pancreatic cancer

Pancreatic cancer

Pancreatic cancer occurs when healthy cells in the pancreas tissue become malignant. Pancreatic cancer is a serious disease that is for unknown reasons becoming more common. In Finland, more than 1000 new pancreatic cancers are diagnosed each year.

Pancreatic cancer occurs when healthy cells in the pancreas tissue become malignant. Pancreatic cancer is a serious disease that is for unknown reasons becoming more common. In Finland, more than 1000 new pancreatic cancers are diagnosed each year.


Pancreatic cancer is a disease of elderly people and is found most in the 70 years of age. Sometimes it is also found in young people.

The pancreas is about 15 cm tall, a latte-like pear-shaped organ. It is located behind the stomach in the small intestine. The wide right part of the pancreas is called the caput, there is a middle part (corpus), and the narrow left part is called a tail (cauda).

Haiku has two functions: firstly, it produces the enzymes necessary for digestion and, secondly, hormones such as insulin, which regulate the use and storage of food in the body.

The vast majority of all pancreatic cancers begin with the part that produces the digestive enzymes needed. The cancer of this type of peacestanding is called adenocarcinoma.

Pancreatic cancer is a rare form of neuroendocrine tumors (neuroendocrine tumour NET), and its one subform is called islet cell carcinoma. Islet cell carcinoma begins with a portion of the hormone production in the pancreas, or an endocrine-disrupting component.

Pancreatic cancers about three percent are neuroendocrine origin. NET tumors are very different in nature from pancreatic adenocarcinoma.

Emitters
The factors influencing the emergence of pancreatic cancer are unknown. Smoking in men, chronic female infections, diets and diabetes are suspected of being linked to cancer.

What causes cancer?

Cancer prevention (without cancer)

Pancreatic cancer
Symptoms
Pancreatic cancer symptoms resemble many other symptoms of the disease and are not always in the early stages. The most common symptoms are weight loss, upper abdominal pain, back pain and yellowing of the skin. Also, bowel function often changes. As a result, diarrhoea and nausea may occur, and sometimes vomiting is also present.

Due to vague symptoms, pancreatic cancer is often found woefully late. In addition, pancreatic cancer is difficult to detect because the pancreas is hidden from other organs in the back and the cancer has room to grow. The stomach, the small intestine, the bile ducts, the gall bladder, the liver and the spleen surround the pancreas.

Pancreatic cancer symptoms may include pancreatic and venous infections, liver enlargement or diabetes.

Pancreatic cancer detection and studies
In patients with suspected pancreatic cancer, there are several ways to study. In general, the tumor is searched by ultrasound, or by an echo study, by CT scan (TT) or by magnetic resonance imaging. These studies are painless. They also often provide an insight into how widespread the cancer has spread.

The suspicious change in the pancreas may be sampled through a needle during a computerized tomography or an echocardiography. The sample may also be taken with a star in the ECCRP study.

In an ERCP study (endoscopic retrograde colonoscopy) a flexible glass-fibre-optic arthroscopy is routed through the mouth and throat to the stomach and then further into the small intestine. Through this pipeline, the researcher injects the contrast agent and sees the area of the subject, such as the pancreas and bile ducts. An ultrasound scan can also be associated with endoscopic research. Often in the same context, a plastic or metal mesh exam is injected to open blocked bile ducts.

Pancreatic cancer can also be searched by the PTC test (percutaneous transhepatic clangography). This method of research is usually used if ERCP fails. In this experiment, insert a thin needle through the right side of the liver, and a contrast agent to the bile ducts is injected through the needle. The X-rays indicate whether additional tissues that clog the road are found. The PTC procedure is usually performed to investigate clogged bile ducts with X-ray contrast agent and to open bile ducts by stout.

Other imaging methods, such as the PET-TT description, are also less commonly used.

When suspected of pancreatic cancer, a blood sample of the tracer CA 19-9, which is part of pancreatic cancer cells to secrete. However, it is only seen in about 80% of pancreatic cancer patients.

Despite these research methods it may happen that pancreatic cancer is diagnosed only after surgery. In surgery, the surgeon examines the pancreas and its adjacent tissues. At the same time, a perception of tumour prevalence can be obtained.

