Pancreatic Cancer Disease - Research Paper Example

? Research Paper: Pancreatic Cancer First Middle initial and of Prof. First and of lecturer March3, 2012 Abstract Pancreatic cancer is one of the fastest spreading and deadliest cancers known to man. It is also called a ‘silent killer’ because the symptoms are absent or very subtle during the early stages of the disease. It is the fourth leading cause of cancer deaths in men and women. According to the American Cancer Society, nearly 43,920 new cases and 37,390 deaths will occur in the United States in 2012 as a result of pancreatic cancer. This disease has been increasing at a rate of 1.5% every year with a survival rate of only 4% in patients five years after diagnosis. Scientists have identified several risk factors that increase one’s chances of developing pancreatic cancer. Some of them include smoking, obesity, chronic pancreatitis and family history. However, the signs and symptoms of this disease typically does not manifest till the tumor grows large enough to press against nearby structures like intestines, nerves or bile duct. Therefore the diagnosis is often made during the later stages of the disease course. The most common signs and symptoms include jaundice, weight loss, changes in fatty tissues and swollen gallbladder. Research has proved that preventive strategies like smoking cessation, maintaining a healthy diet and exercising regularly can significantly reduce the risk of cancer and its recurrence. Numerous studies are currently underway to find a promising technique for early detection and treatment of pancreatic cancer. Pancreatic Cancer Pancreatic cancer is one of the fastest spreading and deadliest cancers known to man with a survival rate of only 4% in patients five years after diagnosis (Bodies exhibition, 2011). It is typically defined as a “disease in which malignant (cancer) cells are found in the tissues of the pancreas” (National Cancer Institute, n.d.). It is also called exocrine cancer. This disease often has poor prognosis because it spreads rapidly and very few patients diagnosed with pancreatic cancer have identifiable risk factors (Nugent, n.d.). The signs and symptoms of this disease typically does not manifest till it is in an advanced stage and therefore diagnosis is often made during the later stages of the disease course (Mayo Clinic, 2010). This is the primary reason why pancreatic cancer is the fourth leading cause of cancer deaths (Mayo Clinic, 2010). There are two main types of pancreatic tumors: 1. Exocrine pancreatic cancer is the most common type of pancreatic cancer and starts in the ducts that carry pancreatic juices (National Cancer Institute, 2010d). Nearly 95% of exocrine pancreatic cancers are adenocarcenomas i.e., it starts in the gland cells. They are mostly malignant. 2. Endocrine pancreatic cancer, also known as islet cell cancer, starts in the cells that make hormones (National Cancer Institute, 2010d). They are relatively less common and can be benign or malignant. Additionally, pancreatic cancer is divided into four stages with stage I being the earliest and stage IV being the most advanced (Nugent, n.d.). Patients in stage I and stage II pancreatic cancer are considered to have ‘resectable’ cancer that can be fully removed by surgery. Patients in stage III pancreatic cancer have ‘locally advanced unresectable’ cancer wherein the chance of cure is lost but radiation treatment is an option. Patients in stage IV pancreatic cancer have ‘metastatic’ cancer wherein chemotherapy is recommended for controlling the symptoms and extending the life of the patient. In particular, the American Cancer Society (2011a) estimates that, nearly 43,920 new cases of pancreatic cancer will be identified in the U.S. in 2012. Again, the disease will be responsible for 37,390 deaths in the country (American Cancer Society, 2011a). This disease has been increasing at a rate of 1.5% every year (American Cancer Society, 2011a). The lifetime risk of developing pancreatic cancer is about 1 in 71 and is the same for men and women (American Cancer Society, 2011a). Therefore, an analysis of the risk factors, symptoms and available treatments for pancreatic cancer reveals the urgency to develop an early detection technique and promising cure for this disease. One of the most important risk factors for pancreatic cancer is smoking. People who smoke are 2 to 3 times more likely to get pancreatic cancer (American Cancer Society, 2011b). In fact nearly 30% of exocrine cancers are thought to be caused due to cigarette smoking (American Cancer Society, 2011b). This may be because cigarette smoke has several carcinogenic chemicals that can enter the blood and affect the pancreas. Obesity is also a major risk factor for exocrine pancreatic cancer. This could be attributed to the fact that obese people have very little physical activity (American Cancer Society, 2011b). In fact exercise has been proved to lower the risk of this cancer. Similarly, the occurrence of chronic pancreatitis is another risk factor for pancreatic cancer. Chronic pancreatitis is defined as the continuing, chronic inflammation of the pancreas that alters its normal structure and functions (Huffman, 2011). Chronic pancreatitis increases the risk of pancreatic cancer; however most patients with this condition never develop pancreatic cancer (American