Pancreatic Cancer

  • Pancreatic Cancer: An Exocrine and Endocrine Disease

    Pancreatic Cancer: An Exocrine and Endocrine Disease

    Pancreatic cancer generally refers to adenocarcinoma of the pancreas, which affects the exocrine cells of the pancreas. Cancer that affects the endocrine glands is known as pancreatic neuroendocrine tumors (pNET).<sup>1</sup>

  • Targeted Areas and Pathology

    Targeted Areas and Pathology

    Exocrine pancreatic cancer cells may originate from the ductal epithelium, connective tissue, acinar cells (see slide), or lymphatic tissue.<sup>2</sup> The dense desmoplastic stroma of adenocarcinomas help construct an immunosuppressed microenvironment, which prevents tumor cell clearance.<sup>3</sup>

  • Risk Factors

    Risk Factors

    Few behavior (eg, cigarette smoking) or dietary factors affect the incidence of pancreatic cancer. Chronic pancreatitis and diabetes are also well known risk factors for the disease. Genetic mutations also account for some cancer cases and usually are caused by somatic mutations.<sup>4</sup>

  • Signs and Symptoms

    Signs and Symptoms

    Most signs and symptoms of pancreatic adenocarcinoma go unnoticed due to the fact that the average age at diagnosis is 72 years.<sup>4</sup> Symptoms are generally nonspecific such as abdominal pain, weight loss, diabetes, jaundice, muscle wasting, and hypercoagulation.<sup>3</sup>

  • Diagnosis

    Diagnosis

    Recent advancements in diagnosing pancreatic cancer, such as ultrasound endoscopic methods and direct histological processing of fine needle aspiration, have been shown to improve diagnostics while limiting the cost and invasiveness of procedures.<sup>3</sup>

  • Stages of Pancreatic Cancer

    Stages of Pancreatic Cancer

    Accurate pretreatment staging is an important factor in proper management of pancreatic cancer, and allows patients with resectable disease to have immediate surgery, lowering their chances of rapid deterioration.<sup>1</sup>

  • Treatment

    Treatment

    Surgical resection is the only potentially curative therapy for pancreatic cancer; however, only 20% of patients are resectable at diagnosis and may require adjuvant therapy. Patients at any stage are recommended to enroll in clinical trials due to the potential efficacy of new therapies.<sup>2,3</sup>

  • Supportive and Palliative Care

    Supportive and Palliative Care

    Palliative care consultation minimizes physical and emotion symptom burden and can improve quality of life and patient satisfaction, while minimizing cost and caregiver burden. Early referral to a palliative care specialist is crucial in patients with pancreatic cancer.<sup>5</sup>

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Despite advances in the treatment of pancreatic cancer, patients with the disease still generally have a poor prognosis with a 5-year survival (at all stages) of 6%, so it is important that quality of life be prioritized starting at diagnosis and continuing through treatment.

There are several known adverse events associated with the disease and its treatment, including venous thrombosis, pain, malignant biliary obstruction, malignant gastric outlet obstruction, pancreatic exocrine insufficiency, cancer-associated anorexia-cachexia syndrome, and depression.6

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