Where Does Your Back Hurt With Pancreatic Cancer?

There are two types of pancreatic cancer.

1. Exocrine pancreatic cancer
2. Endocrine pancreatic cancer

Exocrine pancreatic cancer

It develops in the exocrine cells of the pancreas, which secrete pancreatic enzymes that aid digestion. It is the most common type of pancreatic cancer (95 percent) and affects the exocrine functions of the pancreas.

Different types of exocrine pancreatic cancer include

• Adenocarcinoma, which typically starts in the gland cells in the ducts of the pancreas
• Acinar cell carcinoma, which starts in the pancreatic enzyme cells
• Ampullary cancer, which starts where the bile duct and pancreatic duct meet the duodenum of the small intestine
• Adenosquamous carcinoma
• Squamous cell carcinoma
• Giant cell carcinoma
• Rare exocrine pancreatic tumor (colloid carcinoma, hepatoid carcinoma, pancreatoblastoma, serous cystadenoma, signet ring cell carcinoma, solid and pseudopapillary tumors and undifferentiated carcinoma)

Endocrine pancreatic cancer

It is also called pancreatic neuroendocrine tumors (PNETs) or islet cell tumors. It develops in the endocrine cells of the pancreas that produce hormones that regulate metabolism and blood sugar. It is less common (5 percent) and affects the endocrine functions of the pancreas.

Endocrine pancreatic cancer is named after the hormone-producing cell where cancer begins. 

Types of endocrine tumor include

• Insulinomas (insulin)
• Glucagonomas (glucagon)
• Gastrinomas (gastrin)
• Somatostatinomas (somatostatin)
• VIPomas (vasoactive intestinal peptide [VIP])

The exact cause of pancreatic cancer is unknown. Pancreatic cancer occurs when the cells in the pancreas develop changes (mutations) in their DNA. The mutated abnormal cells grow uncontrollably and eventually forms a tumor.

The risk of pancreatic cancer increases with the following factors.

• Smoking
• Alcoholism
• Diabetes
• Diet high in red meat and fat
• Diet low in fruits and vegetables
• Pancreatitis (chronic inflammation of the pancreas)
• Family history of pancreatic cancer
• Hereditary conditions such as BRCA2 gene mutation, Lynch syndrome, hereditary breast and ovarian cancer syndrome, multiple endocrine neoplasia type 1 (MEN1) syndrome, von Hippel-Lindau syndrome, Peutz-Jeghers syndrome, familial atypical multiple mole melanoma (FAMMM) syndrome and Ataxia-telangiectasia
• Obesity
• Lack of exercise
• Age older than 60 years
• Male gender
• Exposure to pesticides, dyes and chemicals used in metal refining
• Cirrhosis of the liver
• Infection of the stomach by Helicobacter pylori (H. pylori)
• Gingivitis
• High consumption of alcohol

Treatment options depend on the type, size, location and stage of cancer, as well as age and individual preference of the patient.

• Surgery: Surgery may be performed in the early stage when cancer is limited to the pancreas. Surgical approaches include
  • Whipple procedure: It is also known as pancreatoduodenectomy. It is performed when cancer is present in the pancreatic head. The pancreatic head is removed surgically along with a portion of the stomach, duodenum, gallbladder, part of the bile duct and nearby lymph nodes.
  • Distal pancreatectomy: The doctor surgically removes the pancreas tail and sometimes other parts of the pancreas along with the spleen when the tumor is present in the pancreatic body and tail.
  • Total pancreatectomy: The doctor removes the entire pancreas. The patient requires lifelong insulin and enzyme replacement.
• Radiation therapy: The doctor uses X-rays and other high-energy beams to kill the cancer cells.
• Chemotherapy: The doctor uses cancer-killing drugs to destroy the cancer cells and prevent their growth. Sometimes, chemotherapy is combined with radiation therapy (chemoradiation).
• Targeted therapy: In this, the doctor uses drugs to target specific abnormalities in the cancer cells and destroy them. These drugs do not harm the normal cells.

Early diagnosis and treatment of pancreatic cancer increase the chances of recovery.

The five-year survival rate is about

• 34 percent if cancer is limited to the pancreas.
• 12 percent if cancer has spread to the nearby tissues or lymph nodes.
• 3 percent if cancer has spread to other parts of the body.

Early diagnosis and treatment of pancreatic cancer increase the chances of recovery.

The five-year survival rate is about

• 34 percent if cancer is limited to the pancreas.
• 12 percent if cancer has spread to the nearby tissues or lymph nodes.
• 3 percent if cancer has spread to other parts of the body.