Cancer detection and studies

Pancreatic Cancer classification

The selection of pancreatic cancer treatment and the patient's prognosis depend on the prevalence of the tumour and the patient's overall condition. Prevalence is expressed by the use of the TNM classification or the habitat classification. The TNM-classification T (tumor) represents the tumour intrusion into its environment, N (node) spread to nearby lymph nodes and M (metastasis) for potential metastases. Lymph nodes are small pavulike filters through which the lymph flows.

The majority of pancreatic cancers have already been spread outside the pancreas when they are noticed. Metastases are also common. Pancreatic cancer tends to spread to lymph nodes in addition to the liver, lungs, peritoneum and the adrenal glands.

Parent tumor:

The TX parent cannot be classified.

T0 no indication of the parent's tumor.

Tis Carsinoma in situ (cancer precursor).

The T1 tumor is confined to the pancreas and its diameter is not more than 2 cm.

T2 tumor is confined to the pancreas and its diameter is more than 2 cm.

T3 tumors penetrate outside the pancreas, but neither Keliakarunkoon nor the upper mesenteric artery.

T4 the tumor penetrates the keliakarunkoon or the upper mesenteric artery.

Regional lymph nodes:

NX lymph nodes cannot be classified.

No no tumor tissue in the regional lymph nodes.

N1 tumor tissue in regional lymph nodes.

Metastases farther away:

M0 no metastases farther.

M1 metastases farther away.

Habitat classification

Grade 0 TisN0M0

Order IA T1N0M0

Order IB T3N0M0

Aste IIA T3N0M0

Order IIb T1 – 3N1M0

 Grade III T4N0 – 1m0

Grade IV T1 – 4n0 – 1m1

Cancer phases, differentiation and penetration

Pancreatic cancer treatment

Surgery is the only form of treatment that has the potential to cure pancreatic cancer. A permanent healing surgery is possible if the cancer has not sent metastases or increased to the surrounding blood vessels or organs.

If locally advanced pancreatic cancer cannot be cut, its treatment is usually started with a cell blocker and the situation is evaluated after a few months. Sometimes chemotherapy is combined with radiation therapy, in which case it is known as ' ketone treatment '. If the tumor responds to treatment, i.e. decreases well, the surgical possibilities can be reassessed. If necessary, chemotherapy may also be continued after surgery.

Also, only radiation therapy can be used if local cancer cannot be cut.

Cancer treatments

Surgery

Pancreatic cancer is cut whenever possible. A permanent healing surgery is performed if the tumor is small and if it has not sent metastases.  The spread of local lymph nodes usually does not inhibit widespread surgery. The problem is that only 10% to 15% of patients can be treated with such extensive surgery to eliminate all cancer tissue.

Pancreatic cancer surgery treatment is complex. Therefore, a number of methods are available to choose the appropriate situation. The most common In the case of Whipple's surgery, the pancreatic tumor-bearing component, duodenum, half of the stomach and part of the biliary tract and the nearby lymph nodes are removed. A portion of the pancreas saves, which allows the pancreas to still produce enough liquids and insulin to digest the digestive tract.

The size of pancreatic removal differs from the previous one in that it also eliminates the spleen and lymph nodes extensively. Since the pancreas is completely eliminated, the patient develops insulin-requiring diabetes and after the spleen is removed further vaccinations are required.

The third cut method removes the middle part and tail of the pancreas. There is also a need to remove the spleen.

Extensive, permanent healing surgery is now combined with post-surgical chemotherapy, the so-called adjuvant therapy. This will ensure that all cancer cells have been obtained without any doubt being destroyed.

Symptoms of surgery are possible if the pancreatic cancer has spread and cannot be removed. Sometimes the cancer clogs the bile ducts so that the bile is impaptable in the gall bladder. In this case the blockage can be bypassed and controlled by the bile to traverse the small intestine.

If the cancer clogs the food from the stomach, the blockage can be bypassed by making a sexual intercourse (anatomosis) from the stomach to the small intestine, allowing the patient to continue to enjoy the food orally.

Cancer surgery

Radiotherapy

Radiation therapy for pancreatic cancer is complicated by the fact that organs around the pancreas are easily damaged. Pancreatic cancer is also not particularly sensitive, so it requires high radiation doses. The treatment is carefully planned with the help of computer research.

