Pancreatic Cancer Treatment

What Is Pancreatic Cancer and What Are Its Symptoms?

Pancreatic cancer treatment is a highly complex process planned according to the tumor’s location, spread status, and the patient’s general health profile. While the chance of successful surgical treatment increases when diagnosed early, in advanced stages, modern methods such as chemotherapy, targeted therapies, and immunotherapy can provide significant improvements in life expectancy and quality. Therefore, knowing the symptoms, diagnostic methods, and current treatment options for pancreatic cancer is critically important in disease management.

Causes of Pancreatic Cancer

Pancreatic cancer occurs with the uncontrolled proliferation of cells in pancreatic tissue and is a serious disease requiring early intervention due to its aggressive course. Although there is no single cause of the disease, it is known that genetic and environmental factors play a role together. Pancreatic adenocarcinoma, the most common type, originates from cells that produce digestive enzymes in the pancreas.

Genetic predisposition holds an important place among the causes of pancreatic cancer. Gene mutations such as BRCA1, BRCA2, CDKN2A, and STK11 can increase the risk of pancreatic cancer. In individuals with pancreatic cancer in their family, the risk is several times higher than the general population.

Environmental factors can also be effective in disease development. Smoking for many years has been found to be directly related to pancreatic cancer. Smoking can cause cellular deterioration by leading to DNA damage in pancreatic tissue. Diseases such as obesity, chronic pancreatitis, and diabetes can also prepare the ground for cancer development by stressing pancreatic tissue.

Dietary habits are also important in terms of risk. Diet rich in high-fat and processed foods can contribute to long-term inflammation exposure of the pancreas. Excessive consumption of alcohol is also among the factors triggering this process by leading to pancreatitis.

Pancreatic Cancer Risk Factors

There are many risk factors that increase the likelihood of contracting pancreatic cancer. While some of these risks are modifiable, others may not be controllable due to genetic predisposition.

1. Age:

Pancreatic cancer is generally more common in people over 60 years of age. As age progresses, the decrease in cellular renewal capacity increases risk along with the accumulation of mutations.

2. Smoking:

Smoking is one of the strongest risk factors for pancreatic cancer. The risk in smokers is approximately 2-3 times higher than non-smokers.

3. Obesity and sedentary lifestyle:

The risk of pancreatic cancer increases significantly in overweight individuals and especially those with abdominal obesity.

4. Diabetes:

In people who have had diabetes for many years, changes in glucose metabolism can increase the risk of pancreatic cancer.

5. Chronic pancreatitis:

Continuous inflammation can lead to deterioration of pancreatic tissue over time. This condition can prepare the ground for cancer in the long term.

6. Family history:

People with pancreatic cancer in first-degree relatives are in the high-risk group for genetic follow-up.

7. Dietary habits:

Processed meats, high-fat foods, and low-fiber diet can contribute to increased risk.

Pancreatic Cancer Symptoms

Pancreatic cancer generally does not show obvious symptoms in the early stage. Therefore, the disease is often diagnosed at an advanced stage. However, some symptoms may indicate the presence of the disease.

The most common symptom is abdominal and back pain. Due to the anatomical position of the pancreas, as the tumor grows, pain radiating to the back area may occur. Another early finding is loss of appetite and unexplained weight loss. Disruption in the production of digestive enzymes can cause weight loss by affecting nutrient absorption.

Jaundice may occur in tumors located in the head of the pancreas. Jaundice occurs as a result of increased bilirubin levels due to blockage of the bile ducts by the tumor. Yellowing in the eyes, dark-colored urine, and light-colored stool may accompany this condition.

Nausea, indigestion, bloating, fatty stool (steatorrhea), deterioration in blood sugar control, and newly onset diabetes may be among pancreatic cancer symptoms. If these symptoms persist for a long time, consulting a specialist without delay is extremely important for early diagnosis.

Pancreatic Cancer Diagnosis

The diagnosis of pancreatic cancer is made with detailed medical history, physical examination, and advanced imaging methods. Diagnosis is usually confirmed by using several different methods together.

In the initial evaluation, ultrasonography provides general information about the pancreatic region. However, since the pancreas is located deep, CT (computed tomography) and MRI (magnetic resonance) are often used to obtain clearer images. These methods provide detailed information about the size of the tumor, spread to surrounding tissues, and metastasis.

One of the most important diagnostic tools in pancreatic cancer is Endoscopic Ultrasonography (EUS). EUS allows very close visualization of the pancreas and, when necessary, enables definitive diagnosis by taking a tissue sample with fine needle biopsy.

In some cases, PET-CT is used in metastasis screening. In blood tests, the tumor marker CA 19-9 can usually be found elevated, but it is not diagnostic by itself; it is important in monitoring the treatment process.

Types of Pancreatic Cancer

Pancreatic cancer can originate from different cell types and is therefore divided into various subtypes. This classification is of great importance in treatment planning.

1. Pancreatic Adenocarcinoma

It constitutes approximately 90% of all pancreatic cancers. It originates from exocrine cells that produce digestive enzymes. It is the most aggressive and commonly seen type.