Cancer Society, 2011b). Smokers with chronic pancreatitis are at a higher risk of pancreatic cancer (American Cancer Society, 2011b). Again, family history plays a major role in determining one’s chances of getting pancreatic cancer. Inherited gene mutations which are abnormal copies of certain genes are responsible for nearly 10% of pancreatic cancers (American Cancer Society, 2011b). Examples of these genetic mutations include familial pancreatitis caused by mutations of the gene PRSS1. Individuals who inherit the genes for chronic pancreatitis have about 40 to 75% risk of developing pancreatic cancer (American Cancer Society, 2011b). However, the signs and symptoms of pancreatic cancer are absent or very subtle during the early stages of the disease. For this reason pancreatic cancer is also known as a ‘silent killer’. Symptoms begin to develop once the tumor grows large enough to press against nearby structures like intestines, nerves or bile duct. One of the common symptoms of pancreatic cancer is jaundice. The growing tumor in the head of the pancreas can obstruct the bile duct causing the bile to be retained in the body (Pancreatic Cancer Action, n.d.). This causes the skin and white of the eye to turn yellow. The urine also becomes dark and the stools are pale. Another symptom of pancreatic cancer is weight loss. When the tumor presses against the intestines, it affects the appetite and causes nausea (Pancreatic Cancer Action, n.d.). Obstruction of the bile duct can also cause bloating or indigestion after meals affecting ones appetite. This can result in significant weight loss in the affected individual as cancer cells deprive healthy cells of essential nutrients (Pancreatic Cancer Action, n.d.). In addition to jaundice and weight loss, another major symptom of pancreatic cancer is the uneven texture of fatty tissue under the skin (American Cancer Society, 2011c). This is typically caused due to the release of pancreatic enzymes that digest fat. Additionally, some people also have swollen gallbladder. When the tumor blocks the bile duct, it causes the bile to build up in the gall bladder causing it to enlarge. This can be felt during a physical exam or is detected by imaging studies (American Cancer Society, 2011c). Since pancreas is located deep inside the body, many tumors cannot be seen or felt during a routine physical exam. Individuals suffering from pancreatic cancer typically meet a primary care provided complaining of nonspecific symptoms. These complaints will then trigger a more detailed evaluation. To begin with, a physical exam will be conducted wherein the individual’s medical history is checked. The individual will also asked about any physical complaints or symptoms like recent weight loss, pain and changes in appetite, bowel patterns or skin color (University of California, 2012). The individual will then undergo a thorough physical exam focusing primarily in the abdominal area to check for masses or fluid buildup in the areas of pancreas, stomach, liver and gallbladder (University of California, 2012). The collar bone and other locations in the body will also be checked for swelling or other signs of metastasis as cancer can also spread to lymph nodes. After the physical exam, the individual will be asked to undertake a computed tomography (CT) scan. This is a non-invasive method of examining the internal organs by capturing a series of thin X-ray images (University of California, 2012). It helps to detect tumors and determine if the cancer has spread to other parts of the body. The three-dimensional CT scan, also called ‘spiral’ CT scan is useful in creating extremely detailed images of the pancreas and nearby blood vessels and structures. The CT scan may be followed by magnetic resonance imaging (MRI). MRI uses magnetic waves to scan and create detailed images of the pancreas, liver and gallbladder. It has been found to be very helpful in detecting, characterization and staging pancreatic cancer, especially in those individuals whose major blood vessels are compressed or invaded by cancer (Memorial Sloan-Kettering Cancer Center, n.d.). Later on a biopsy may also be scheduled which involves collecting small amounts of tissue from a particular site with the help of a needle and examining it under a microscope to identify the type of cells collected (University of California, 2012). Biopsy may be performed under an endoscopic ultrasound, under the guidance of a CT scan or at the time of open surgery of the abdomen. Some of the key strategies to prevent pancreatic cancer are smoking cessation, maintaining a healthy diet and exercising regularly. Research has proved that these preventive strategies can significantly reduce the risk of cancer and its recurrence. However, once an individual is diagnosed with pancreatic cancer, the treatment options are very limited. Currently, the only curable treatment is to surgically remove the cancer (Nugent, n.d.). However treatment is dependent on which stage the cancer is detected. If pancreatic cancer is detected early in stage I or stage II, surgery is recommended. The most common surgical procedure to remove pancreatic cancer is called ‘Whipple’ and it involves removing parts of the stomach, duodenum, pancreas, bile duct, lymph nodes and gallbladder (Nugent, n.d.). Following the surgery, chemotherapy is typically recommended