Pancreatic cancer

Pancreatic cancer is a disease caused by tumor growth in the pancreas. The pancreas is a large gland that is part of the digestive system and has a length of about 15 cm. Pancreatic cancer can affect men and women and generally affects people over 75 years old.
The pancreas has an important function for the body because it produces digestive enzymes that break down food so that it can be absorbed by the body. In addition, the pancreas also produces hormones, including insulin, which functions to maintain the stability of blood sugar levels in the body.

Symptoms of pancreatic cancer

Pancreatic cancer in the early stages usually does not cause symptoms and makes diagnosis more difficult. Symptoms of advanced pancreatic cancer depend on which part of the pancreas is infected because the pancreas has two types of glandular tissue. The first is a gland that produces digestive enzymes or called exocrine glands. The second is a hormone-producing gland, also called the endocrine gland.

Exocrine glands are the glands most often affected by pancreatic cancer with symptoms such as jaundice, weight loss, back pain or stomach pain.

In addition to some of the symptoms mentioned above, there are several other symptoms of pancreatic cancer, including:

• Diabetes
• Fever and chills
• itchy
• Blood clots easily
• Nausea and vomiting
• indigestion
• Changes in intestinal habits
• Loss of appetite
• fever

Causes of pancreatic cancer

So far, the cause of a person with pancreatic cancer is not known with certainty, but several risk factors can increase the risk of developing pancreatic cancer, as follows.

• Diabetes can increase the risk of pancreatic cancer. Conversely, malignant tumors that develop in the pancreas can also be a cause of diabetes.
• Helicobacter pylori bacteria that cause stomach infections slightly increase the risk of pancreatic cancer.
• Smoking can increase the risk of pancreatic cancer because poisons and harmful chemicals can irritate and inflamed body tissues and organs.
• Over 75 years old.
• People who don't do a lot of physical activity, who are overweight or obese, and who don't follow a healthy diet.
• You suffer from inflammation of the pancreas or pancreatitis.
• Does a close family member suffer from pancreatic cancer?

In addition to the risk factors mentioned above, other risk factors can increase the risk of contracting pancreatic cancer, namely people who consume a lot of alcohol and people with chronic hepatitis.

Diagnosis of pancreatic cancer

It is difficult to diagnose pancreatic cancer in the early stages because it often causes no symptoms in patients. Physical examination to detect pancreatic cancer is difficult because the location of the pancreas is quite hidden in the body and surrounded by parts of the intestine.

Here are some tests that can be done to diagnose pancreatic cancer:

• Organ imaging tests such as ultrasound, computed tomography, MRI and PET. In addition, endoluminal ultrasound (EUS) can also be done if a CT scan or MRI is still unclear. An endoscope or small camera will be inserted through the stomach into the stomach to photograph the condition of the pancreas.
• Laparoscopy or "keyhole" surgery in the abdominal area involves inserting a small microscope called a laparoscope, which allows organs to be seen in the abdominal and pelvic cavities.
• Retrograde cholangiopancreatography (ERCP) endoscopy is almost identical to EUS, the process of inserting an endoscope through the mouth and into the stomach. However, in the ERCP process, an endoscope is used to inject special dyes into the pancreatic and bile ducts to detect the presence of blocked tumors. This test is done if someone has jaundice.
• Biopsy or the process of taking samples of cells suspected of being tumors must be examined under a microscope. A small instrument mounted on the endoscope can be used for biopsy during the laparoscopic procedure, ERCP or EUS.

The stages of cancer are divided into four stages or commonly known as stages. The doctor will classify the stage of the cancer according to the diagnosis. The following is a classification of the stage of pancreatic cancer:

• If the cancer is only in the pancreas and has not spread to other areas, it is called stage I.
• If the cancer has spread to tissues and organs close to the pancreas, or if it has been able to infect the lymph nodes, this is stage II.
• If the cancer has spread more to large blood vessels around the pancreas and may have been infected with lymph nodes, it is called stage III.
• If the cancer has spread to other organs such as the lungs, liver and peritoneum or the lining lining the abdominal cavity, it is called stage IV. 

