Pancreas

Pancreatic head cancer

Despite the success of modern medicine, cancer is now becoming more common, and their effective treatment has not yet been found. In some species, the mortality rate is about 90% even with all the existing therapeutic methods. Such aggressive malignant pathologies include pancreatic head cancer. The special location of this organ, as well as the rapid development of the tumor, make this form of the disease one of the most prognostically unfavorable - it takes 4th place in terms of the number of deaths.

general characteristics

Cancer of the head of the pancreas is one of the most aggressive forms of a tumor, although it is quite rare. Its peculiarity is that it is usually found at the stage when the operation is no longer possible due to the large number of metastases. And such a late diagnosis is due to the special location of the pancreas in the depth of the abdominal cavity, as well as the absence of pronounced symptoms in the initial stages.

Older people are most susceptible to the appearance of pancreatic head cancer - 2/3 of patients are patients over the age of 45 years. In addition, it is noted that in men this pathology occurs a little more often than in women.

If the pancreas is affected by a tumor, more than 70% of it is localized in the head. This is the largest part of the body, its foundation. But here all the main processes of enzyme production take place, ducts exit into the gastrointestinal tract. And the head is in contact with other organs. Therefore, such a tumor especially quickly metastasizes. Most often the tumor spreads through the bloodstream and lymphatic system. Metastases can penetrate the liver, intestines and even into the lungs.

Varieties

A tumor in this place usually develops from the organ’s own tissues. Most often these are epithelial cells of the duct of the gland that have undergone mutations. Sometimes parenchymal or fibrous tissue is affected. The tumor grows most often diffusely, that is, evenly in all directions. But its nodal growth is possible, as well as rapid germination in neighboring tissues, blood vessels and organs.

Most often, with such a diagnosis, they are confronted with carcinoma. This is a tumor that develops from the epithelial cells of the mucous membrane of the pancreatic ducts. They undergo mutations, and this process proceeds fairly quickly. Slightly less common in this place is squamous cell carcinoma or anaplastic.


The tumor develops from the gland's own cells, localizing most often inside the ducts, but sometimes on its surface

Stages

Only a small percentage of patients have the opportunity to get rid of this pathology. Indeed, in most cases, the tumor of the pancreatic head is inoperable.

In accordance with this, there are 4 stages of cancer in this place:

  • At the initial stage, the tumor is localized only in the pancreas. It usually has a size of no more than 2 cm. Symptoms are mild, so pathology is rarely diagnosed at this time.
  • Stage 2 is characterized by the exit of the tumor into the abdominal cavity. Usually, its cells germinate in the bile ducts and duodenum. In addition, cancer cells can enter the lymph nodes. In this case, in addition to pain, nausea and digestive disorders begins weight loss.
  • At stage 3, metastases spread to all organs of the digestive system, are found in large blood vessels.
  • The most severe course of pathology is its 4th stage. Metastases can penetrate into the bones, lungs, brain.

The reasons

Oncological diseases are being actively studied now, but until now scientists cannot say exactly why they appear. Such a tumor develops quite often against the background of a long-term chronic pancreatitis. Especially if the patient does not comply with the recommendations of the doctor. At the same time, pancreatic secretion in the gland is stagnant. This, as well as the constant inflammatory process, leads to tissue degeneration and the formation of a tumor. People with a hereditary predisposition to the development of tumors are especially susceptible to this.


Frequent drinking of alcohol can provoke cancer

Since pancreatic head cancer develops from its own cells, any violation of its functions can provoke such a process. First of all, there is a high risk of developing pathology in diabetes mellitus. This disease can lead to glandular hyperplasia of the gland. In addition, it often happens when alcoholism and smoking. After all, alcohol and nicotine contribute to the formation of a large number of toxins, even carcinogens. This increases the production of lipids that cause epithelial hyperplasia.

Regular consumption of fatty, spicy and preserved foods causes an increased production of pancreozymin, which can also cause cell degeneration. A negative effect on the state of the pancreas is overeating, excessive consumption of sugar, foods with preservatives, prolonged fasting and the lack of therapy for diseases of the gastrointestinal organs. Pathologies such as cholecystitis, cholelithiasis, peptic ulcer and duodenal ulcer can lead to oncology.

Studies have also determined that a cancer is often found in this place in people working in hazardous industries. These are workers of the chemical, woodworking industry, agriculture. In addition, people living in ecologically unfavorable areas are subject to the appearance of malignant tumors.

Symptoms

Most often, the first symptom of pancreatic head cancer, on the basis of which a tumor is diagnosed, is pain. But the problem is that strong pains arise at a time when the tumor is already growing to such an extent that it squeezes the surrounding organs or nerve endings. At first, the symptoms are mild and can be accepted by patients as a reaction to poor-quality food or exacerbation of gastritis.

But pathology can be detected in the initial stages. Cell degeneration is usually accompanied by intoxication of the body. This is manifested by decreased appetite, severe weight loss of the patient and weakness. A similar condition is also caused by dysfunction of the gland and the deterioration of digestion.

In addition, in cases of pancreatic head cancer, the following symptoms are often observed:

  • nausea, vomiting;
  • anorexia;
  • belching, flatulence;
  • feeling of heaviness after eating;
  • upset stool.

Pains in this form of cancer become severe with a large tumor.

