Pancreas Cancer

The pancreas is an important organ which produces chemicals to help in the digestion of food, and also in the production of hormones, like insulin, to regulate our body functions. Common problems include inflammation and cancer formation. Pancreas cancer can be aggressive.

 

What is the pancreas?

 

The pancreas is an organ located at the upper abdomen, and it lies behind the stomach. Within the pancreas is a system of small tubes, also known as pancreatic ducts, which transports the enzymes produced by the pancreas into the small intestine to help digestion. The pancreas also produces a number of hormones to regulate body functions. One of these hormones is insulin, which regulate our blood sugar level.

What is pancreas cancer?

Pancreas cancer usually refers to a cancer of the cells lining the ducts within the pancreas. Therefore, the scientific medical term for this type of cancer is known as pancreatic ductal adenocarcinoma. This is a very aggressive cancer. Only 1 out of 10 patients who has this disease can be treated by surgery. This is because most patients, upon diagnosis, are already at an advanced stage.

What are the risk factors of developing pancreas cancer?

Family history of pancreatic cancer

Smoking

Obesity

Diabetes

People who has a cystic tumour of the pancreas (such as intra-ductal papillary mucinous tumours)

Chronic inflammation of the pancreas (chronic pancreatitis)

Older age, as most patients tend to be older than 65 years of age Family history of genetic syndromes which predispose to cancer, such as a BRCA2 gene mutation, Lynch syndrome, etc.

What are the symptoms?
  • Upper abdominal pain, which may radiate to the back
  • Developing jaundice which is yellowing of your skin and the white of your eyes. The patient would usually also noticed that his urine has turned quite dark. He also complained of generalized itch of the skin
  • Loss of appetite
  • Loss of weight
  • Oily stools
  • New-onset diabetes

What will the doctor do to diagnose the cancer?

The doctor would usually get a specialized scan, such as the CT scan or MRI. Sometimes a biopsy may be needed. The doctor would also need to check if the cancer has spread, and hence, he may also get a PET scan.

What is the treatment of pancreas cancer?

Depending on what is the stage of the cancer, the doctor will then decide on the appropriate treatment. If the cancer is advanced and has spread beyond the pancreas, the doctor will recommend chemotherapy or radiotherapy or both.

 

If the cancer is still confined to the pancreas, surgery is possible. Surgery offers the best hope. The type of surgery depends on the location of the cancer in the pancreas.

 

If the cancer is in the head of the pancreas, the surgeon will perform either the Whipple Operation or the Pylorus-Preserving Pancreatico-Duodenectomy (or PPPD). In the Whipple operation, part of the stomach is also removed, but in PPPD, the whole stomach is left intact.

 

If the cancer lies in the body or the tail of the pancreas, the surgeon will perform a distal pancreatectomy.

 

You can read more about these operations in the tabs below.

Whipple operation

The Whipple operation is an operation to remove the head of the pancreas, along with the duodenum, a portion of the bile duct, the gallbladder, and a portion of the stomach.

 

After removal of these structures the remaining pancreas, bile duct and the stomach is then stitched back into the intestine to reconstitute the continuity of the digestive tract.

 

 

Whipple operation is a major operation that require around 6-8 hours. You will be nursed in the High Dependency ward or even the ICU for one or two days.

 

The patient will have a nasogastric tube and a urine catheter. In addition, there will be one to two surgical tubes placed into the abdomen to remove any residual fluid or blood. You would not be allowed to eat for a couple of days. Intravenous fluid will be given for hydration as well as nutrition.

 

The average length of stay is 10-14 days. If there are any complications, the length of stay will be prolonged.

 

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Pylorus-preserving pancreatico-duodenectomy (PPPD) Operation

Pylorus-preserving pancreatico-duodenectomy surgery is similar as Whipple Operation and the difference is the entire stomach is preserved and not removed. PPPD is said to allow better long-term digestive function and better quality of life.

Read More
Distal Pancreatectomy

This is an operation to remove the tail and/or the body of the pancreas. The spleen may be removed as well or may be left behind. The choice depends on the disease itself. Leaving the spleen behind is called spleen-preserving distal pancreatectomy.

 

Distal pancreatectomy may be performed using the laparoscopic technique in certain situations.

 

If the cancer is in the body or the tail of the pancreas, then the surgery that would be done is called a distal pancreatectomy. The spleen may be removed at the same time.

 

Read More

If you are told that you have a pancreas tumour, and would like to know if an operation is needed, and what type of technique is suitable for your condition,
please do not hesitate to contact us.

Arrange for consultation

 

 

Are there any other types of pancreas tumour?

 

The answer is yes. These may be less aggressive, and therefore cure is quite possible. Examples are:

 

  • Neuroendocrine tumours. These are tumours are arise from the hormone producing cells in the pancreas. Examples of such pancreatic neuroendocrine tumours (or pNET for short) includes insulinoma, gastrinoma, etc
  • Cystic tumours of the pancreas. These are fluid containing tumours. If they are small, and do not have any high-risk features, they may be left alone and just observed. If they become larger than 3cm, or have high-risk features, then surgery becomes necessary.

 

There are some alternative surgical techniques to remove such tumours, and it include laparoscopic or keyhole operations. Other options include:

 

  • Segmental pancreatectomy – this removes a middle portion of the pancreas
  • Enucleation – this removes a small portion of the pancreas

How to prevent pancreas cancer?

The key is to have a healthy lifestyle:

  • Stop smoking
  • Eat a well-balanced diet
  • Maintain a healthy weight
  • Exercise regularly
  • Drink in moderation

Got any questions?

We can give you the peace of mind.