Pancreatic Cancer

Pancreatic cancer is a highly aggressive and often deadly disease that starts in the tissues of the pancreas—a gland situated behind the stomach that assists in digestion and blood sugar regulation. The most prevalent type is pancreatic adenocarcinoma, which develops from the exocrine cells lining the pancreatic ducts. Less common types include neuroendocrine tumors, which usually grow more slowly.

This cancer is challenging to detect early because it often causes vague symptoms or none at all in the initial stages. When symptoms do manifest, they may include abdominal or back pain, weight loss, jaundice (yellowing of the skin and eyes), loss of appetite, and new-onset diabetes.

Risk factors encompass smoking, chronic pancreatitis, obesity, diabetes, family history, and certain genetic syndromes (e.g., BRCA mutations, Lynch syndrome). Common Therapies for Pancreatic Cancer

Treatment depends on the cancer’s stage and whether it can be surgically removed:

1. Surgery

   • Only about 15–20% of cases are resectable at diagnosis

   • Whipple procedure (pancreaticoduodenectomy): Removal of the head of the pancreas, part of the small intestine, gallbladder, and bile duct

   • Distal pancreatectomy: Removal of the body and tail of the pancreas

   • Often followed by chemotherapy to reduce recurrence risk

   
   

2. Chemotherapy

   • Mainstay for most patients, especially those with inoperable or metastatic disease

   • Common regimens:

     • FOLFIRINOX (5-FU, leucovorin, irinotecan, and oxaliplatin): For patients with good performance status

     • Gemcitabine ± Nab-paclitaxel: Used widely in advanced cases

   • Chemotherapy may also be used before surgery (neoadjuvant) to shrink tumors

   
   

3. Radiation Therapy

   • May be used in combination with chemotherapy (chemoradiation) in locally advanced or borderline resectable tumors

   • Sometimes used palliatively to relieve symptoms

   
   

4. Targeted Therapy

   • Limited but emerging role

   • Olaparib: PARP inhibitor for patients with BRCA1/2 mutations

   • Ongoing research is exploring more biomarkers for targeted treatment

   
   

5. Immunotherapy

   • Generally not effective for most pancreatic cancers due to its immunosuppressive tumor environment

   • May be used in rare cases with high microsatellite instability (MSI-H) or mismatch repair deficiency (dMMR) using checkpoint inhibitors like Pembrolizumab

   
   

6. Supportive and Palliative Care

   • Critical due to the aggressive nature of the disease and frequent symptom burden

   • Focuses on pain control, nutritional support, and quality of life

Pancreatic cancer has one of the lowest survival rates of all cancers, making early detection and ongoing research into better treatments essential.