2. Neuroendocrine Tumors (PNET)

It develops from hormone-producing cells of the pancreas. It may have a slower progressing structure. Functional ones give symptoms with excessive hormone production, while non-functional ones may give late symptoms.

3. Intraductal Papillary Mucinous Tumors (IPMN)

These are lesions developing in the pancreatic duct with a risk of becoming cancerous.

4. Acinar Cell Carcinoma, Mucinous Carcinoma, etc.

These are rarer special tumor types.

Since each type’s behavior pattern, response to treatment, and prognosis are different, determining the correct one plays a critical role in treatment success.

Pancreatic Cancer Stages

Staging in pancreatic cancer is done according to the size of the tumor, lymph node involvement, and metastasis status. This staging determines the direction of treatment.

Stage 0 – In Situ Cancer

Cells are limited to the innermost layer of the pancreas. It is a very early stage.

Stage 1 – Localized Tumor

The tumor is only in the pancreas. At this stage, the chance of surgical success is high.

Stage 2 – Regional Spread

The tumor may have spread to tissues or lymph nodes around the pancreas.

Stage 3 – Locally Advanced Stage

The tumor has spread to important structures such as major vascular structures. Surgery may generally be difficult or impossible.

Stage 4 – Metastatic Stage

Cancer has spread to the liver, lungs, or other organs. The aim of treatment is to prolong life expectancy and improve quality of life.

Pancreatic cancer treatment is planned with a multidisciplinary approach and is shaped specifically for the patient. Methods used in treatment include surgery, chemotherapy, targeted therapies, and immunotherapy.

1. Surgical Treatment

Surgery is the only curative (completely healing) method in pancreatic cancer. However, it is important that the tumor is surgically removable. Main methods used:

Whipple procedure (Pancreaticoduodenectomy)
Distal pancreatectomy
Total pancreatectomy

These surgeries require high experience.

2. Chemotherapy

Can be applied before surgery (neoadjuvant) or after surgery (adjuvant). It is also used to reduce tumor burden or prolong life expectancy in patients who cannot undergo surgery.

3. Radiotherapy

In some locally advanced stages, tumor control can be increased by applying in combination with chemotherapy.

4. Targeted Therapies and Immunotherapy

Drugs targeting molecular targets can be applied according to the genetic characteristics of the tumor. Particularly in patients with BRCA mutation, PARP inhibitors can be effective. Immunotherapies such as PD-1 inhibitors can also be used in selected patients.

5. Palliative Treatment

In advanced stages, it is applied for purposes such as maintaining quality of life, controlling pain, and relieving bile duct obstruction.

Methods of Protection from Pancreatic Cancer

Lifestyle changes play an important role in protection from pancreatic cancer. Quitting smoking, maintaining a healthy weight, and regular physical activity help reduce risk. Eating fiber-rich foods, limiting alcohol, and staying away from processed foods support pancreatic health.

It is of great importance for individuals with chronic pancreatitis, those with pancreatic cancer in their family, or those carrying genetic risk to have regular check-ups for early diagnosis.

Modern Approach to Pancreatic Cancer Treatment with Prof. Dr. Samet Yardımcı

Working with the right specialist in a complex disease like pancreatic cancer directly affects treatment success. Prof. Dr. Samet Yardımcı has extensive experience in pancreatic surgery and gastrointestinal system oncology, and offers his patients evidence-based, personalized, and modern treatment methods. He adopts a multidisciplinary approach in diagnostic process management, surgical planning, determination of appropriate treatment combinations, and regular follow-up processes. He is a reliable point of reference for patients who want to get a second opinion or create a treatment plan regarding pancreatic cancer.

Frequently Asked Questions (FAQ)

1. What are the most common symptoms of pancreatic cancer?

Back and abdominal pain, loss of appetite, rapid weight loss, jaundice, fatty stool, and newly onset diabetes are the most common symptoms.

2. Can pancreatic cancer be diagnosed early?

Early diagnosis is difficult because it generally does not show symptoms. However, regular screening is important in individuals in the risk group.

3. Can pancreatic cancer be completely cured?

Recovery is possible with surgical treatment in the early stage. In advanced stages, treatment aims to increase life expectancy and quality of life.

4. What are the main risk factors for pancreatic cancer?

Smoking, obesity, chronic pancreatitis, genetic predisposition, and long-term diabetes are the most important risk factors.

5. Is the CA 19-9 test sufficient in the diagnosis of pancreatic cancer?

No. It is not diagnostic by itself. It is evaluated together with imaging and biopsy.

6. What is the most effective treatment method for pancreatic cancer?

Surgery is the only curative method. However, not all patients may be suitable for surgery.

7. What is the Whipple procedure?

It is a comprehensive surgery applied in pancreatic head tumors and requires high experience.

8. Is immunotherapy used in pancreatic cancer treatment?

Yes, immunotherapy can be effective especially in patients with certain genetic profiles.

Instagram: Prof. Dr. Samet Yardımcı