The tests that detect this devastating cancer! The symptoms of pancreatic cancer appear when it is quite advanced.
In the early stages it is asymptomatic and is accidentally discovered following routine imaging investigations, such as abdominal ultrasound.
Advanced pancreatic cancer is manifested by symptoms such as pain in the upper abdominal floor, often with irradiation in the spine, jaundice (yellow teguments and sclera), steatorrhea (soft, unattached, floating chairs above the water), involuntary weight loss and many other nonspecific digestive symptoms (nausea, vomiting, bloating, etc.), said Dr. Adelina Popescu, specialist gastroenterologist at DigestMed Clinic.
If there are manifestations that can raise the suspicion of pancreatic cancer, blood tests and imaging investigations should be carried out under the guidance of the specialist doctor. Usual blood tests may show increased inflammatory samples, increased liver enzymes, increased GGT and bilirubin, increased pancreatic enzymes, hyperglycemia, increased tumor markers (CA 19-9, CEA).
It is worth mentioning that tumor makers do not always grow in pancreatic cancer and that their normal value does not exclude this diagnosis.
The first imaging investigation in the diagnosis of pancreatic cancer is abdominal ultrasound. It is indeed an investigation dependent on the operator and the patient (difficult evaluation in the bloated and obese patients), but it guides the diagnosis. If there are changes in the pancreas, the result of the ultrasound is completed with a tomographic evaluation or by magnetic resonance imaging with intravenous contrast substance. These investigations can diagnose pancreatic cancer, but most often, biopsy of the pancreatic tumor formation is required for certainty and to determine the tumor type. Sometimes complementary diagnostic methods are needed: retrograde endoscopic cholangiopancreatography (ERCP), which visualizes the biliary and pancreatic pathways, and ecoendoscopy, which visualizes the tumor and its regional extent; by both methods biopsies can be taken.
After the diagnosis of a malignant pancreatic tumor, the staging is performed by computed tomography or nuclear magnetic resonance with contrast substance, evaluating the local extension and / or at the level of the other organs. The early stages, although rare, are surgically resectable and even curable.
The classic operation in pancreatic head cancer is cephalic duodenopancreatectomy (Whipple procedure), in which half of the pancreas and duodenum are resected. Unfortunately, most patients are diagnosed in advanced stages, surpassed by surgery. Advanced pancreatic tumors are either regionally extended to the surrounding vessels and organs, or extended remotely to the lungs, liver, brain, etc. The surgical treatment in these situations is palliative, being useful only in solving some complications associated with the disease. Chemotherapy and radiotherapy are needed as adjunctive treatment in the early forms of cancer, reducing the risk of recurrence, or as palliative treatment for prolonging life and reducing pain in advanced forms. Pain in pancreatic cancer is violent and hardly responds to the usual painkillers, often requiring opioid drugs such as morphine. The prognosis of pancreatic cancer is poor and the 1-year survival is below 28%.