to lower the chances of the cancer returning. However, only 20% of individuals who undergo this surgery live beyond five years (Nugent, n.d.). If pancreatic cancer is detected in stage III, then concurrent treatments of low-dose chemotherapy and radiation is typically given. This has been found to be very effective in lowering the risk of local growth of the cancer (Nugent, n.d.). If pancreatic cancer is detected in stage IV, systemic treatment and chemotherapy is recommended to extend and improve the quality of lives of patients (Nugent, n.d). In conclusion, the current knowledge about the risk factors, symptoms and available treatments for pancreatic cancer underscores the need to develop an early detection technique and promising cure for this disease. Following a diagnosis of pancreatic cancer, an individual should adopt some lifestyle changes which include quitting smoking and alcohol, eating healthy and choosing a plant-based diet, choosing foods low in fat and salt, exercising, improving self-esteem and reducing anxiety and depression (National Cancer Institute, n.d.b). In addition to the lifestyle changes, follow-up care for pancreatic cancer is also very important as it helps to resolve ongoing problems due to cancer or its treatment and also check for any physical or psychological effects of the treatment on the patient. Follow-up care involves regular medical and physical examination including review of medical history. It may include imaging procedures, endoscopy, blood tests and other lab tests for monitoring purposes (National Cancer Institute, 2010c). It may also include home care, occupational or vocational therapy, pain management, physical therapy or support groups. In order to develop a promising technique for early detection and treatment of pancreatic cancer, numerous studies are currently underway. Researchers from University of North Carolina Hospitals have developed the 3D gradient-echo MRI technique (Birchard et al., 2005). This is helpful in detecting tumors that are less than 2 centimeters in size as it provides higher quality images of the pancreas thereby helping in early detection of pancreatic cancer. Again, the effect of using complementary or alternative medicines like Psorinum therapy in the treatment of pancreatic cancer is being studied (Chatterjee et al., 2011). Scientists are also studying several vaccines that are meant to stimulate a person’s immune system to attack the cancer cells (American Cancer Society, 2011c). These efforts emphasize the efforts made by scientists and researchers to develop an early detection technique and promising cure for pancreatic cancer, which is the need of the hour. References American Cancer Society. (2011a). What are the key statistics about pancreatic cancer? Retrieved from http://www.cancer.org/Cancer/PancreaticCancer/DetailedGuide/ pancreatic-cancer-key-statistics American Cancer Society. (2011b). What are the risk factors for pancreatic cancer? Retrieved from http://www.cancer.org/Cancer/PancreaticCancer/DetailedGuide/ pancreatic-cancer-risk-factors American Cancer Society. (2011c). What’s new in pancreatic cancer and research treatment? Retrieved from http://www.cancer.org/Cancer/PancreaticCancer/DetailedGuide/ pancreatic-cancer-new-research Birchard, K.R., Semelka, R.C., Hyslop, W.B., Brown, A., Armao, D., Firat, Z., & Vaidean, G. (2005). Suspected pancreatic cancer: Evaluation by dynamic gadolinium-enhanced 3D gradient-echo MRI. American Journal of Roentgenology, 185(3), 700-703. Bodies exhibition. (2011). Pancreatic cancer: The silent killer. Retrieved from http://www.bodiestheexhibition.com/news/90-pancreatic-killer-silent-killer.html Chatterjee, A., Biswas, J., Chaterjee, A., Bhattacharya, S., Mukhopadhyay, B., & Mandal, S. (2011). Psorinum therapy in treating stomach, gall bladder, pancreatic and liver cancers: A prospective study. Evidence-Based Complementary and Alternative Medicine, 2011, 1-7. Huffman, J.L. (2011). Chronic pancreatitis. Medscape Reference. Retrieved from http://emedicine.medscape.com/article/181554-overview Mayo Clinic. (2010). Pancreatic cancer. Retrieved from http://www.mayoclinic.com/health/ pancreatic-cancer/DS00357 Memorial Sloan-Kettering Cancer Center. (n.d.). Pancreatic cancer: Diagnosis and staging. Retrieved from http://www.mskcc.org/cancer-care/adult/pancreatic/diagnosis-staging National Cancer Institute. (2010a). Pancreatic cancer. Retrieved from http://www.cancer.gov/ cancertopics/types/pancreatic National Cancer Institute. (2010b). Getting follow-up medical care. Retrieved from http://www.cancer.gov/cancertopics/coping/life-after-treatment/page3 National Cancer Institute. (2010c). Follow-up care after cancer treatment. Retrieved from http://www.cancer.gov/cancertopics/factsheet/Therapy/followup National Cancer Institute. (2010d). What you need to know about pancreatic cancer. Retrieved from http://www.cancer.gov/cancertopics/wyntk/pancreas Nugent, F. W. (n.d.). Pancreatic cancer. Retrieved from http://www.medicinenet.com/ pancreatic_cancer/article.htm Pancreatic Cancer Action. (n.d.).What is obstructive jaundice? Retrieved from http://pancreaticcanceraction.org/facts-figures/jaundice/ University of California. (2012). Pancreatic cancer diagnosis. San Francisco Medical Center. Retrieved from http://www.ucsfhealth.org/conditions/pancreatic_cancer/diagnosis.html Read More