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Pancreatic cancer is one of the most deadly types of cancers on the planet. Symptoms and diagnostic testing are not very specific and as a result, many cases will be diagnosed in the late stages of the disease. Here, we will examine why that is the case.

When it comes to the diagnosis of cancer, the prognosis can vary significantly depending on the type of cancer a person is battling. Innovations in treatment options have also improved the quality of life for many cancer patients, but there are still a few cancers that can leave doctors with very few treatment options for patients. 

Pancreatic cancer is one of them; it is considered to be one of the most lethal forms of cancer with one of the lowest survival rates. Here, we will focus on some of the reasons why the prognosis is so poor and what types of symptoms and treatment options are possible if the cancer is caught early on. 

Important stats on pancreatic cancer 

Pancreatic cancer is the fourth leading cause of cancer-related deaths in the United States and in the top 5 of malignant cancers in Europe. Nearly 85 percent of all pancreatic cancers are considered to be adenocarcinomas and about 33 percent of them will be seen on the body and the tail of the pancreas.

The only possible treatment for these types of cancers will be surgical removal of the pancreas but this is only possible in 15 to 30 percent of cases. The prognosis of this disease is considered to be poor but approximately 30 percent of patients will survive after 5 years if the tumor was removed and small. This figure drops to only 10 percent if the cancer has spread beyond the margins of the tissue removal when the tumor was removed. 

Pancreatic cancer: Warning Signs and symptoms to watch out for 

The symptoms of pancreatic cancer will vary depending on where in the pancreas the tumor is located. The pancreas is divided into 3 anatomical parts: the head, the body and the tail.

Most tumors of the pancreas will be located in the head of the pancreas and early symptoms for this type of cancer will be abdominal pain, weight loss, yellowing of the skin (known as jaundice) and fatty stools (known as steatorrhea). 

Tumors located on the body and the tail of the pancreas may have similar symptoms but their onset may only occur very late into the disease. Most patients may have vague abdominal pain for a few months that doctors are unable to diagnose. This can even be after CT scans or abdominal ultrasounds. The skin will jaundice as the weight of the patient drops and only after the tumor has grown in size will severe abdominal pain manifest. 

Why is pancreatic cancer such a hard disease to diagnose?

The reason that the prognosis for pancreatic cancer is so poor is that most patients will be diagnosed only after months of medical testing, which will itself begin after symptoms are already apparent. This can be a frustrating point for patients and family to deal with, but when you look at how the anatomy of the abdominal cavity is arranged, the pancreas is an organ that is normally hidden or at least partially hidden by your intestines because it lies very low in your abdomen. Because of this, it is hard for even the best specialists to make a diagnosis based on an ultrasound of your stomach. 

After a few attempts at doing an abdominal ultrasound without success, the next step in diagnosis would be doing a CT scan to get a better overview of the abdominal cavity. Only large lesions in the pancreas will be easier to identify on a CT scan so there is no guarantee that doing a CT scan earlier in the diagnostic work-up of the disease will help make a diagnosis. 

It is entirely possible, (unfortunately, even probable) that a patient will have no clear diagnosis even after a CT scan and US scan of the abdomen while still suffering from their symptoms. At this stage, a doctor can try to rule out other diseases like gallbladder stones that could be causing similar symptoms by doing endoscopic ultrasound (known as an ERCP).

This would actually be a surgical procedure where a camera will be inserted into your pancreatic duct to try to determine if a stone is the cause of these symptoms. Fragments of a tumor may be seen on the camera at this stage but if the tumor is located on the body or the tail, this may also not be possible. 

When you add all these challenges together, it is no surprise that most pancreatic cancers are diagnosed at a late stage of the disease.

The tumors can grow quickly so as weeks and months pass without a clear answer, the tumor will eventually become more obvious once it is large enough to see in a picture. Blood testing is also possible to help point in the direction of pancreatic cancer but many of these tests are very general and will not guarantee a proper diagnosis. In many cases, patients may even be having a CT scan of their abdomen for another reason and be diagnosed with pancreatic cancer by chance. 

Treatment options for pancreatic cancer

 As I have alluded to above, the only effective treatment option for pancreatic cancer would be the surgical removal of the organ.

In most cases, not only will the part of the pancreas with the tumor need to be removed, but surrounding organs are also likely already harboring malignant tissue that will need to be removed.

A portion of the small intestine and the gallbladder are also structures that will need to be removed using a procedure known as the "Whipple’s Procedure". Remember that only 15 to 30 percent of patients even qualify for surgery if the tumors are found early on. If the surgery were to be performed, the patients will also have to take supplemental enzymes, limit the types of food they are able to consume, and will likely have a colostomy bag for a period of time so qualify of life for these patients is also reduced. 

In the majority of cases of pancreatic cancer, however, chemotherapy will be the treatment option recommended for the patient. Chemotherapy will be used more as a palliative care agent to help reduce symptoms of pain and improve the quality of life for the patient. 

Final thoughts 

Pancreatic cancer is a very hard diagnosis to hear if you are a patient. As you have seen above, the diagnosis is challenging and the prognosis is bleak so it is best to try to limit risks that could predispose you to the disease. Although there are no clear-cut risk factors for the disease, studies indicate a family history of pancreatic cancer, smoking, pancreatitis and type 2 diabetes could increase your risk of getting the disease. These are very common problems in the medical community so they will not guarantee you to have pancreatic cancer for sure but may help doctors screen more aggressively for the disease early on to try to catch it before metastasis.

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