Pancreatic cancer ranks fourth among malignant tumors of the gastrointestinal tract (after stomach cancer, colon cancer and cancer of the esophagus) and is 2-3% of all cancers. Significantly more common in men, mostly aged over 50 years.
Among the urban population of pancreatic cancer occurs more frequently than among residents of rural areas.
Risks
Aware of the various factors contributing to the development of pancreatic cancer:
Clinical picture
The clinical picture of lesions of the pancreas depends on the tumor. The tumors most often located in the head of the pancreas (75% of cases), sometimes hitting her body and tail.
Symptoms of cancer head of pancreas can be divided into two periods. In the early stages of the disease little worried sick, and they do not seek medical help. The first alarming symptom of the disease is most often a pain in the epigastrium and hypochondrium sometimes with irradiation in the back (girdle pain), with the increase of intensity during the night. In the future, characterized by progressive weight loss without any clear reason, the severity of the epigastric region after the meal, general weakness and disability.
With the progressive increase in tumor appears leading sign of cancer head of pancreas – jaundice – a consequence of tumor compression of common bile duct. It starts suddenly, without preceding pain attack, then rapidly increases. Join itchy skin, dark urine and stool discoloration. In addition to jaundice may have severe digestive disorders: loss of appetite, nausea, belching, vomiting, diarrhea, there is increasing dehydration, cachexia (a sharp decrease in body weight).
Cancer of the body or tail of the pancreas is manifested in the later stages, such as tumor localization causing obstructive jaundice in only 10% of cases. Cancer of the body glands quickly germinates in mesenteric vessels, portal vein. Sometimes (10-20%) in connection with the destruction of insulin-producing cells develop diabetes. Tumor of the tail of the pancreas often germinates portal vein and spleen vessels, which leads to the development of portal hypertension with splenomegaly and other characteristic symptoms. With the localization of tumor in the tail and the body of cancer pain is particularly pronounced in relation to the germination of many tumor surrounding the gland nerve plexus. Often the first and only symptom of cancer of the body and tail of the pancreas may be multiple venous thrombosis.
Some rare forms of tumors originate from cells secreting the hormones of the pancreas, which largely determines the clinical picture of the disease. Thus, tumor, highlighting glucagon, leads to an increase in blood sugar levels, and dermatitis. Tumor, highlighting insulin, leads to a severe reduction in blood sugar, which is manifested in weakness, cold sweat, loss of consciousness, and with prolonged duration – the violation of the brain.
Diagnosis
In the diagnosis of tumors of the pancreas are applied instrumental and laboratory techniques.
Major instrumental techniques include:
Ultrasound (ultrasonography) – the most common and available method for diagnosing diseases of the pancreas. But, unfortunately, the possibility of ultrasound are not limitless and any entity may identify and evaluate the ultrasonic sensor. Here come to the aid of more modern technology.
CT (computed tomography), MRI (magnetic resonance therapy) are more informative than ultrasound, but did not always allow one hundred percent correct diagnosis.
Endoscopic ultrasound and intraduct – variety ultrasound, a combination of ultrasound and endoscopic technique, in which the study is carried out from the lumen of the stomach and duodenum, which adjoins the pancreas. Hence, a clearer picture and the possibility of more accurate diagnosis of pancreatic cancer.
When intraduct ultrasound (currently the most accurate noninvasive study tool used for the diagnosis of tumors of the pancreas), an endoscope with a probe conducted into the duodenum, determined by the location to which empties into pancreatic duct (duct Virsungov), after which the sensor is put forward and introduced into the lumen duct. Study is carried out through the pancreatic duct, ie in the vicinity of cancer tissue.
In some cases, apply angiographic study, diagnostic laparoscopy.
Laboratory techniques
Determination of blood parameters, indirect evidence in favor of the destruction of the pancreas.
This:
In some cases, despite the use of these diagnostic procedures, there are considerable difficulties in the differential diagnosis of some forms of chronic pancreatitis (benign disease of the pancreas). In this situation, the final diagnosis is made on the basis of cytological and histological examination of material obtained at biopsy.
It should be remembered that the identification of any, even malignant disease at an early stage improves the forecast of the forthcoming treatment.
Treatment
Treatment of pancreatic cancer surgery. In previous years the operation was purely palliative in nature and amounted to the imposition of an anastomosis for diversion of bile to the intestine. Over the past decade, surgery of this area has achieved considerable success. In the early, uncommon forms of cancer of the head of the pancreas produce a complex operation – pancreat-duodenal resection, removing part of the pancreas with ducts and duodenum, and then sophisticated reconstructive techniques restore the pathways of bile and intestinal contents. But such a radical operation is possible only in 10-30% of patients. Carcinoma of the body or tail of the pancreas is removal of the affected part of the gland. With common processes and, especially, in the presence of metastases, which are cancer of the pancreas makes quite early in the nearby and distant lymph nodes in the abdomen, producing the above palliative surgery.
Radiation therapy is ineffective. Some successes have during chemotherapy.
Metastasis
Pancreatic cancer metastasizes early and often in regional lymph nodes and liver. It is also possible metastasis to the lungs, bones, peritoneum, pleura, adrenals, etc.
Forecast
When tumors pancreat-duodenal zone of severe weather, for early detection of these tumors in most cases is difficult and the implementation of radical intervention is possible only in limited cases.
Almost 70% of patients, diagnosis is late. Results of treatment of such patients in this connection is very bad. In the U.S., adenocarcinoma of the pancreas takes 4 place in the structure of cancer death.
Prevention
Denial of smoking. Excluding the impact of harmful factors of environment, occupational hazard (asbestos dust). Early treatment of chronic pancreatitis, diabetes mellitus. Systematic preventive examinations in the presence of cysts and benign tumors of the pancreas, chronic pancreatitis.
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