Pancreatic cancer develops from the uncontrollable division of pancreatic cells due to mutations.

What are the types of pancreatic cancer?

Pancreatic cancer tumours are classified based on the cells where they originate. They may either be exocrine or neuroendocrine (NETs).

• Exocrine tumours can be found in nearly all pancreatic tumours. The most frequently occurring pancreatic cancer is adenocarcinoma of the pancreas, where cancer begins in the cells of the ducts found along the lining of the pancreas. Adenocarcinoma is the most common form of exocrine tumour, with it accounting for 95% of exocrine cancers.
• Neuroendocrine tumours (NETs) account for less than 2% of pancreatic cancers. Compared to exocrine tumours, this form of cancer typically has a better prognosis.

What are the risk factors for developing pancreatic cancer?

The following risk factors have been identified:

• Tobacco smoking
• Diabetes mellitus
• Obesity
• Excessive alcohol drinking
• Chronic inflammation of the pancreas or pancreatitis
• Genetic factors and family history of pancreatic cancer

Out of all these risk factors, a combination of smoking, diabetes, and poor diet greatly increases the risk of pancreatic cancer.

As the cancer progresses, the patient may experience complications from pancreatic cancer such as:

• Weight loss
• Jaundice
• Severe pain
• Bowel obstruction

What are the signs and symptoms of pancreatic cancer?

Pancreatic cancer may not have symptoms, or it may not be easily detectable. Some of the most common symptoms are:

• Consistent upper abdominal pain or discomfort
• Jaundice (yellowing of the skin and the white of the eyes)
• Itchy skin
• Darker colour of skin
• Dark coloured urine
• Light coloured faeces
• Loss of appetite and weight loss
• Nausea and vomiting
• Feeling tired or having no energy
• Worsening of diabetes

How do doctors diagnose pancreatic cancer?

Pancreatic cancer is hard to be detected at early stages during a typical check-up. However, if your doctor suspects that you have pancreatic cancer, they may ask for some imaging tests such as a CT scan, MRI, and endoscopic ultrasound (EUS) to be performed.

If required, the doctor may also perform an endoscopic ultrasound-based biopsy for pancreatic tissues to test further.

Blood tests may be required to evaluate liver function (in case of jaundice) and to check for high levels of tumour-specific markers such CA 19-9. This is a protein released by pancreatic cells and may indicate a tumour.

Learn more about the different types of screening and diagnostic procedures performed to diagnose pancreatic cancer.

How is pancreatic cancer treated?

Following are some common treatment options for pancreatic cancer. The treatment plan usually depends on the stage of the cancer.

1. Surgery
   • Pancreatectomy is performed to remove the cancerous parts of the pancreas. The affected lymph nodes may also be removed during the surgery.
   • Whipple procedure is done when the tumour is located in head of the pancreas. Here, the parts removed are the head of the pancreas, the duodenum, gall bladder, and some lymph nodes.
   • Distal pancreatectomy for the body or tail of the pancreas.
2. Chemotherapy
   • Chemotherapy involves the usage of anti-cancer drugs that shrink tumour before surgery, kill remaining cancer cells after a surgery, and relieve symptoms in advanced cancer.
3. Radiotherapy
   • Radiotherapy uses high-energy radiation to kill cancer cells. It is sometimes given along with chemotherapy to shrink tumour, kill cancer cells and provide symptoms relief.
4. Immunotherapy
   • Immunotherapy stimulates the immune system to recognise and destroy cancer cells.
5. Targeted therapy
   • Targeted therapy targets the changes in the pancreatic cancer cells that grows the tumour.

Pancreatic cancer treatment plan usually depends on the stage of the cancer. Treatment starts at Stage 0 when abnormal cells are found along the ducts of the pancreas. Stage 4 is the most severe stage when the tumour has grown large, and cancer has spread to other parts of the body.

Additionally, supportive and palliative care may be provided with:

• Pain management
• Jaundice treatment
• Treating intestinal blockages
• Diabetes control
• Emotional support

Learn more about the different types of treatment technologies to treat pancreatic cancer.

What can I do to reduce the risk of developing pancreatic cancer?

While pancreatic cancer cannot be entirely prevented, healthy lifestyle choices are recommended to reduce the risk of developing the disease. These include:

• Quit smoking
• Avoid overconsumption of alcohol
• Keep a healthy body weight
• Maintain healthy sugar levels

Do I need to get screened for pancreatic cancer?

There are currently no available routine screening tests for individuals at average risk. However, endoscopic ultrasound or MRI may be able to help those who are at a high risk of pancreatic cancer detect the disease early. This includes anyone with a strong family history of pancreatic cancer or a genetic condition that is known to increase their risk.

Make an appointment at Pantai Hospitals

Early detection of pancreatic cancer makes it easier to treat the disease with effective and appropriate treatment. A dedicated multidisciplinary team of specialists and oncologists at Pantai Hospitals is available for consultation to provide the best care and assistance to patients through screening, diagnosis, and treatment.

Get in touch with us to book an appointment today if you have any concerns or questions about pancreatic cancer treatment options.

Pantai Hospitals have been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.