The pancreas is a multifunctional human body that participates in the process of digestion and produces a number of hormones.
Cancer damage to the pancreas is quickly formed and passes to neighboring organs. Disease spread is in sixth place among all malignant lesions, there is an annual increase in patients with pancreatic cancer.
Concept of the disease
Pancreatic cancer combines malignant neoplasms developing in one part of the organ.
Pancreatic cancer cancers are detected annually in 8-10 people out of every 100,000 people, and this type of malignant pathology is growing. Among the sick more men, and the peak incidence falls on 60-70 years.
Photo of of pancreatic cancer
Cancerous formations in the pancreas at the first stages do not give a clear clinical picture, and this leads to late diagnosis of a dangerous ailment. Aggressiveness of the course of this type of oncology is explained by the rapid appearance of metastases. If cancer is detected in advanced stages, the forecast is unfavorable.
Code of the disease according to the ICD 10 C25 - malignant neoplasm of the pancreas. This code also has several partitions depending on the location of the tumor:
- C 25.0 - lesion of the head of the prostate.
- C25.1 is a new growth of the body.
- С25.2 - defeat of the tail part.
- С 25.3 - cancer of the prostatic ducts.
- C 25.9 - unspecified site.
Classification of
Several classifications of pancreatic cancer are used. By the structure of cells, that is, histological analysis is distinguished:
- Protocol adenocarcinomas. This form of cancer more often affects the head of the body, among patients more than men who have crossed the age of 55 years. At the time of diagnosis of the disease, the tumor size is often more than 5 cm. The average survival rate is up to 16 weeks, five-year survival is observed in only one percent of patients with ductal adenocarcinoma.
- Giant cell adenocarcinomas. Revealed in 6% of patients with malignant organ damage. The tumor is similar in appearance to hemorrhagic cysts, in half of cases it grows in the head of the prostate. The prognosis for this form of cancer is extremely unfavorable, the patients on average after an establishment of the diagnosis live two to three months.
- Mucinous adenocarcinoma. Occurs rarely, is an adenomatous malignant neoplasm. Women of this form of pancreatic cancer are exposed more often, more than half the time the tumor starts to form in the body organ. Mucinous adenocarcinoma is characterized by aggressive course, the survival rate during the year is noted only in 33% of patients.
- Mucinous cystadenocarcinoma. Occurs rarely and is localized in most cases in the body of the prostate. The main cause is malignancy of mucoid cystadenoma. Appears late. In establishing the diagnosis, the tumor sometimes reaches a size of up to 16 cm. Metastases are found in 20% of patients, if complete resection is performed, then the five-year survival rate reaches 65%.
- : Iron-squamous cell carcinoma. Detected in 4% of all malignant lesions of the pancreas. The propensity to develop glandular squamous cell cancer is three times higher in men. A neoplasm is formed in more than half the cases in the head of the organ. One-year survival is possible in 5% of cases.
- Acinar or gizzoidiform cancer. This type of cancer is more likely to affect people of a fairly young age, neoplasms are detected both in the body and in the head of the pancreas. With this type of cancer, the forecast is always unfavorable, one-year survival is observed only in 14% of cases.
- Pancreas. Detected in children, malignant neoplasm is regarded as extremely unfavorable.
- Intra-flow papillary-mucinous tumors. The main cause is excessive production of mucus and simultaneous obstruction of the ducts. In 80% of cases, it appears in women. It must be said that this type of tumor can be both malignant and benign.
Pancreatic tumors of malignant origin can produce hormones in excess.
The group of these neoplasms includes:
- Insulin. In excess, insulin is released, the main function of which is a decrease in blood glucose.
- to Gastrin. The neoplasm produces gastrin, which is responsible for the secretion of enzymes and hydrochloric acid by the stomach. This type of tumor becomes the cause of peptic ulcer.
- to Glucagon. It is produced in an increased volume of glucagon, leading to an increase in glucose in the blood.
By localization, pancreatic cancer is divided into:
- Malignant degeneration of the body.
- Head cancer.
- Tail cancer.
Manifestations of the disease at the site of localization
Symptomatic of pancreatic cancer is divided into general and one that depends on the localization of the tumor in the organ.
- The cancerous tumor that forms in the head of the pancreas causes jaundice and severe skin itching, a person who is sick finds a darkening of the color of urine and clarification of the stool, which in some cases becomes even white. Tumor compression of the duodenum and gallbladder leads to nausea and vomiting, which facilitates well-being.
- The prostate cancer of the pancreas is mainly manifested by pain, which increases in the horizontal position. This fact is explained by the fact that the tumor of the body in this position puts pressure on the solar plexus. In the advanced stages the pain is constant, and its intensity does not change from the change in the position of the body.
