Several types of growths can occur in the pancreas, including cancerous and noncancerous tumors. The most common type of cancer that forms in the pancreas begins in the cells that line the ducts that carry digestive enzymes out of the pancreas (pancreatic ductal adenocarcinoma).
Signs and symptoms of pancreatic cancer often don't occur until the disease is advanced. They may include:
- Abdominal pain that radiates to your back
- Loss of appetite or unintended weight loss
- Yellowing of your skin and the whites of your eyes (jaundice)
- Light-colored stools
- Dark-colored urine
- Itchy skin
- New diagnosis of diabetes or existing diabetes that’s becoming more difficult to control
- Blood clots
Imaging tests help find out where the cancer is located and whether it has spread from the pancreas to other parts of the body. Usually, a CT scan is done but sometime depending on the condition and MRI or PET scan is required. A biopsy also may be required using ERCP or Endoscopic Ultrasound. Apart from the scan , A Liver function test , Tumor markers and other blood tests are done.
With these results, The stage of the Cancer is established which helps determine what treatments are most likely to benefit you.
Treatment may include surgery, radiation, chemotherapy or a combination of these.
Surgery for tumors in the pancreatic head. If your cancer is located in the head of the pancreas, you may consider an operation called a Whipple procedure (pancreaticoduodenectomy)
The Whipple procedure is a technically difficult operation to remove the head of the pancreas, the first part of the small intestine (duodenum), the gallbladder, part of the bile duct and nearby lymph nodes. In some situations, part of the stomach and colon may be removed as well. The remaining parts are reconnected to the pancreas, stomach and intestines to allows you to digest food..
- Surgery for tumors in the pancreatic body and tail. Surgery to remove the left side (body and tail) of the pancreas is called distal pancreatectomy. In this procedure the spleen may also be removed.
- Surgery to remove the entire pancreas. In some people, the entire pancreas may need to be removed. This is called total pancreatectomy. You can live relatively normally without a pancreas but do need lifelong insulin and enzyme replacement.
- Surgery for tumors affecting nearby blood vessels. Many people with advanced pancreatic cancer aren’t considered eligible for the Whipple procedure or other pancreatic surgeries if their tumors involve nearby blood vessels. At highly specialized and experienced medical centers, surgeons may offer pancreatic surgery operations that include removing and reconstructing affected blood vessels.
A pancreatic cyst is a closed sac lined with epithelium and located on or in your pancreas. They can range from benign pseudocysts to malignant cysts (cancerous and spreading)
Pseudocysts often follow pancreatitis or can also result from injury to the abdomen, such as from a road traffic accident.
You may not have symptoms from pancreatic cysts, which are often found when imaging tests of the abdomen are done for another reason.
When signs or symptoms of pancreatic cysts do occur, they typically include:
- Persistent abdominal pain, which may radiate to your back
- Nausea and vomiting
- Weight loss
- Feeling full soon after you start eating
DIAGNOSIS AND TESTS
Testing may include the following:
- Ultrasound Abdomen
- CECT Abdomen
- EUS (endoscopic ultrasound) is usually a secondary test to further evaluate a pancreatic cyst and/or to distinguish a pancreatic pseudocyst from other types of cystic lesions. Analysis of fluid obtained by the cyst via a fine needle is done to differentiate the types of cysts and pseudocysts.
- ERCP (endoscopic retrograde cholangiopancreatography) enables the doctor to view the structure of the common bile duct, other bile ducts and the pancreatic duct.
After the investigations, the cyst can be identified as:
- Pseudocysts (not cancerous – benign)
- Serous cystadenomas(Rarely cancerous)
- Mucinous cystic neoplasms(Precancerous)
- An intraductal papillary mucinous neoplasm (IPMN)(Precancerous or cancerous)
- Solid pseudopapillary neoplasms (Precancerous)
- A cystic neuroendocrine tumor (Precancerous)
Some types of pancreatic cysts require surgical removal because of the risk of cancer. Surgery might be needed to remove an enlarged pseudocyst or a serous cystadenoma that’s causing pain or other symptoms. These surgeries can be done using a laparoscope.
A pseudocyst may recur if you have ongoing pancreatitis.