Humanity’s fight against pancreatic cancer has been a gritty yet mostly disappointing one. With a multitude of modern advancements promising to help us gain some ground, the progress is yet sluggish. But positivity and persistence has seldom failed. We will, thus, remain tenacious and continue to be grateful for small but significant areas in which our patients are being better benefited.
This shy but potentially deadly organ, the pancreas, is snugly situated deep in our abdomen, right in front of the spine. When pancreatic cells multiply in an uncontrolled manner, tumors develop. They may arise from the exocrine cells (which produce juices to digest food) or the endocrine cells (which produce hormones that regulate blood sugar level, among other things). The classical cancers are adenocarcinomas which are usually exocrine. Neuroendocrine tumors generally originate from endocrine cells and are much better behaved, giving us many options to control or cure it. Other cystic tumors may also develop, but are usually benign and easier to treat.
The reason these dreaded tumors develop is not fully understood, but the cause is largely attributed to genetic mutations that happen inexplicably or those passed down in families. Pancreatitis, obesity, long-standing diabetes, and smoking contribute to the chances of developing this disease.
Pancreatic cancer is often detected late in its course because the symptoms are often vague. Significant pain or jaundice usually troubles the patient only after the tumor is more advanced. But once it has been suspected, imaging like CT scans or PET scans are used to accurately detect the diagnosis and stage. Endoscopic techniques may also be used for stenting or biopsy.
Surgery is still the only chance for cure, though it is not a possibility more often than not. Surgical results are improving without a doubt with excellent outcomes. Minimally invasive techniques have further decreased the morbidity. Chemotherapy, chemoradiation, or targeted therapy are options following surgery, or can be used for palliation if surgery is not possible.
Neuroendocrine tumors, on the other hand, are easier to cure or keep in check. Treatment options are also vaster. Surgery, somatostatin analogues, targeted therapy, peptide therapy, and liver targeted therapy are some of the treatment options.
We must tailor treatment according to the individual patient. It is therefore imperative that the management of pancreatic tumors be carried out in a specialized center with substantial expertise in this particular field. Early detection is rarely possible, so our focus remains on aggressive treatment and palliation. We will continue to battle this disease knowing well that we can not succeed until we have tried.