- The tail cancer of the body gives the least symptoms compared to other localizations of the tumor, especially in the first stages of its development. A growing tumor of the tail affects the nerve endings, lymph nodes, spleen, portal vein of the liver and this leads to the appearance of severe pain. In the tail of the gland are the islets of Langerhans responsible for the production of insulin, the cancer destroys them and the patient can be diagnosed with diabetes mellitus
Symptoms in the early stages of
The first signs in men and women that indicate a pancreatic cancer tumor are difficult to recognize on their own.
In pancreatic cancer, several of the most common manifestations of the disease are:
- Gastrointestinal signs of the disease. These symptoms appear when a growing tumor squeezes or passes to a number of organs located - liver and stomach. Common Complaints:
- In the shingling pain of a blunt character that passes from the epigastric region to the back. In the beginning, pain arises periodically, but at the last stages becomes permanent.
- On rapid stomach overflow.
- For heartburn.
- To the nausea. Often there is vomiting, which usually appears 20-30 minutes after eating and it brings relief.
- On frequent bloating.
- To change the usual gustatory sensations from eating normal foods.
- On jaundice of the skin and sclera.
- On diarrhea. With cancer of the prostate is a violation of the absorption of fat, and this leads to diarrhea, the feces have an extremely unpleasant smell.
- Systemic symptoms. Malignant pancreatic lesions are manifested by weakness, frequent dizziness, lack of appetite, sleep disturbances. Some patients complain of reduced work capacity, the appearance of unexplained anxiety, a quick change of mood. As with any cancer, cancerous formation of the prostate is also manifested by weight loss, increased sweating, and sometimes subfebrile temperature. In the later stages of destruction of tissues that produce insulin, it becomes a cause of diabetes. Transition of the malignant process to the veins of the liver leads to the development of poorly treatable thrombophlebitis of the limbs and to ascites. Some patients note a strong thirst, increased urination, the examination reveals swelling. Pancreatic cancer affects the nervous system, which causes tremors of the limbs, periodic fainting. From the heart in patients revealed tachycardia, low blood pressure, pain.
- Skin Changes. The defeat of the pancreas with a malignant neoplasm leads to a discoloration of the skin, it becomes icteric. There is a yellow coloration of the mucous membrane of the mouth, a sclera of the eyes. The emerging icterus is accompanied by the appearance of itching, which spreads throughout the body. But most of all the itch bothers in the field of feet and palms. In malignant lesions of the prostate, in some patients on the skin in the joint area appear small nodules that have a pinkish color.
Signs that occur with rare cancers
Rare forms of organ cancer include those emerging tumors that can produce excess hormones.
These types of cancer are manifested not only the above symptoms, but also those signs, the appearance of which is explained by the altered hormonal background.
- Gastrinoma is characterized by the production of gastrin , which in turn causes damage to the gastric mucosa. Patients feel almost constant pain in the stomach, eructation and heartburn, there is a decrease in weight. At inspection signs of a gastritis and a peptic ulcer of the stomach are revealed.
- Insulin leads to the production of insulin in large quantities. The hormone sharply reduces the level of sugar, which ends in dizziness, weakness, increased sweating, anxiety and a sense of fear. In severe cases, hypoglycemic coma develops.
- Glucagon. The hormone glucagon produced at this type of tumor becomes the cause of increased thirst, frequent urination, significant weight loss.
- Somatostatinoma produces a large volume of somatostatin hormone. This type of tumor manifests itself in painful sensations in the epigastric region, bloating, liquid stool with fetid odor, strong and rapid weight loss.
Investigations of patients with cancer of the pancreas revealed a small number of people who had a number of specific symptoms before the development of the main symptomatology of the disease.
About six months before the discovery of the main signs of the disease, some of these respondents found that they began to evoke habitual and even favorite smells and tastes - coffee, wine, some food, in a sudden disgust.
5% of respondents had a feeling of rapid saturation and strong weakness. One percent of people a few months before the discovery of pancreatic cancer had an acute attack of pancreatitis.
Immediate contact with a doctor should be if a long time there is a lack of appetite, weight decreases, there are persistent discomfort. Diarrhea, discoloration of feces and darkening of urine are also symptoms of serious enough diseases.
Causes of
There is no single cause leading to the development of pancreatic cancer, in 40% of patients with this diagnosis there were no common provoking factors.
But, nevertheless, an anamnesis record shows that there are several etiological conditions in which the risk of developing a new growth increases several fold is:
- Smoking. In people who smoke people, cancer, localized in one part of the pancreas, is detected twice as often compared to those who do not have this harmful habit. In the increased risk zone are people who smoke more than one pack a day. Meanwhile, refusal of smoking leads to the fact that the probability of tumor development decreases many times.
- Diseases of the pancreas. Pancreatitis and diabetes mellitus lead to a slow inflammation that can stimulate the formation of atypical cells.
- Specific features of power supply. The probability of the formation of a cancerous tumor in the tissues of the pancreas is higher in those who like fatty and carbohydrate food.