Treatment for pancreatic cancer

Treatment of pancreatic cancer in each patient is different because several factors determine the type of treatment performed:

• The part of the pancreas that is infected with cancer.
• The level of spread of cancer or the stage suffered.
• Patient age.
• Overall patient health.
• Patient preferences or preferences for care.

Treatment of patients with pancreatic cancer aims to remove tumors and other cancer cells from the body. However, if this is not possible, the doctor will continue with treatments to prevent the tumor from growing because it can cause further damage. In addition, the treatment carried out is very helpful in relieving symptoms and making patients feel comfortable.

Treatment or healing process of cancer will be much more difficult if the tumor appears in a large body or has spread. Talk to your doctor and family members to decide what type of treatment is right for you. Here are some types of treatments that can be given to treat pancreatic cancer.

operation

The most common type of pancreatic cancer treatment is surgery because it can fully treat pancreatic cancer. However, not all patients with pancreatic cancer can undergo surgery, with only 1 in 5 patients who are eligible for tumor removal surgery.

Several factors can determine the success of tumor removal surgery, including:

• The tumor does not spread to other parts of the body.
• Tumors do not grow around important blood vessels.
• The patient has good general health.

Here are some surgical procedures to treat pancreatic cancer:

• The most common operation is Whipple surgery, which involves removing the head of the pancreas. During this operation, the doctor may also take the first part of the small intestine, the gallbladder, part of the bile duct and sometimes a part of the stomach. About 30% of Whipple-operated patients need enzyme-based drugs to digest food. This operation has a faster recovery time than surgery to remove the pancreas completely.
• Total pancreatectomy surgery to remove the entire pancreas. In addition, this operation also removes organs from the spleen, bile ducts, parts of the small intestine, gallbladder, lymph nodes around the pancreas and sometimes parts of the stomach. Patients who have undergone this operation must consume enzymes to help digest food. The appointment of the pancreatic organs that produce insulin will also cause diabetes. In addition, patients must take lifelong penicillin antibiotics and routine vaccinations to prevent infection and blood clots from removing the organ from the spleen.
• Distal pancreatectomy to remove body parts and tail from the pancreas while leaving the head of the pancreas. This operation also removes some of the stomach, large intestine, left kidney, left adrenal gland and the possibility of the left diaphragm will also be removed.
• If it cannot be cured, surgery can be done to relieve symptoms and make the patient feel more comfortable. This procedure uses ERCP to place a tube stent or opening in the bile duct to prevent the buildup of bilirubin which causes jaundice. Bypass surgery that blocks the bile duct can be done if the use of a stent is not suitable for the patient. The blocked bile duct will be cut and connected back to the intestine so that it can channel bile.

The recovery process of pancreatic cancer after surgery must be taken into account because it requires a lot of time. Here are a few things to consider in the post-surgery recovery process for pancreatic cancer:

• Make sure the painkillers are suitable and in sufficient dosages for the postoperative period.
• Patients cannot eat or drink immediately after surgery because the digestive system such as the intestine needs time to recover.
• Before the patient can eat and drink more regularly, he will drink little by little.
• A series of chemotherapy for six months is usually recommended after surgery. This has a large impact on the patient's chances of healing. 

chemotherapy

To destroy malignant cancer cells in the body or prevent their growth, patients can undergo chemotherapy with anticancer drugs. Chemotherapy can be done before or after surgery, or if surgery cannot be done. Chemotherapy drugs have two forms, namely those taken directly and those given intravenously.

Chemotherapy has many side effects because it can attack healthy and normal cells. Possible side effects include thrush, fatigue, nausea and vomiting. In addition, chemotherapy can also increase the risk of infection. Side effects experienced by patients during chemotherapy are usually only temporary and will disappear once treatment is complete.

The risk of side effects will increase if the patient undergoes a combination of chemotherapy, but this can increase the possibility of controlling or reducing the cancer suffered.
radiotherapy

To help reduce tumors and eliminate pain, patients can take cancer treatment using high energy radiation beams called radiation therapy. For patients who cannot perform surgery to treat cancer, doctors generally recommend a combination of chemotherapy-radiotherapy.

However, this therapy has several side effects, such as loss of appetite, nausea, vomiting, fatigue, diarrhea and rashes. Side effects experienced by patients due to radiation therapy are usually only temporary and will disappear once treatment is complete.

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