Pancreatic Cancer, Second Opinions & Treatment Choices

Pancreatic cancer occurs when pancreatic cells begin to multiply at a rapid rate. It can occur anywhere in the pancreas, and the severity depends on the location and size of the tumour. The cancerous cells are able to invade other parts of the body and can potentially spread of other organs in the body.  

Around 8,500 people are diagnosed with pancreatic cancer in the UK each year. In recent years due to research and new treatment developments, the survival rate from those diagnosed with pancreatic cancer has increased by 3% to between 5-8%. By accessing the right treatment for your situation, the chance of living well with pancreatic cancer can dramatically increase.   In the United States, the statistics are similar accounting for 3% of all cancer diagnoses and 7% of all cancer related deaths. The five year net survival rate in Canada is 8%.[1]

What is Pancreatic Cancer

Pancreatic cancer is cancer that occurs in the pancreas. The pancreas has two main functions. The first is to help us digest food. The pancreas contains exocrine glands which create the enzymes to help us process food. The second function is to control our blood sugar levels and produce insulin which is done through endocrine glands that create hormones.

Pancreatic cancer can affect either the function of the exocrine or endocrine glands.  

Types of Pancreatic Cancer

Pancreatic Adenocarcinoma

The most common form of pancreatic cancer is adenocarcinoma, which accounts for approximately 85% of all pancreatic cancers. This exocrine type of cancer begins in the secretory part of the pancreas where digestive enzymes are produced.

Pancreatic Non-adenocarcinoma

1-2% of pancreatic cancer cases are neuroendocrine tumours which start in the hormone producing pancreatic cells which govern blood-sugar levels. These are often slower growing and less aggressive than adenocarcinoma tumors. 

Causes of Pancreatic Cancer

The exact cause of pancreatic cancer is unknown. Factors which may contribute to an increased likelihood of developing pancreatic cancer include:

• Smoking
• Obesity
• Poor diet
• Diabetes
• Pancreatitis
• Family history
• Age - most often diagnosed in the over 65s

A combination of poor lifestyle and family history of mutated genes are likely to put individuals at the highest risk. Depending on your general health, age and other factors can influence the severity of pancreatic cancer.

The Main Symptoms of Pancreatic Cancer

The main symptoms of pancreatic cancer are:

• Jaundice
• Weight loss or a change in appetite
• Loss of appetite
• Lethargy
• High temperature
• Pain above the stomach and in the back. Pain experienced in the tummy can sometimes be mistaken for indigestion and therefore, it’s important to have this checked out
• Bloating

Other symptoms may include bowel obstruction, vomiting, bloating, diarrhoea or constipation. If you or a loved one are experiencing any suspected symptoms of pancreatic cancer, it’s important to seek medical advice early on to ensure a correct diagnosis can be made and it can be treated at an early stage.

How is Pancreatic Cancer Diagnosed?

An initial doctor’s visit with suspected pancreatic cancer will usually involve a discussion about family history, lifestyle and dietary habits. A physical examination is likely to be performed, and if your GP suspects pancreatic cancer is a possibility, they may order blood and urine tests, and refer you for an MRI or CT scan. A biopsy will confirm the presence of a tumour.

While there is no definitive blood or urine test to confirm a cancer diagnosis, there are markers which can help.

MRI scans take images of internal organs, and will identify if your pancreas is enlarged.

CT scans provide detailed imagery which help identify if cancerous cells have spread to other areas.

A biopsy is the only way to confirm the presence of cancerous cells. Every pancreatic tumour is different, and a pathologist looking at tissue samples will work out which type of pancreatic cancer to diagnose based on the appearance and arrangement of the cells.

If you’re going through tests for pancreatic cancer, it can be an extremely worrying time. It can be beneficial to take someone you trust to any appointments you have to support you and help you deal with any diagnosis you receive.

Pancreatic Cancer Stages and Grades  

If you receive a pancreatic cancer diagnosis, your cancer will also be staged. Pancreatic cancer is commonly staged into 4 stages from Stage 1 to 4. The higher the number, the more advanced the cancer is. According to the National Cancer Institute, stages are broken down into:

Stage 1

A stage 1 diagnosis can be split up into stage 1A and Stage 1B. 1A means that the tumour is less than 2 centimetres while 1B means the tumour is larger than 2 centimetres.

Stage 2

Stage 2 pancreatic cancer can again be categorised by Stage 2A and Stage 2B. In Stage 2, the cancer may have started to spread to nearby tissue and organs but has not yet spread to lymph nodes whereas Stage 2B can mean the cancer has started to spread to lymph nodes.

Stage 3

In stage 3, the cancer may have started to spread to both lymph nodes and major blood vessels.

Stage 4 

At stage 4, pancreatic cancer can be classed as being in advanced stages and may have spread to other organs in the body including the lung or liver. During this stage, it may be more difficult to treat the cancer however treatment may be available to ease pain, manage symptoms and prolong life. Find out more about treatment options for advanced pancreatic cancer.

An accurate diagnosis of staging is vital for the best treatment recommendation. A second opinion can confirm both your diagnosis and the stage of your cancer. Learn more about treatment for different stages of pancreatic cancer.

Treatment for Pancreatic Cancer

Depending on the size and grade of the cancer, the type, if it has spread, your health and other underlying conditions will impact on the treatment or combination of treatments you may have.

Common treatment options for pancreatic cancer include surgery, chemotherapy (regional or adjuvant), radiotherapy, immunotherapy, ablation or embolization treatments (IRE) and supportive care. However, with new treatment modalities you may be able to access other treatment options with specialist doctors that you may not have considered or tried before. Sometimes the best option may include more than one type of treatment, and if you have advanced stage pancreatic cancer, your treatment may be focused on making you feel more comfortable and limiting the spread of the disease. 

Your team of doctors should explain all treatment options in full including the benefits and side effects to create a treatment plan that is right for you. You should be able to talk openly with your doctors throughout the process about getting help to manage side effects or what to do if you want to change your treatment plan. Getting a second opinion on your treatment plan can ensure you have evaluated all your options.

If you or a loved one have received a pancreatic cancer diagnosis and wish to explore treatment options, Oncolomed have access to a wide range of options. Find out more about treatment options for pancreatic cancer.

The Importance of Getting a Second Opinion for Pancreatic Cancer  

It’s widely encouraged for patients to get a second opinion about their diagnosis and/or treatment options.  As pancreatic cancer can often be mistaken for other diseases, you may seek confirmation of your diagnosis and want a deeper understanding of the stage of your cancer. A second opinion can provide additional information and provide an opportunity to ask more questions in order to guide you to make an informed decision about your care.

Whatever the reason, Oncolomed can help facilitate second opinions with pancreatic cancer specialists from leading hospitals globally to ensure you have a personalised treatment that is right for you. Find out more about the benefits and why getting a second opinion could be invaluable in your fight against pancreatic cancer.

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[1] https://www.cancer.ca/en/cancer-information/cancer-type/pancreatic/prognosis-and-survival/survival-statistics/?region=on