Pancreatic cancer: symptoms, prognosis, can it be cured?
Aggressive and difficult to detect at an early stage, pancreatic cancer affects both men and women.
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What are its signs? How is it diagnosed and curable? Opinions of Dr. Jérôme Loriau, head of the digestive surgery department of the Paris Saint-Joseph hospital group.
Definition and function of the pancreas
The pancreas is an organ of the digestive system. Hidden in the abdomen, it is located behind the stomach, just in front of the vertebrae.
The role of the pancreas is, on the one hand, to regulate the level of glucose in the blood and, on the other hand, to produce enzymes that allow the digestion of food.
The tumors can be located in the head of the pancreas but also more to the left side of the pancreas, called the tail. They are the consequence of the anarchic development of pancreatic cells.
Pancreatic cancer is an aggressive cancer. It is often diagnosed late because it can progress long before it causes symptoms.
If your signs of onset are not specific, certain manifestations should alert you and prompt you to consult a physician. Persistent pain in the stomach and back, for example, are symptoms that should be taken seriously.
Jaundice, itching or severe digestive problems are also signs that should not be overlooked.
Loss of appetite, sudden and unexplained weight loss, fatigue, nausea, bloating or fever are all signs that should prompt you to consult a physician.
Risk factors: age, obesity, tobacco, alcohol
Currently, several risk factors have been identified.
Tobacco, excessive alcohol consumption, overweight and inactivity are factors that promote the development of pancreatic cancer.
"Chronic inflammation, as in the case of chronic alcohol-related pancreatitis, is often a breeding ground for cancer," says Dr. Jérome Loriau, head of the digestive surgery department at the Paris Saint-Joseph Hospital Group.
In some cases, the appearance of this cancer is the result of a genetic predisposition caused by a mutation in a gene.
The number of patients suffering from pancreatic cancer continues to increase. In 2011, approximately 9,000 people were suffering from it. The disease affects both men and women and is usually diagnosed after the age of 50.
"By 2030, pancreatic cancer could be the second leading cause of cancer death in Europe.
In 30 years, the number of cases has doubled in men and tripled in women," warns Dr. Jérôme Loriau.
Scientists are also currently trying to establish whether there is a link between certain environmental factors, such as pesticides, and this cancer.
The onset of the above symptoms should prompt you to consult a physician. Based on this medical appointment, the physician can then decide whether or not to prescribe additional testing.
After the clinical interview, the CT scan is a key test to detect the presence of a tumor.
Magnetic resonance imaging (MRI), echoendoscopy and sometimes endoscopic retrograde opacification of the pancreatic ducts (ePRe) can also be used.
Echoendoscopy allows us to take biopsies of the pancreas and thus confirm the diagnosis if necessary.
Treatments: chemotherapy, ablation, radiotherapy
Surgery (removal of the tumor, if limited to the pancreas and without metastases), chemotherapy (prior to surgery, and to treat advanced and/or inoperable tumor), radiation therapy and/or chemoradiotherapy may be offered.
This decision is taken collectively during a commission (Pluridisciplinary Concertation Meeting) of several professionals. A symptomatic, analgesic or morphine treatment can also be prescribed to relieve pain.
Survival and recovery rates
This type of cancer often progresses silently and is discovered late in most cases.
The chances of survival at 5 years vary from 5% for non-operable cancers, to 30% when the tumor can be operated on at the time of discovery.
Numerous figures are circulating, but they should be taken with caution.
In fact, these averages include all pancreatic cancers (different stages, treatment possibilities, other diseases, etc.).
Each situation being particular, it is absolutely essential that these issues be discussed with the specialized team in charge of the treatment.
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