Pancreatic tumor

Apr 14, 2012 , Jiří Dyntr

rakovina-slinivky.jpg - kopie
rakovina-slinivky.jpg - kopie
Pancreatic cancer is one of the seven most common cancers. Among pancreatic tumors also belongs the so-called ductal adenocarcinoma, for which the prognosis for patients is very unfavorable, only about 16% of patients survive for the next five years. The main symptoms of pancreatic cancer include anorexia, abdominal pain, fatigue, jaundice or an unexpected attack of acute pancreatitis.

Pancreatic tumor

The pancreas is an organ of the abdominal cavity placed between the stomach and the spine, and performs many functions. Its exocrine part is responsible for the formation of pancreatic enzymes that are essential for the digestion of certain food components. Its endocrine part produces hormones insulin and glucagon, which regulate the metabolism of sugars in the body. Like other organs the pancreas may also be affected by cancer. Benign pancreatic tumors are rare. Pancreatic cancer is one of the most malignant tumors of all, which is primarily due to the fact that it is diagnosed late due to the presence of non-specific symptoms.

Tumor

A tumor is a group of interrelated processes that lead to a change of normal cell behavior. For tumor cells it is typical that they proliferate uncontrollably, completely independent of the host organism. Generally tumors may be benign and malignant. For benign tumors characteristic is slow growth, they do not invade into the surrounding tissues and do not metastasize, form distant cancerous sites. On the other hand malignant tumors in most cases grow rapidly and destroy adjacent tissues, and form metastasis in the body.

Pancreatic tumor and its types

Pancreatic tumors can be divided into several groups according to the tissue from which they become from and certain other characteristics. Benign pancreatic tumors are rare. Pancreatic carcinoma is a malignant tumor that has a very poor prognosis. The incidence that the pancreatic tumor is a carcinoma is up to 90%.

Benign pancreatic tumor

Benign pancreatic tumors are rare. We can meet with the so-called cystic tumors, which are characterized by fluid-filled cavities of variable consistency, a cyst. They are benign, but they can oppress the bile ducts and cause jaundice. Also are known malignant cystic pancreatic tumors. Another type of benign pancreatic tumors are lipomas that form from adipose tissue. Rarely we can meet with benign tumors that produce hormones, such as insulinoma or gastrinoma.

Malignant pancreatic tumor

Malignant pancreatic tumor is called carcinoma. It is one of the tumors with the worst prognosis. The most common type of pancreatic carcinoma is called ductal adenocarcinoma, which affects the lining of the pancreatic ducts. Under normal circumstances pancreatic digestive juice is secreted through them into the small intestine, where it is involved in the digestion of food components. These tumors are malignant and very dangerous, often leading to the patient's death even after complete surgical removal and chemotherapy. They grow very aggressively and may even penetrate into the walls of the surrounding organs and large blood vessels, and cause many other problems. Mainly they metastasize into the liver. Affected are also adjacent lymph nodes, or the peritoneum.

Symptoms of pancreatic tumor

Malignant and benign pancreatic tumors are manifested similarly. The maliciousness of especially the malignant pancreatic tumor consists in the fact that in the beginning it causes no significant problems. It is also the cause of its late diagnosis. Initially the symptoms are subtle and do not cause the patient any trouble. Gradually may appear fatigue, anorexia, vague abdominal pressure, nausea or vomiting soon after eating. Potential oppression of the biliary tract frequently results in jaundice. More severe damage of the pancreatic tissue can result in diabetes or outbreaks of acute pancreatitis, i.e. acute pancreatic necrosis. The warning symptom is acute pancreatitis without excessive intake of alcohol and other risk factors. Pancreatic cancer is also suspected with the onset of new diabetes after 60 years. Indeed, if its source was a different disease it would be manifested in a much younger age.

Risk factors of malignant pancreatic tumor

Various studies determined factors that lead to greater likelihood of pancreatic carcinoma, a malignant pancreatic tumor. These are mainly 60 years of age, smoking, it has been shown that malignant pancreatic tumor in smokers is 2 to 3 times more often than in non-smokers. Other risk factors are diabetes, male gender, chronic pancreatitis and, finally, a hereditary predisposition. If one of the closest relatives underwent pancreatic carcinoma, this increases the risk for the individual to 3x. It was also shown that the presence of colon cancer and ovarian cancer within relatives also increases the risk of developing pancreatic cancer.

Diagnosis of pancreatic tumor

Diagnosis of pancreatic cancer results from a careful medical history, laboratory and imaging methods. Mainly ultrasonography and CT of the abdomen is used, sometimes also an approach called ERCP, endoscopic retrograde cholangiopancreatography. In this examination a probe is introduced through the mouth to the duodenum, where is the common bile and pancreatic tract orifice. The probe is then directed into the duct where a contrast agent is applied to monitor and obtain a comprehensive image of the state and patency of the ducts. It is also necessary to remove a tissue for histological examination, a biopsy.

Treatment of pancreatic tumor

Treatment of benign tumors is usually surgical, where the entire tumor is removed from the body. In the case of a carcinoma the decision is based on the type and stage of the tumor and surgical treatment, chemotherapy, or radiotherapy is chosen. In most cases, we choose the combination of these approaches. In the case of advanced carcinoma palliative treatment is chosen that does not cure the patient, but only improves his quality of life.

Surgical treatment of malignant pancreatic tumor

Surgical treatment involves removal of the affected part of the pancreas, or the entire organ. The range of the operation is decided by the size of the tumor and its location. In the case that it is not possible to completely remove the tumor and at the same time it prevents flow of bile, a bypass is performed, thus bridging. This restores the flow of bile and digestive juices and eliminates jaundice.

Chemotherapy of malignant pancreatic tumor

Chemotherapy is a systematic treatment of pancreatic cancer, and involves the application of special drugs that destroy cancer cells. Unfortunately, it is an aggressive treatment that attacks also healthy cells of the human body, which is associated with side effects. If chemotherapy is applied before surgery, it is expected that the tumor shrinks and is easier to remove, this is called neoadjuvant chemotherapy. If chemotherapy is applied after surgery, this is called adjuvant chemotherapy and its aim is to prevent metastasis.

Radiotherapy of malignant pancreatic tumor

Radiotherapy is a local treatment of pancreatic cancer and involves irradiation of the tumor. It is used in combination with previous methods. Radiotherapy is often used after surgery to destroy cancer cells that may remain in the area of the previous tumor. Irradiation is used in the case of incurable pancreatic cancer to relieve pain.

Side effects of malignant pancreatic tumor treatment

Treatment of pancreatic cancer is, in most cases, aggressive, so it leads to many side effects. In the case of surgical treatment it is primarily an effect on digestion. The patient should be on a diet and gets painkillers, medication for diarrhea and later pancreatic enzymes that are not present in the body due to the removal of the organ. Side effects of chemotherapy depend on the type of the applied substance. Most frequent is fatigue, frequent infections, bleeding tendencies, which are due to bone marrow suppression due to chemotherapy. Furthermore, frequent is hair loss, anorexia, vomiting, nausea, or inflammation in the oral cavity. Radiotherapy typically causes fatigue, redness and dryness of skin in the point of irradiation.

Conclusions...

Benign pancreatic tumors are rare. However, pancreatic carcinoma is one of the seven most frequent cancers in the UK and is considered one of the most malignant tumors. Given that initially it is manifested by non-specific symptoms, you need to keep it in mind and in case of any suspicion visit your doctor as soon as possible.

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