Radiation therapy is mainly used if the cancer is localized and the tumor is tried to shrink so that it could be cut. Treatment lasts about five weeks.

Treatment. Radiotherapy can also be used in combination with chemotherapeutic agents. The most common is to combine the radiotherapy with gemsitabine or fluoruracil, e.g. tablet medicine as capecitabine.

Treating the symptoms with radiotherapy. Sometimes radiation therapy is used to relieve symptoms of metastases, and a shorter treatment may also be sufficient.

Radiotherapy

cell blockers

Cell blockers are drugs for the destruction of cancer cells. They can be given as tablets or as a drip directly into a vein. Chemotherapy is unfortunately not a cure for the spread of pancreatic cancer, but it can relieve the symptoms caused by the disease. In addition, it extends life time to some extent. The treatment alignment is a brake on the progression of the disease.

Chemotherapeutic agents are used if the pancreatic cancer cannot be cut. However, no effective medicine or combination of medicines is yet in place, so new therapies are being investigated.

Gemsitacine is most commonly used to treat pancreatic cancer in the treatment of chemotherapeutic agents. It is usually a well tolerated drug that causes little side effects. Fluoruracil is sometimes also used. In well-condition patients, composite chemotherapy with a combination of gemsitababine, fluoruracil or capecitabine may be considered, using another chemotherapy or several chemotherapeutic agents (e.g. NAB-paclitaxel, Oxaliplatin, Capecitabine, or NAL-iri).

According to current knowledge, the most effective treatment is Folfirinox, which combines fluoruracil, oxaliplatin, irinotecan and calcium folinate. Combination therapies are much more severe than gemsitabine therapy and are therefore recommended only in good condition and adolescents. The stent also causes some limitations to the combination of the choice of treatment.

cell blockers

Other medicines

cell blockers resonate with poorly spread pancreatic cancer, so a lot of new biological agents have been studied. Erlotinib is used in new medicines, which can be used in combination with Gemsitababine as first-line treatment of pancreatic cancer, but other medicines are only in the research phase.

Pancreatic Islet cell carcinoma

Symptoms

Islet cell carcinoma First symptoms are usually upper abdominal pain, nausea, persistent fatigue, weakness and sudden weight gain. Due to these symptoms, seek medical attention.

The so-called functional islet cell cancers cause symptoms depending on the hormones they secrete. Insulinoma causes, for example, hypoglycaemia (which results in neuroglypathic and sympathetic nervous system symptoms) and gastritis recurrent gastric ulcers and prolonged diarrhoea.

Pancreatic islet cell cancer detection and studies

Since the symptoms of islet cell carcinoma are general, a wide range of studies may be required to investigate the disease. Often the same research methods are used as for other pancreatic cancers.

It may also be useful to view pancreatic vascular disease, since tumour vascular disease often differs from normal eternity. Pancreatic vasculsis can be viewed by an X-ray study, where a contrast agent is injected into the blood vessels. Urine and blood tests are tested for hormone levels in the body.

The diagnosis of insulin insulinoman is based on an inappropriate increase in serum insulin found in the 72-hour fasting test. The diagnosis of Gastrinoman is aimed at demonstrating the inappropriate secretion of gastritis, and diagnostics can be confirmed in laboratory studies. Sekretin.

Cancer detection and studies

Pancreatic Islet Cell Cancer classification

Islet cell carcinoma can be divided into functional and non-functional cancer. In functional edible islet cells, hormone production accelerates and cells produce extra hormones. In non-functional edible hormonal production remains normal.

The functional islet cell cancers are several types and are named after the hormones they secrete. The most common are insulinoma and gastroinoma.

Insulinoma produces too much insulin hormone. Insulin regulates the metabolism of the body's carbohydrates, or sugar compounds, and converts blood glucose to energy. If too much insulin is excreted, the blood sugar level decreases and sugar is stored in the tissues. Low blood sugar levels are called hypoglycaemic episodes. Its symptoms include disturbances in consciousness, visual disturbances, lack of concentration, convulsions, hunger and sweating.

