Pancreas is a 12-15 cm long and 2.5 cm wide fish-like organ that consists of a wide head, a tapering body, and a narrow tail. It is situated behind the stomach with its head connected the duodenum (the initial portion of the small intestine) via two ducts: the pancreatic duct and the accessory duct.
It is made up of mainly 2 types of cells – the exocrine cells (99%) and the endocrine cells (1%). The main functions of the pancreas include secretion of digestive juice and several hormones (glucagon, insulin, somatostatin, and pancreatic polypeptide).
Pancreatic adenocarcinoma (affecting exocrine cells) is the most common (95% of the cases) type of pancreatic cancer.
Pancreatic Cancer Infographics
Most common risk factors for pancreatic cancer are smoking, being overweight or obese, industrial or occupational exposure, genetic factors, family history, history of diabetes or chronic pancreatitis, etc.
Most common symptoms with which it may present are jaundice, pain in upper abdomen or back, unexplained weight loss, vomiting, loss of appetite, light colored stools, dark colored urine, etc.
Endoscopic ultrasound and biopsy help in confirmation of diagnosis, whereas, imaging tests (CT/MRI/PET) are required to stage the disease.
T staging describes the locoregional extent of the tumor. It may be T1 to T4 depending on size of tumor and involvement of surrounding structures.
N and M Staging
N is the nodal staging that may be N0 or N1 depending on the involvement of regional lymph nodes involved by tumor. And M is the metastatic staging that can be M0 or M1 depending on the presence of distant tumor spread.
Resectability based on Extent of Tumor
Based on the staging discussed above, the pancreatic cancer may be resectable, borderline resectable, or unresectable. It depends on the involvement of nearby structures by the tumor, as discussed below.
Treatment of Localised and Locally Advanced Disease
Based on the resectability of localised and locally advanced disease, treatment decision is taken as shown in the following infographic.
Treatment of Metastatic Disease
And here is the treatment for metastatic pancreatic cancer, that has spread to distant sites.
Pancreatic Cancer Videos
CancerBro meets Mr. Parker – Pancreatic Cancer Patient
Watch the video below, where CancerBro meets Mr Parker who has recently been diagnosed with pancreatic cancer.
Risk factors for pancreatic cancer are explained below.
Symptoms and signs with which pancreatic cancer presents commonly.
Investigations for Diagnosis and Staging
Following video explains the investigations that are required to confirm the diagnosis and stage the disease.
Anatomy of Pancreas
It is important to know the anatomy of pancreas and surrounding structures to understand the staging in a better way.
TNM staging is explained below in an easy to understand manner.
Localised and Locally Advanced Disease
Here we will discuss the treatment for pancreatic cancer that is localized to pancreas or invaded locoregionally to nearby structures.
And below we have discussed the treatment for pancreatic cancer that has spread to distant sites.