Is Back Pain Constant With Pancreatic Cancer?

Pancreatic cancer is cancer that begins in the tissues of the pancreas, an organ located behind the stomach.
Pancreatic cancer is cancer that begins in the tissues of the pancreas, an organ located behind the stomach.

Pancreatic cancer is cancer that begins in the tissues of the pancreas, an organ located behind the stomach. Pancreatic cancer occurs when the healthy pancreatic cells grow out of control, forming a tumor.

Pancreatic cancer spreads quickly and has a poor prognosis because it is often detected late, there are no symptoms until it has spread to other organs.

Common symptoms of pancreatic cancer are

  • Dull pain in the upper abdomen and/or middle or upper back, which is probably caused by the tumor irritating the nerves in that area or pressing on the spine.
  • The back pain with pancreatic cancer may initially come and go, but it is aggravated during eating.
  • The pain eventually becomes persistent. The back pain caused by pancreatic cancer can be temporarily relieved by bending over unlike a typical back pain caused by sore muscles and other muscle or spine injuries.
  • The abdominal and back pain (muscular origin) is typically not related to activity or any food. Hence, new onset of back pain should be evaluated by a doctor.

Stages of pancreatic cancer

After diagnosis, staging of cancer is made based on the spread of cancer

  • Stage I: Tumor exists only in the pancreas.
  • Stage II: Tumor has spread to nearby abdominal tissues or lymph nodes.
  • Stage III: Cancer has spread to major blood vessels and lymph nodes.
  • Stage IV: Metastasis of cancer. Cancer has spread to other parts of the body.

What is the survival rate for pancreatic cancer?

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 nearby tissues or lymph nodes.
  • 3 percent if cancer has spread to other parts of the body.

What are the types of pancreatic cancer?

There are two types of pancreatic cancers.

  1. Exocrine pancreatic cancers: They develop in the exocrine cells of the pancreas, which secrete pancreatic enzymes that aid digestion. These are the most common type of pancreatic cancer (95 percent) and affect the exocrine functions of the pancreas.
  2. Endocrine pancreatic cancers: They are also called pancreatic neuroendocrine tumors (PNETs) or islet cell tumors. They develop in the endocrine cells of the pancreas that produce hormones that regulate metabolism and blood sugar. They are less common (5 percent) and affect the endocrine functions of the pancreas.

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What causes pancreatic cancer?

The cause of pancreatic cancer is unknown. Pancreatic cancer occurs when cells in the pancreas develop changes (mutations) in their deoxyribonucleic acid (DNA). The mutated abnormal cells grow uncontrollably, take over the growth of healthy cells and eventually forming a tumor. They erose the pancreas and spread to the nearby organs.

Risk factors of pancreatic cancer

Factors that increase the risk of pancreatic cancer include

  • Smoking
  • Alcoholism
  • Diabetes
  • Diet high in red meat and fat
  • Diet low in fruits and vegetables
  • Chronic inflammation of the pancreas (pancreatitis)
  • 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
  • Aged 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
  • Gingivitis

What are the signs and symptoms of pancreatic cancer?

Symptoms are not caused in the early stages. Later stage symptoms include

  • Abdominal or back pain
  • Loss of appetite
  • Unintended weight loss
  • Jaundice (yellowing of the skin and eyes)
  • Fluid in the abdomen
  • Nausea and vomiting
  • Light-colored stools
  • Dark urine
  • Itchy skin
  • Recent-onset diabetes or diabetes that is difficult to control
  • Blood clots
  • Weakness and fatigue

How is pancreatic cancer diagnosed?

Pancreatic cancer can be diagnosed using the following tests and procedures.

  • Family and medical history
  • Physical examination
  • Blood chemistry test
  • Urine test
  • Stool test
  • Tumor marker test to check the presence of the tumor marker, CA 19-9
  • Imaging tests, such as computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) scans
  • Abdominal or endoscopic ultrasound helps generate pictures of the pancreas
  • Laparoscopy helps assess the spread of cancer
  • Endoscopic retrograde cholangiopancreatography (ERCP) uses a dye to highlight pancreatic bile ducts and X-rays are taken
  • Biopsy (sample tissue from the tumor is examined under a microscope)

How is pancreatic cancer treated?

Treatment option depends on the type, size, location and stage of cancer, as well as the age and individual preference of the patient. The treatment options for pancreatic cancer are

  • Surgery: Surgery may be performed in the early stage when the cancer is limited to the pancreas.
  • Radiation therapy: X-rays and other high-energy beams are used to kill cancer cells.
  • Chemotherapy: Cancer-killing drugs are used to destroy cancer cells and prevent their growth.
  • Targeted therapy: Uses drugs to target specific abnormalities in cancer cells and destroy them.

How can pancreatic cancer be prevented?

The risk of pancreatic cancer could be reduced by

  • Quitting or avoiding smoking
  • Maintaining healthy weight
  • Exercising
  • Consuming more vegetables, fruit and whole grains
  • Consuming less red meat

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References
Dragovich T. Pancreatic Cancer. Medscape. https://emedicine.medscape.com/article/280605-overview