A gastro-tumor produces large amounts of a hormone called gastrin. Gastrin increases the production of stomach acids, and the gastric mucosa is therefore readily accessible.

Other types of islet cell carcinoma can occur in the pancreas, small intestine or stomach. These include, for example, Glukagonoma, Somatostatin, Vipooma and carcinomas. Tumors can confuse the body's hormonal balance and cause a wide range of symptoms.

The prevalence of islet cell carcinoma is classified in three categories:

1. Single islet cell carcinoma in the pancreas

2. In several parts of the pancreas manifested as an islet cell carcinoma

3. Islet cell carcinoma to nearby lymph nodes in the pancreas or to other parts of the body

Cancer phases, differentiation and penetration

Pancreatic islet cell cancer treatment

Pancreatic islet cell carcinoma can be treated with surgery, chemotherapy and hormone therapy.

The treatment of islet cell carcinoma depends on the prevalence of cancer, the type of cancer and the patient's overall condition. Gastro-type islet cell carcinoma can be treated in addition to surgery, including by cutting off the pancreas-regulating nerve or by blocking the hepatic artery.

In the treatment of the insulin-type islet cell carcinoma, chemotherapy and hormone therapy are used in addition to surgery. Symptoms are mild with medicines. The liver's leading artery can also be obstructed, and thus inhibits the growth of cancer cells in the liver. The treatment lines for other islet cell cancers are in the same direction.

Cancer treatments

Surgery

Surgery is the most common form of treatment for islet cell carcinoma. The doctor may remove the cancer by surgery, which will eliminate the same majority of the pancreas or even the entire pancreatic as well as the nearby lymph nodes. In the case of gastritis, it is sometimes also to remove the ulcer in the stomach.

Cancer surgery

cell blockers

Cell blockers are drugs for the destruction of cancer cells. They can be given as tablets or as a drip directly into a vein. Chemotherapy is unfortunately not a cure for the spread of pancreatic cancer, but it can relieve the symptoms caused by the disease and prolong the life time.

Chemotherapy is unfortunately not a cure for the spread of pancreatic cancer, but it can relieve the symptoms caused by the disease and prolong the life time..

Chemotherapeutic agents are used to treat pancreatic cancers that cannot be cut. However, no effective medicine or combination of medicines is yet in place, so new therapies are being investigated. Doxorubibicin, Fluoruracil J and Streptotzosin are the most commonly used chemotherapeutic agents in the treatment of pancreatic cancer.

Treatment of recurted cancer: Repeated cancer is usually treated with medical treatments.

cell blockers

Other medicines

Biological medications, called so-called "precision medications" have been studied in cancer treatment with a lot. For example, Everolides, octreotide and sunitinib are used in the treatment of pancreatic neuroendocrine cancers. The drug treatment is chosen according to the type of cancer and the prevalence of cancer. Drug therapy prevents the growth of malignant cancer cells and is used to alleviate the tumour-resulting symptoms.

Monitoring, regeneration and prognosis

Pancreatic cancer patients monitoring is individual. The frequency of monitoring depends on what treatments have been used and what the patient's general condition is. Following treatment with cancer and possible adjuvant therapy, patients are usually monitored for five years.

Pancreatic cancer prognosis depends a lot on whether the tumor has been completely removed during surgery or not. If the tumor has been removed, more than half of the patients will live longer than a year and a quarter of more than three years. If no surgery is performed, only one in ten patients will live longer than a year. The poor prognosis is due to the fact that the majority of pancreatic cancer patients are very elderly and the disease is usually recognized only when it is already widespread.

Islet cell carcinoma Prognosis is much better than regular pancreatic cancer. For the non-functioning islet cell carcinoma, 75% will be alive five years after the diagnosis and half a further 10 years. Islet cell carcinoma may recur. Cancer can be new in the pancreas or other parts of the body.

The vast majority of islet cell cancers are benign or highly differentiated. Insulinomas are generally benign, and cancer can be cured by surgery. A malignant and metastatic insulin prognosis is poor, and these patients live on average two years after diagnosis.

Also, gastrinomas are generally benign, and many live ten years after diagnosis. The prognosis for malignant and liver metastases is inferior. Two of these patients are alive after five years of diagnosis.