characteristic of pancreatic cancer, and yet, their presence should not be ignored, specially where the problem persists and the cause remain undetected even after a routine check-up.
Some of the more common signs and symptoms that are seen in the early stages of pancreatic cancer are listed below:
(1) LOSS OF APPETITE & WEIGHT LOSS are the most common signs seen in almost 75% of persons with pancreatic cancer.
(2) ABDOMINAL PAIN is the second most common sign seen in almost two third of patients. Characteristically, the pain is gnawing in character, radiates to the back and may be relieved by leaning forward.
(3) JAUNDICE results from encroachment of cancer of the head or body on the bile duct leading to its blockage. Obstruction of bile flow leads to accumulation of BILIRUBIN, a pigment of bile in blood that causes discoloration of skin, eyes and urine.
(4) BLEEDING INTO INTESTINES is often seen as dark tarry stools, and in such cases, stool tests would also indicate bleeding in the upper intestines.
(5) ITCHING OF PALMS & SOLES can sometimes be there because of the accumulation of bilirubin, resulting from obstruction of bile duct by cancer growth.
(6) LOOSE SMELLY STOOLS or STEATORRHEA may result from the lack of enzyme released by pancreas that are required to digest fats.
(7) HOARSENESS OF VOICE may also be seen in many patients.
(8) PARA-NEOPLASTIC SYNDROMES refer to unusual conditions caused by the chemicals released by cancer. It may consist of darkening of skin color, decomposing or shifting location of fat in the body, development of new hair or arthritis.
(9) DIABETES is an early sign in case of endocrine cancer and being easily detected, it helps in early diagnosis of endocrine cancers, provide sufficient emphasis is given to other symptoms.
One of the main difficulty in early detection of pancreatic cancer stems from the fact that none of the signs of pancreatic cancer are very specific, and most of the time these signs are observed due to other diseases. Many of these are often not taken seriously by the patients themselves, and even when consultation is made with a medial practitioner, cancer cannot be diagnosed unless other more common causes of these symptoms can be ruled out, consuming precious time in the process.
Thus, it becomes important that there is necessary awareness about the pancreatic cancer and its early signs. Once the signs alert the person, medical tests like ultrasonography, CT scan and endoscopy followed by a biopsy can help confirm the diagnosis of cancer allowing early treatment.
There is no single guideline that can solve this problem. However, given the fact that pancreatic cancer can be fatal, it is better to remember certain thumb rules and follow them.
(1) Keep yourself aware – knowing as to what could be the early indications is first and most essential step. In particular, knowing the nature of abdominal pain that is caused by pancreatic disease and the fact that it is relieved by leaning forward can be very helpful. It is important to remember that the physician only knows as much about the symptoms of the patient as the patient is able to explain, and proper description of pain or other symptoms can go a long way in suspecting the disease.
(2) Always insist on ultrasonography or abdominal scan with CAT or MRI, in case of unidentified source of persistent symptoms like weight loss, jaundice, bleeding in intestines or abdominal cramps.
(3) Go for regular comprehensive medical check-up at regular intervals, and keep your medical records readily available for the benefit of the physician
(4) Lab Investigations - Routine lab investigations can provide some significant clues for detection of pancreatic cancer. These include ABNORMAL LIVER FUNCTION TESTS suggestive of obstructive jaundice, and the presence of CARBOHYDRATE ANTIGEN 19.9 (CA 19-9), a tumor marker that suggests pancreatic cancer.
To conclude, early detection of pancreatic cancer is not easy. It is also not common often to arouse a suspicion easily. Yet, given the fact that early diagnosis is the best available option for the survival of such patients, its awareness can be one of the most valuable tools in dealing with it!
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