November is Pancreatic Cancer Awareness Month. Around 8,000 people are diagnosed with pancreatic cancer each year in the UK, and doctors aren’t completely sure what causes it. It’s the 10th most common cancer (excluding non melanoma skin cancer).
The pancreas is part of your digestive system and sits high up in the abdomen. It’s six inches long and shaped like a leaf. There are two parts, the part which produces digestive juices (the exocrine pancreas) and the part that produces insulin (the endocrine pancreas). The cancers that develop in these parts of the pancreas differ from each other. If your pancreas does not produce enough insulin, it causes diabetes.
Smoking cigarettes, cigars and pipes and chewing tobacco have all been found to cause pancreatic cancer. A recent report found that 1 in 3 pancreatic cancers may be linked to smoking.
Other medical conditions
A number of other medical conditions have been linked to pancreatic cancer including:
*Inflammation of the pancreas
*Tooth or gum disease
*Hereditary cancer gene
7 out of 10 cases of chronic pancreatitis are caused by long term heavy drinking. Chronic pancreatitis is a risk factor for pancreatic cancer. The risk is higher for people that drink three or more alcoholic drinks per day as opposed to one drink per day.
Research has found that red meat can cause pancreatic cancer. Some studies have highlighted a link between this type of cancer and too much saturated fat.
Being overweight has been linked to pancreatic cancer. Around 1 in 10 cancers in the UK have been linked to obesity (overweight people produce more insulin).
Symptoms (obviously most of these symptoms do not necessarily mean you have cancer)
*Pain in the stomach area or back (7 out of 10 GP patients)
*Jaundice (5 out of 10 GP patients)
*Symptoms from endocrine pancreatic tumours
It can be difficult to diagnose pancreatic cancer as the symptoms are similar to some other conditions. If you go to see your GP with symptoms they will probably check your eyes and the colour of your skin for jaundice, test your urine for bile and take a blood sample if needed. They may also examine your tummy to feel for any swelling. If there is cause for concern, your GP will refer you to hospital for tests and for specialist advice and treatment. At the hospital, you may have a blood test and a chest x-ray to check your general health. There are a number of tests which are used to determine whether pancreatic cancer is present:
Waiting for test results can be difficult and you may need support to cope with anxiety at this time.
Cancer can occur in any part of the pancreas, but 8 out of 10 cancers start in the head of the pancreas. There are several different types of pancreatic cancer. The most common type is ductal adenocarcinoma, which starts from cells in the lining of the pancreatic ducts. More than 9 out of 10 pancreatic cancers (95%) are ductal adenocarcinomas.
Other, less common, types of pancreatic cancer include:
• cystic tumours – these are fluid-filled sacs in the pancreas, some of which are cancerous
• acinar cell carcinomas – these start from the cells that make pancreatic juice
• neuroendocrine tumours – these begin in the endocrine cells where insulin and other hormones are made
• lymphoma – this is a cancer of the lymphatic tissue in the pancreas.
Your MDT (multi-discliplinary team) will create a treatment plan based upon the type of cancer you have. Surgery, chemotherapy and radiotherapy are all used to treat pancreatic cancer. If you have early stage pancreatic cancer the most common treatment is surgery to remove the affected part or all of the pancreas. Chemotherapy may be used afterwards to reduce the chances of the cancer from coming back. Sometimes chemotherapy and radiotherapy are combined (chemoradiation). Supportive care techniques are used to reduce pain and manage symptoms (stents to relieve jaundice and other symptoms, nerve blocks can be used to relieve pain).
Coping emotionally and practically with pancreatic cancer
Being diagnosed with pancreatic cancer can be very difficult to cope with. You might feel scared, anxious, upset and confused. If the cancer is advanced and has spread you might go into shock or denial about the news. You may lose weight and have jaundice, which can affect your body image and self-confidence. The jaundice may cause skin problems and itching. If you’ve had part or all of your pancreas removed you may need to take insulin or tablets to regulate your blood sugar. You may also need to take enzyme supplements to help with digestion. It can take a while to get the drugs right. You may also have to eat smaller meals and take nutritional supplements.
You may also be very tired as a result of treatment and develop cancer fatigue. Your relationship might be affected and your sex life may suffer. You may have to have time off work which can affect you financially.
If you are currently affected by pancreatic cancer and struggling emotionally please get in touch for a free consultation to discuss the issues.