As the tumor grows, it can squeeze the bile ducts. This disrupts the movement of bile and is externally manifested in the form of obstructive jaundice. The skin and mucous membranes of the patient may turn yellowish or greenish-brown in color, there is a strong itch. In addition, the urine darkens, and feces, on the contrary, discolor. In this case, patients often have very severe pain.

When these tumors often develop complications caused by damage to neighboring organs. This may be an increase in the liver, splenic ascites, pulmonary infarction, intestinal bleeding, peptic ulcer. Often, the growth of metastases in the circulatory system leads to thrombosis of the lower extremities.

Diagnostics

Diagnosis of pancreatic head cancer is complicated by the deep location of this organ, as well as the absence of specific symptoms. Manifestations of pathology may be the same as in some other diseases of the digestive system. It is necessary to differentiate a tumor with duodenal ulcer, aortic aneurysm, benign neoplasms, acute pancreatitis, cholecystitis, bile duct obstruction.

Therefore, in order to make the correct diagnosis, a comprehensive examination is necessary. The most commonly used methods are:

  • endoscopic ultrasound;
  • MRI of the pancreas;
  • ultrasonography;
  • positron emission tomography;
  • duodenal intubation;
  • coprogram;
  • MSCT of the abdominal cavity;
  • endoscopic retrograde cholangiopancreatography;
  • needle biopsy;
  • blood tests.

To detect a tumor in the pancreas is possible only with a comprehensive examination

Treatment

Treatment of patients with this diagnosis is carried out in a hospital. Such a tumor progresses very quickly, so a combination of several methods is necessary: ​​surgery, chemotherapy, radiation exposure. Modern methods are also used, for example, biotherapy. This is the use of unique drugs that specifically target cancer cells. Keytrud, Erlotinib or special therapeutic vaccines are used. But anyway, any treatment for this pathology is poor quality and uncertain.

Pancreas Removal

The only way to get rid of this tumor is surgery. After all, it represents the degenerated own cells of the gland, which are already impossible to return to normal. In the early stages, surgical treatment can stop the spread of the tumor. But for this it is necessary to remove all its cells. Therefore, complete pancreaticoduodenal resection is usually performed. This removes part of the pancreas, sometimes the stomach or duodenum, the surrounding vessels and tissues.

Only in rare cases with such an operation is it possible to preserve the functions of the digestive system. But usually when choosing a method of surgical treatment, the doctor chooses the lesser of two evils. And although with such operations, the mortality rate is 10-20%, only this gives the patient a chance to live for several more years.

In the last stages of pancreatic head cancer with metastases to the liver and other organs, the removal of the tumor is no longer effective. Therefore, palliative operations are carried out that make life easier for the patient, improve digestion, eliminate jaundice. This, for example, gastric bypass surgery or endoscopic bile duct stent placement.


Chemotherapy helps to reduce the size of the tumor and prevent its recurrence after surgical removal.

After the operation, chemotherapy is required to prevent relapse and improve the quality of life of the patient. Special drugs are also needed for inoperable cancer. This treatment allows you to slow down its tumor growth and even reduce its size. Somatostatin and Triptorelin are effective even in advanced cancer.

With an inoperable form of cancer, radiation is used. Radiation therapy can destroy cancer cells in a few sessions. This allows you to slightly slow down metastasis and extend the life of the patient. But if we study the statistics, in which it is noted how many patients have lived with this pathology for several years, it is clear that an effective treatment method has not yet been found. Even with the use of all known methods, more than 80% of patients die within the first year after the diagnosis.

Forecast

Favorable prognosis for cancer of the head of the pancreas can be only for those who are diagnosed with pathology at an early stage, which is rare. The earlier treatment is started, the higher the chance of recovery. If the tumor is localized only in the pancreas and has not yet metastasized, it can be removed.

The operation in combination with chemotherapy gives some patients the opportunity to recover and live on without this terrible diagnosis. But this is only possible in 10% of cases.

In the second stage, there is usually no metastasis, but the tumor grows to a large size, which violates the functions of all the organs of digestion. Only one operation is ineffective in this case. Chemotherapy and radiation are necessary to suppress the malignant growth of cells. And when diagnosing cancer in the later stages, the mortality rate during the year is 99%. But even the combined treatment in the initial stages of the disease does not guarantee a complete cure. Typically, patients with this diagnosis do not live longer than 5 years.


Proper nutrition will help reduce the risk of cancer

Prevention

Cancer on the head of the pancreas occurs infrequently, but is the most aggressive form of the tumor. Patient survival depends on the stage of the disease, the size of the tumor and the degree of damage to the adjacent tissues. For successful recovery, it is very important to start the treatment of pathology at the initial stage, which is very rare. After all, detect cancer in this place can only be a comprehensive survey.

Therefore, the main method of preventing pathology is regular check-ups with a doctor. This is especially necessary when a hereditary predisposition or exposure to adverse factors. It is necessary to treat all diseases of the digestive organs in time, and in the presence of diabetes or pancreatitis, carefully follow all the recommendations of the doctor. You need to give up bad habits, try to avoid stress. And in the diet to limit the consumption of fats, confectionery, smoked meats and canned food.

Cancer of the head of the pancreas is a very serious pathology that can be fatal in a short time. Therefore, you should try to eat right, maintain a healthy lifestyle and regularly undergo examinations with a doctor. This will help to detect the tumor at the initial stage, when there is still a chance to get rid of it.

Watch the video: Pancreatic Cancer in 2016 - Timothy R. Donahue, MD. UCLA Digestive Diseases (September 2019).