Description pancreatic cancer
Pancreas in Latin says pancreas. In the gastrointestinal tract is not a section, through which it passes through the food such as the stomach or intestine, but serve therein digestive and endocrine function. Namely excludes the whole range of enzymes that break down food in the intestine, neutralizes acidic gastric contents and also produces significant hormones, e.g., insulinresponsible for the intake of glucose into cells, thereby lowering blood sugar.
Pancreas is therefore in our body one of the most important organs regulating metabolic and digestive processes. His illness are therefore very serious.
Histologically, there are two types of pancreatic cancer – ductaland mucinous (mucin = mucus, a tumor with mucus production) depending on what cells are derived. Highly malignant ductal adenocarcinoma is all.
The incidence of pancreatic cancer in the last years clearly rises. In the Czech Republic, her sick about 15-20 patients per 100,000 inhabitants. A slightly more common in men and two-thirds of patients aged 65 years and over.
This unusually fast growing tumors is characterized by a particularly poor prognosis patients, even though it is subjected to treatment which prolongs the patient’s life maybe several tens months.
Risk factors and prevention of pancreatic cancer
Like other malignant (malignant) tumors formed and pancreatic cancer disorder of certainregulatory genes, which are responsible for cell cycle control, cell proliferation and their extinction. Once the damage to any of these genes, the cells are freed regulatory mechanisms – excessively multiply and subject to cell death. They are also slightly modified so that they look different and does not fulfill its function adequately.
Pancreas a certain time period ceases to function as a whole – digestive tract lacks the enzymes necessary for digestion of all nutrients, and hormones which are important not only for the digestive system, but for the whole organism.
Damage regulatory genes, however, does not arise out of nothing is nothing. Occurs effects of some harmful factors. The main one is smoking, which leaving the only prevention of this cancer.
Repeatedly studied relationship with drink black coffee, alcohol, chronic inflammation of the pancreas (pancreatitis) and prolonged diabetes, but without a reliable license these associations.
Secondary prevention is early detection of cancer (nepodcenění some symptoms, preventive examinations), which still had metastases in other organs. Unfortunately for pancreatic cancer comes overwhelmingly too late because the symptoms are in the early stages so expressed.
Symptoms and course of pancreatic cancer
Incipient pancreatic tumor is usually asymptomatic (= no symptoms), and were also resides malignancy and treacherous this tumor. A little later, the tumor can be characterized by yellowing of the skin and mucous membranes (ie. Jaundice, or jaundice, which does not have an infectious origin), after which an interval of about three months comes abdominal pain, nausea and other conditions of undetermined difficulties.
These symptoms are indicative of local spread of the tumor to the surrounding area, but may not yet be established metastases. Patients also significantly slimmer due to poor nutrient absorption and thereby decrease energy intake.
Up to 80% of cancers are diagnosed at an advanced stage, when patients have metastases in other organs, especially the liver, lungs, peritoneum and retroperitoneal (abdominal wall and cavity) .Vzácné are metastases in the adrenal glands.
When tumor ingrowth into the environment may occur more difficult depending on the location. For example, if the cancer is in retroperitoneal cavity (the space at the back in front of the spine) progressively increases, leads to visceral pain which is persistent and very badly affected. Or it may also put pressure on the nerve plexus around the spine, which is manifested by pain, which retreats in rescue position, bent or huddled in the belly. The tumor usually oppresses and bile ducts, then manifestation of the above- mentioned jaundice.
Examination of pancreatic cancer
The most important is considered ultrasound and CT. Not only localized tumor, but these imaging techniques allow you to do so as well. Percutaneous aspiration (a very thin needle prick, which is under the control of ultrasound or CT scan, in order to know exactly where to inject) to obtain cytology material and its subsequent investigation.
Your doctor will do further tests may be abbreviated as ERCP (endoscopic retrograde cholangiopancreatography – are investigated by the pancreatic and bile ducts leading into the small intestine). It is a tube inserted into the digestive tract.
The tubing is also used in the so-called. Endoscopic ultrasonography, an ultrasound, which is done from the inside, not classically outside through the abdominal wall, or similar to other endoscopic methods tube is introduced orally. This test is important to determine the stage of disease and also is used for sampling. Differentiate benign (ie, relatively good – a lot) and malignant (cancerous) tumor nature. Cancer we’re talking about, of course, belong among malignant tumors.
Another possibility is an examination of tumor markers. These are substances that are normally absent in the body and are characteristic of a particular tumor. Unfortunately, pancreatic cancer can serve as a preventive screening because they are not quite so sensitive and specific, ie. that we might find for example also in inflammation and other diseases or conditions of the organism and can not therefore rely on (among very reliable markers include PSA for prostate cancer).
Theoretically could be examined as well as the product itself damaged gene which is the essence of the disease. It is called K-ras, and we found him in the serum or in cytology samples. Practically, however, this test is technically very demanding, and yet is not commonly used.
Treatment of pancreatic cancer
The first is mainly the operation, if the tumor can still operate, which is in very advanced stages already impossible. Surgery is the only curative approach, which provides the patient a chance for a cure.
Some surgical procedures are used only for improving the quality of life of a person with this cancer.It introduces various drains and stents to prevent or eliminate clogging of the biliary tract or intestine.
Likewise, can improve quality of life as well as radiation or chemotherapy. Served with gemcitabine (Gemzar) and its combination with oxaliplatin. The active may be a combination of other cytostatic agents such as fluorouracil.
An essential part of treatment is to relieve pain, which is the dominant symptom in patients.Conventional analgesics have sufficient efficacy, therefore in various forms administered opioids. In extreme cases, surgery is the solution that would eliminate the nerve plexus leading to the pancreas and thus canceled the pain.
Patients are given the so-called. Substitution therapy, which is the payment of enzymes and hormones that due to a malfunction of the pancreas are lacking. Insulin therapy depends on the degree of disorder of the carbohydrate tolerance.
Other Names: pancreatic cancer, malignant neoplasm of pancreas, malignant tumor, pancreatic tumor, pancreatic cancer, pancreatic