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Pancreatic Cancer — Symptoms, Diagnosis & Treatment Options

Pancreatic cancer is a cancer that begins in the pancreas, a gland behind the stomach that helps with digestion and blood sugar control. Although not as common as colorectal cancer, pancreatic cancer is known for being aggressive and often detected late because early symptoms are vague.


 


Common Symptoms of Pancreatic Cancer


Symptoms depend on where in the pancreas the cancer begins (head, body, or tail) and how advanced it is.


1. Jaundice (Yellowing of eyes and skin)




  • Common when tumor blocks bile duct




  • Includes dark urine & pale stools




2. Upper abdominal or back pain




  • Pain may radiate to the back




  • Often dull & persistent




3. Weight loss & loss of appetite




  • Very common presentation




4. New-onset diabetes




  • Especially after age 50




  • Diabetes that suddenly becomes uncontrolled can be a clue




5. Indigestion, nausea or bloating


6. Fatigue


7. Change in stool consistency




  • Greasy, foul-smelling stools (steatorrhea) due to lack of digestive enzymes




 


 


What Tests & Investigations Are Needed?


For proper diagnosis & staging, doctors usually perform:


1. Contrast-enhanced CT Scan (Pancreas protocol)




  • Main investigation for detecting tumor and assessing spread




2. MRI / MRCP




  • Useful for evaluating bile duct obstruction and pancreatic ducts




3. Endoscopic Ultrasound (EUS) with Biopsy




  • Helps confirm diagnosis with tissue sampling




  • Detects small tumors not visible on CT




4. ERCP (Endoscopic Retrograde Cholangiopancreatography)




  • Used mainly to place a bile duct stent in jaundiced patients




5. PET Scan




  • Sometimes used to detect metastasis




6. Blood Tests


 




  • Liver function tests (LFT)




  • Tumor markers like CA 19-9 (not diagnostic but helpful in follow-up)




  • Blood sugar levels (diabetes link)




 


Treatment Options for Pancreatic Cancer


Treatment depends on the stage, place of tumor, and whether it can be removed surgically.


Category 1: Resectable (Operable) Tumors


If the tumor is limited & can be removed, surgery offers the best chance of cure.


Common operations:




  • Whipple Procedure (Pancreaticoduodenectomy) — for head of pancreas tumors




  • Distal Pancreatectomy — for body/tail tumors




  • Total Pancreatectomy — less common




Surgery is major & requires expert GI or HPB surgeons.


Post-surgery:


 




  • Chemotherapy may be given to reduce recurrence




 


Category 2: Borderline Resectable Tumors


Tumor touches nearby blood vessels but may become operable after treatment.


Treatment:


 




  • Neoadjuvant chemotherapy or chemoradiotherapy




  • Re-evaluation for surgery afterward




 


Category 3: Locally Advanced / Unresectable


Tumor has spread locally and cannot be removed without major vessel involvement.


Treatment:


 




  • Chemotherapy




  • Radiotherapy in some cases




  • Palliative procedures if needed




 


Category 4: Metastatic Stage (Spread to liver, lungs or peritoneum)


Here, surgery is usually not useful.


Treatment:




  • Chemotherapy




  • Targeted therapy (selected cases)




  • Immunotherapy (for MSI-high tumors)




  • Pain management & nutritional support




  • Biliary stenting if jaundice present




 


Goal: Improve survival & quality of life