The pancreatic cancer rarely appears in the early stages, therefore it is difficult to be treated.
Often, patients seek medical help in weeks or even months after symptoms appear, which reduces the chances of successful treatment.
Pancreatic cancer rarely appears in the early stages. At the time of the appearance of any symptoms, the diagnosis of this malignant tumor is usually not difficult. Unfortunately, it is for this reason that pancreatic cancer is hardly treated, and mortality in this disease is extremely high.
Of course, the main goals are the earliest detection and diagnosis. How does this happen? In this article we will discuss, first of all, the adenocarcinoma of the pancreas, which accounts for up to 95% of cases of cancer of this organ.
Pancreatic cancer: Symptoms
Symptoms of pancreatic cancer are extremely nonspecific, that is, they can also occur in the mass of other diseases. These signs include pains in the upper abdomen, often on the left, which may spread to the back or wear a hanging character.
Pain sensations may be exacerbated after eating or in a horizontal position. There is also loss of appetite, nausea, vomiting, weight loss (sometimes very significant). It may be jaundice (Yellow skin color and sclera) as a result of compression of a growing tumor of bile ducts and a violation of bile drainage.
Medical search for the root cause of all these symptoms is based on the following principles:
- Study of the history of the disease. The physician interviews the patient about the peculiarities of the course of the disease, paying particular attention to the time of appearance of symptoms, the nature and location of pain, the presence of diseases of the pancreas (including cancer) in relatives, smoking, and more.
- An objective review of the patient is conducted, during which a doctor can (painfully dilate) through the anterior abdominal wall a painful tumor-like formation (with large tumor size). Also pay attention to the color of skin and sclera, weight loss.
- Laboratory tests show a disturbance of bile outflow and other deviations
Instrumental methods for the diagnosis of pancreatic cancer
Based on an objective review and results of a laboratory examination, the doctor may suggest one of the instrumental methods that will show the structure of the pancreas and localization of the tumor:
- Computer tomography (CT): a device called a tomograph with X-rays makes a lot of pictures, which then, with the help of a computer, form a coherent image of the organs of the abdominal cavity.
- Magnetic resonance imaging (MRI) is carried out using magnetic waves, which create a detailed image of the internal organs, in particular, the pancreas, the liver and the gall bladder.
- Ultrasound (ultrasound) is performed with the help of safe sound waves, which are reflected from the walls of the internal organs, creating their image on the screen of the monitor
- Positron Emission Tomography (PET): The study is conducted after intravenous administration of radionuclide (radioactive glucose) that is absorbed by cancer cells. PET Scan helps determine the extent of the metastasis of a cancerous tumor.
If methods of instrumental examination revealed some kind of education in the pancreas, then the diagnosis of cancer is probable, but not yet final. Only a biopsy (taking a sample of tissue from an organ with further examination under a microscope) can confirm the diagnosis of a malignant tumor. There may be several types of biopsy:
- Percutaneous biopsy (sometimes referred to as a fine-needle aspiration biopsy): under the visual control (most often the ultrasound apparatus), the surgeon inserts a needle into education, capturing part of the tumor tissue.
- Endoscopic retrograde cholangiopancreatography (ERCP): an endoscope (a thin flexible tube with a camera at the end) is introduced through the mouth in the 12th-small intestine. Then bile ducts and ducts of the pancreas are filled through it with a contrast agent and an X-ray is taken. The endoscope also uses a sample of tissue.
- Endoscopic ultrasound is performed similarly to ERCP: the endoscope is brought to the pancreas, and its ultrasound sensor determines the position of the tumor. The biopsy is performed using a thin needle located at the end of the endoscope.
- Laparoscopy is a surgical procedure performed through a small incision on the anterior abdominal wall. With the help of this method, the surgeon can not only take a sample of tissue, but also inspect the abdominal cavity from the inside for the subject of the spread of the tumor. However, in comparison with other procedures, laparoscopy is more dangerous.
If pancreatic cancer seems highly probable and the tumor can be surgically removed, the doctor may recommend surgery without a preliminary biopsy.
Researchers are in constant search for new methods for early detection of pancreatic cancer. These include blood tests for cancer markers, that is, biochemical indicators that indicate the presence of a malignant process. These markers include the carcinoembryonic (or cancer-embryonic) antigen and the cancer antigen CA19-9, whose level in pancreatic cancer rises.