Pancreatic cancer

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What is it about ?

The pancreas is a digestive gland located in the upper abdomen, behind the stomach. It has two functions:

  • Produce and secrete hormones in the blood, such as insulin and glucagon to regulate the level of sugar in the blood (blood sugar) (endocrine secretion);
  • Produce and secrete enzymes in the small intestine for the digestion of sugars, fats and proteins (exocrine secretion).

The term ‘pancreatic cancer’ is used to refer to different kinds of tumors. THE’pancreatic adenocarcinoma is one of the most frequent forms. Pancreatic islet tumors (insulinoma, gastrinoma, vipoma, carcinoid tumors, etc.) themselves produce hormones and are very rare.

Chances of survival

Without treatment, pancreatic cancer is particularly fatal : The average survival after being diagnosed is about 4 to 6 months. Only 1 in 5 patients can be treated with the aim of being cured. In general, the percentage of survival after being diagnosed with pancreatic adenocarcinoma at 5 years is just 12%.

Diagnostic

The diagnostic steps are therefore not only aimed at establishing the diagnosis itself, but also at determining at an early stage whether a cure is possible. To do this, we take into account the extent and stage of the tumor (this is called a ” staging “).

What is its frequency?

The risk of developing pancreatic cancer increases withage. In Belgium, there are more than 1,600 new cases every year1. The disease appears on average around the age of 70 years. It is the 11th most common form of cancer in Belgium (3% of all cancers). In 2016, 1,705 people did not survive this cancer in Belgium.

How to recognize it?

It is advisable to consult a doctor if:

  • you have an unpleasant and persistent sensation in the upper abdomen;
  • you have lost weight in recent months / weeks without being able to explain the reason.

How is the diagnosis made?

The doctor will think about the possibility of pancreatic cancer if you see him for pain in the upper abdomen, for a diabetes recently appeared or for inflammation of the pancreas (acute pancreatitis). The doctor will list your complaints and pay particular attention to the following symptoms:

  • weightloss ;
  • unexplained pain in the upper abdomen;
  • jaundice, mainly if you are not really in pain;
  • pain in the upper abdomen that may radiate to the back;
  • diabetes of recent onset;
  • loss of appetite ;
  • discomfort;
  • specific symptoms that may indicate an excessively high production of pancreatic hormones.

More than 90% of people with a pancreatic tumor have weightloss, have pain in the upper abdomen or have jaundice.

Exams

A number of other aspects are also checked. The basic exams are as follows:

  • a ultrasound and one CT scan upper abdomen;
  • a blood sample is taken to determine a few parameters.

It happens that Additional tests are necessary to confirm the diagnosis, in particular by:

  • endoscopy;
  • an MRI;
  • a PET-CT;
  • laparoscopy (exploratory surgery) in the stomach.

The endoscopic exam allows you to look inside the gastrointestinal system to see where the problem may be. During this examination, the doctor may possibly perform surgical procedures or perform imaging studies.

What can your doctor do?

  • We can achieve a whipple operation (pancreatoduodenectomy) in about 1 in 5 people with pancreatic cancer.
    • The procedure involves removing the pancreas and duodenum. This is only possible if the tumor has not spread to nearby tissue.
  • A chemotherapy or radiation therapy is often given if the tumor has spread to nearby tissue.
    • The treatment relieves complaints and symptoms in about half of those who suffer from it, but has little long-term effect on their chances of survival.
  • In order to relieve the symptoms and possibly the obstruction of the bile ducts, a stent. Surgery can also help bypass the gastrointestinal tract where the problem is.

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