- Obesity and, accordingly, hypodynamia.
- Heredity. There is a tendency to the appearance of malignant organ damage in the blood relatives of one family.
- Alcoholism.
- Exposure to chemicals, eg asbestos, pesticides, formulations used in the metallurgical industry.
Among patients with oncological disease of the pancreas, more people over 60 years of age, and among them the percentage of men is higher. Of the races, more African African patients are affected.
Stages and prognosis of survival
- The first stage of the disease is exposed when a tumor is detected up to 2 cm in size, not extending beyond the body. At this stage of cancer development, it is possible to carry out any surgery on the technique of performing a surgical operation, which significantly prolongs life. But not all neoplasms can be removed without subsequent complications, so a positive outcome of the disease is detected only in half of the patients. At the first stage after the operation, the development of relapse in the following years is not ruled out, but other types of treatment do not even give such a chance.
- At the second stage, the neoplasm is still of minor dimensions, but the cancer cells already penetrate into the neighboring organs and into the lymphatic system. In stage 2A, fiber, duodenum, ligaments, common bile duct and liver tissue are involved in the process. Metastases are not detected. At stage 2B there is metastasis of the lymph nodes between the vena cava and the aorta. In the second stage, the survival of the patients undergoing surgery is reduced. It is especially difficult to remove the tumor located in the head, since this part of the organ is adjacent to the inferior vena cava, duodenum, aorta. Technically, the operation on the head of the prostate is complicated and is successfully completed only in 20% of cases. The long-term prognosis is also unfavorable, the five-year survival rate in the second stage is revealed only in 8% of patients.
- The third stage of prostate cancer is characterized by the germination of a tumor into the spleen, nerves, duodenum, renal artery, aorta. The transition of cancer to important blood vessels makes it impossible to perform surgical intervention. It is possible to carry out only palliative operations, which are necessary to eliminate complications caused by oncology. Chemotherapy and other treatment options alleviate the condition of the patient, but prolong the life of these methods can not more than a year.
- At the fourth stage, a malignant neoplasm of the pancreas is detected in half the cases. The prognosis is one of the most unfavorable, metastases are common in the bone system, the brain. The patient has severe intoxication, ascites, develops diabetes mellitus. With the use of modern methods of treatment, about 5% of patients survive for about a year.
Metastases
Metastasis in pancreatic cancer occurs by hematogenous, lymphogenic and implantation pathways.
With lymphogenous spreading into the cancerous process, pancreatoduodenal, retropiloric, hepatoduodenal, upper cerebrovascular, celiac and paraortal lymph nodes are involved.
Hematogenously, cancer cells are transferred to the liver, lung and kidney tissues, bone system, brain.
Implantation pathway is a contact transfer of atypical cells to organs located in the abdominal cavity.
Secondary foci for neoplasm of pancreas can be cancerous ascites and peritoneal carcinomatosis.
How to check for a malignant tumor?
If a pancreas cancer is suspected, the doctor may prescribe several studies at once, most often to determine changes in the organ, the location of the tumor and its size, use:
- ultrasound. In addition to conventional scanning, endoscopic can be used.
- Computer tomography.
- Endoscopic retrograde cholangiopancreatography, this study reveals changes not only in the pancreas, but also in the liver, ducts, gall bladder.
- Laparoscopic examination.
- Biopsy.
- Study of blood indicators, which include the definition of oncomarkers.
Is pancreatic cancer treated?
The success of the treatment of prostate cancer depends on the stage at which the malignant process is detected. There are more chances in patients with the first stage of neoplasm, but, unfortunately, the initial forms of the disease are most often an accidental finding.
In the initial stages, one of the types of surgical intervention is used, during which either the whole organ or one of its parts is removed. If necessary, the spleen is removed along with the affected lymph nodes.
When pancreatectomy is removed, not only the organ, but also part of the stomach, intestines, lymph nodes, spleen and gallbladder.
How long can I live?
In the course of a surgical operation, the patient's chances of not having a recurrence of the disease and on the successful outcome of the treatment are close to 50% of the cases. The prognosis depends on what part of the body the neoplasm is formed.
- If the cancer process begins at the head of , then removal of the tumor only in 15-25% of cases leads to positive results. In the absence of surgical treatment, 85% of patients die within the first year.
- Pancreatic body cancer is more often detected in an inoperable stage, so most patients die within a few months.
- Cancer of the tail of the body is also detected late and such a tumor rapidly germinates the hollow vein and the vessels of the spleen, which excludes the operation to remove the neoplasm. At the last stage of the disease, the lethal outcome is unavoidable within three to four months.
Malignant pancreatic disease is one of the most aggressive oncological diseases.
To identify cancer at the first stage, you need to pay attention to your own health, and rejection of bad habits and adherence to a healthy diet increase the chances of not becoming a hostage to a fatal illness.
How to get rid of the pain in pancreatic cancer, this video will tell: