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Pancreatic cancer is the tenth most common cancer in men and the seventh most common in women.

The most common type of pancreatic cancer is adenocarcinoma, which begins in the cells that line your organs.

What is pancreatic cancer?

Pancreatic cancer begins when abnormal cells in the pancreas grow and divide out of control and form a tumor.
 
The pancreas is a gland located deep in the abdomen, between the stomach and the spine. It makes enzymes that help digestion and hormones that control blood-sugar levels.
 
Organs, like the pancreas, are made up of cells. Normally, cells divide to form new cells as the body needs them. When cells get old, they die, and new cells take their place.
 
Sometimes this process breaks. New cells form when the body does not need them, or old cells do not die. The extra cells may form a mass of tissue called a tumor.
 
Some tumors are benign. This means they are abnormal but cannot invade other parts of the body.
 
A malignant tumor is called cancer. The cells grow out of control and can spread to other tissues and organs.
 
Even when the cancer spreads to other areas of the body, it is still called pancreatic cancer if that is where it started. Pancreatic cancer often spreads to the liver, abdominal wall, lungs, bones and/or lymph nodes.

Signs and Symptoms of Pancreatic Cancer

Pancreatic cancer may cause only vague, unexplained symptoms, such as:
 
_Pain, usually in the abdomen or back
_Weight loss
_Jaundice (yellowing of the skin, eyes or both) with or without itching
_Loss of appetite
_Nausea
_Changes in stool
_Pancreatitis (swelling of the pancreas)
_Recent-onset diabetes
 
If you are experiencing one or more of these symptoms, we urge you to speak to your doctor immediately and reference pancreatic cancer.
 
Fatigue, weakness and depression are also symptoms. A person with advanced pancreatic cancer may also have fluid in the abdomen and blood clots.

What causes pancreatic cancer?

There isn’t a clear answer. We don’t know exactly what causes pancreatic cancer. But experts have identified some risk factors.

Pancreatic cancer risk factors

Anything that increases your chance of developing pancreatic cancer is a risk factor. Some risk factors can be changed, while others cannot.
 
*Risk factors that can be changed include:
 
_Smoking and tobacco use: People who smoke are about twice as likely to develop pancreatic cancer.
_Obesity: Being very overweight (having an elevated body mass index, or BMI) increases your chance of developing pancreatic cancer by 20%.
 
*Other pancreatic cancer risk factors can’t be changed, including:
 
_Age: The risk of pancreatic cancer increases sharply after 55 years old.
_Race: African-Americans are more likely to have pancreatic cancer than other ethnic groups.
_Family history: Hereditary genetic changes may account for about 10% of pancreatic cancers. Examples of genetic syndromes that can cause exocrine pancreatic cancer include: Hereditary breast and ovarian cancer syndrome caused by mutations in the BRCA1 or BRCA2 genes, Lynch syndrome (usually defects in MLH1 or MSH 2 genes), and hereditary pancreatitis due to mutations in PRSSI gene.
_Diabetes: People with long-standing history of type 2 diabetes have an increased likelihood of developing pancreatic cancer.
_Chronic pancreatitis: Long-term inflammation of the pancreas is linked with increased pancreatic cancer risk, especially in smokers.
 
Not everyone with the above risk factors gets pancreatic cancer. However, if you have risk factors, you should discuss them with your doctor.

Complications of pancreatic cancer

Pancreatic cancer tends to spread (metastasize) to nearby blood vessels, lymph nodes, and then to your liver, peritoneum (the lining of your abdominal cavity) and lungs.
 
The majority of pancreatic cancers have already spread beyond the pancreas at the time of diagnosis.

Tests for pancreatic cancer

You will need tests and scans to check for pancreatic cancer if a Doctor refers you to a specialist.
These tests can include:
 
_blood tests
_scans, like an ultrasound scan (sometimes from inside your body using a thin, flexible tube called an endoscope), CT scan, PET scan, or MRI scan
_collecting a small sample of cells from the pancreas (called a biopsy) to be checked for cancer
_a small operation to look inside your tummy, called a laparoscopy
_a test called an ERCP – where an endoscope is passed through your mouth to your stomach and X-rays are taken of your pancreas
 
You may not have all these tests.
 
These tests can also help find problems in other nearby organs, such as your bile ducts, gallbladder or liver.

Pancreatic Cancer Diagnosis

Pancreatic cancer is difficult to detect and diagnose for the following reasons:
 
*There aren’t any noticeable signs or symptoms in the early stages of pancreatic cancer.
*The signs and symptoms of pancreatic cancer, when present, are like the signs and symptoms of many other illnesses.
*The pancreas is hidden behind other organs such as the stomach, small intestine, liver, gallbladder, spleen, and bile ducts.

Some people decide to get a second opinion

You may want to get a second opinion to confirm your pancreatic cancer diagnosis and treatment plan. If you seek a second opinion, you will need to get medical test results and reports from the first doctor to share with the second doctor. The second doctor will review the pathology report, slides, and scans. They may agree with the first doctor, suggest changes or another treatment approach, or provide more information about your cancer.
 
To learn more about choosing a doctor and getting a second opinion, You can contact Us via chat (both in English and Arabic) for help finding a doctor, or getting a second opinion appointment directly Through Link.

Treatment for pancreatic cancer

Pancreatic cancer can be difficult to treat. It may include surgery, chemotherapy, radiotherapy and supportive care
 
The treatment you have will depend on:
 
_the size and type of pancreatic cancer you have
_where it is
_if it has spread
_your general health
 

*Surgery

Your treatment will depend if the cancer can be removed or not.
 
_if pancreatic cancer is found early and it has not spread, you may be able to have surgery to remove it
_if the cancer cannot be removed, you may have surgery to help control some of your symptoms.
 
Surgery to remove pancreatic cancer
There are several surgeries used to treat pancreatic cancer.
 
Surgery will remove part or, in a small number of cases, all the pancreas. All or parts of other organs around the pancreas may also need to be removed.
 
Recovery from surgery to treat pancreatic cancer can take a long time. The specialist team looking after you will discuss all the benefits and side effects.
 
Surgery to help control symptoms of pancreatic cancer
This can include surgery to:
 
_unblock the bile duct or stop it getting blocked, which helps with jaundice
_unblock the first part of the small intestine (duodenum) or to stop it getting blocked, which helps with feeling or being sick
_bypass a blockage in the bile duct or small intestine (duodenum), which helps with jaundice and feeling or being sick
 
Many of these procedures are done using endoscopy, where the surgeon uses a long, thin, flexible tube to reach the blockage or organ.
 
The aim of these operations is to help improve your symptoms, not to cure the cancer.
 

*Chemotherapy


Chemotherapy uses medicines to kill cancer cells.
 
You may have chemotherapy for pancreatic cancer:
 
_to control symptoms if you’re not able to have surgery because you are very unwell, or the cancer cannot be removed by surgery – it may be combined with radiotherapy (chemoradiotherapy)
_after surgery to help stop the cancer coming back
_before surgery to help make the cancer smaller
_to treat early cancer
 

*Radiotherapy


Radiotherapy uses high-energy rays of radiation to kill cancer cells.
 
Radiotherapy is not often used to treat pancreatic cancer. But you may have radiotherapy:
 
_to treat early cancer if you are not able to have surgery because you are very unwell or the cancer cannot be removed by surgery – it’s usually combined with chemotherapy (chemoradiotherapy)
_with chemotherapy before surgery to help make the cancer smaller
_to help control and improve the symptoms of advanced cancer
 

*Supportive care


There are several other treatments that can help you feel better and improve the symptoms of pancreatic cancer. This is called supportive care.
 
Treatments can help with many symptoms of pancreatic cancer, including:
 
_problems eating and weight loss, including prescribing enzyme replacement tablets to help you digest your food better
_relieving any pain
_tiredness
_feeling or being sick, including prescribing anti-sickness tablets
 
The specialists will talk to you about what supportive care you might need.

When to see a doctor

Make an appointment with a health care professional through LINK if you have symptoms that worry you.
المصادر والمراجع
 
https://www.mdanderson.org/cancer-types/pancreatic-cancer.html
https://www.cancer.gov/types/pancreatic/patient/pancreatic-treatment-pdq
https://my.clevelandclinic.org/health/diseases/15806-pancreatic-cancer
https://pancan.org/facing-pancreatic-cancer/about-pancreatic-cancer/what-is-pancreatic-cancer/
https://emedicine.medscape.com/article/280605-overview
https://www.nhs.uk/conditions/pancreatic-cancer/tests-and-next-steps/
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