The pancreas is a vital organ of the gastrointestinal system. The pancreas sits behind your stomach, under the liver, and close to your gallbladder and bowels. The pancreas is between six and ten inches long and two inches wide with three parts, the head, the body, and the tail.
95% of the pancreas comprises exocrine tissue that produces pancreatic enzymes for digestion. The remaining 5% of tissue consists of endocrine cells called islets of Langerhans that produce the hormones insulin and glucagon that regulate blood sugar and pancreatic secretions.
Caused by changes to cell DNA, cancer can start in nearly any place in the human body. Pancreatic cancer begins as either exocrine or endocrine pancreatic cells mutate and grow rapidly and uncontrollably. When these mutated cells clump together, they form tumors that disrupt the pancreas’ essential functions, as noted above.
Pancreatic cancer can start in the head, body, or tail of the pancreas. When the pancreas does not function properly, you can have trouble digesting food or maintaining blood sugar in a healthy range. An ill pancreas’ consequences may include diarrhea, bloating, flatulence, oily and foul-smelling stool, weight loss, malnutrition, poor blood sugar control, and diabetes.
How many types of pancreatic cancer are there?
While there are several types, pancreatic cancer is divided into two categories:
- Cancer that starts in exocrine cells that produce pancreatic enzymes for digestion.
- Cancer begins in endocrine cells that produce hormones that regulate blood sugar.
Each category has different cancer types that vary in symptoms and prognosis.
Exocrine (Nonendocrine) Pancreatic Cancer
This type of pancreatic cancer develops in exocrine cells that form the pancreas’ exocrine gland and ducts that secrete digestive enzymes.
The various kinds of nonendocrine pancreatic cancers account for over 95 percent of all cancers of the pancreas. They include the following:
Pancreatic ductal adenocarcinoma (PDAC)
PDAC occurs in the lining of the tree-like series of ducts in the pancreas from where digestive enzymes flow out.
The symptoms of PDAC can be from many other causes, so don’t be alarmed if you have any of these symptoms. Jaundice and Diabetes are the two biggest warnings.
Common symptoms of ductal adenocarcinoma:
- Stomach and Back Pain – A dull pain in the upper abdomen and/or middle or upper back that comes and goes. A tumor formed on the pancreas pressing on the spine may be the cause.
- Jaundice – A tumor in the head of the pancreas can block the bile duct causing jaundice symptoms:
- Yellowing of the skin and eyes
- Dark urine
- Pale, greasy stools that float in the toilet
- Pruritus (itchy skin)
- Weight Loss
- Gastrointestinal (GI) Problems – As a tumor spreads, it may press on the stomach and digestive system, causing:
- Loss of appetite
- Bloating or swelling in the abdomen
- Fatigue – Extreme tiredness may be a sign of pancreatic cancer.
- Diabetes – Pancreatic cancer can kill the cells that make insulin, causing blood sugar levels to rise.
Ductal adenocarcinoma can develop from the cells that make the pancreatic enzymes. This uncommon malignant cancer is called acinar cell carcinoma and constitutes only 1-2% of all exocrine pancreatic cancer types.
Acinar cell carcinoma symptoms are similar to PDAC symptoms, including abdominal pain, nausea, and weight loss. Jaundice is not common. Because of an increase in enzymes, some patients may have skin rashes and joint pain.
Squamous Cell Carcinoma
An extremely rare nonendocrine cancer made purely of squamous cells that form in the pancreatic ducts. Squamous cells are not usually found in the pancreas, so there are few cases to understand its causes. Most cases aren’t discovered until after metastasis.
Pancreatic Adenosquamous Carcinoma
With characteristics of PDAC malignant glandular cells and Squamous Cell Carcinoma, it’s a more aggressive tumor than ductal adenocarcinoma, with a poorer prognosis. However, it’s a rare type occurring in only 1% to 4% of exocrine cancers.
Pancreatic Colloid Carcinoma
Colloid carcinoma is a distinct type of cancer of the pancreas that secretes a protein called mucin, the chief constituent of mucus. Colloid carcinoma accounts for 1-4% of exocrine pancreatic cancers. The tumors start in pancreatic ducts and often grow from benign cysts. Because its structural characteristics are pools of mucinous material confined to a limited area floating in mucin, the cancer is unlikely to spread.
Neuroendocrine Pancreatic Cancer (NET)
Neuroendocrine pancreatic cancer starts from islet cells in the endocrine gland that secretes insulin and glucagon into the bloodstream to regulate blood sugar. Also known as islet cell carcinoma, the tumors may be benign or malignant. Either non-cancerous or cancerous, they can cause serious health issues.
NETs are rare, accounting for less than 5 % of all pancreatic cancer cases, and are classified into four types:
- Gastrinoma – a neuroendocrine tumor that forms in gastrin-producing cells, a hormone that aids in digestion with stomach acid release.
- Insulinoma – tumors that form in the pancreas’ insulin-producing cells that can cause an overproduction of insulin resulting in dangerously low blood sugar.
- Glucagonoma – A rare neuroendocrine tumor (NET) causing the overproduction of glucagon, a hormone that works with insulin to control blood sugar.
- VIPoma – a rare endocrine islet cell tumor that overproduces vasoactive intestinal peptides.
Benign Precancerous Lesions
The pancreas can occasionally form benign tumors or cysts. Benign, meaning non-cancerous.
However, occasionally tumors such as intraductal papillary-mucinous neoplasms (IPMN) can progress to invasive pancreatic cancer.
Lesions may be found when a patient is being scanned for an unrelated medical reason. A doctor may remove the lesion surgically or monitor it to ensure it does not become malignant.
Diagnosing pancreatic cancer
Often when a patient is diagnosed with pancreatic cancer, it is already at an advanced stage because typically, there are no early symptoms. The difficulty in detection is partly because the pancreas is deep in the gut, hidden by vital organs like the liver, stomach, and bile duct.
If your doctor suspects pancreatic cancer due to some signs or symptoms you may have, they can perform a range of tests. This includes:
Imaging tests – A doctor can take pictures of your internal organs using CT scans, MRI scans, or endoscopic ultrasound (EUS).
- Percutaneous biopsy – A test known as fine-needle aspiration (FNA) can be performed. The doctor, guided by images from ultrasound or CT scans, inserts a thin, hollow needle through the skin into the pancreas and removes a small piece of a tumor.
- Blood tests – Your blood and be tested for specific proteins cast off by pancreatic cancer cells called tumor markers.
Contact New Hope now!
Suppose you or someone you care for is dealing with pancreatic cancer or is having symptoms. In that case, New Hope Unlimited is here to help whether needing diagnosis, treatment, or a second opinion. Call us at (480) 696-5330 or use our online form to get in touch now.