Pancreatic Cancer

Pancreatic Cancer overview and Definition

The cancer cells multiplying in the pancreas constitutes the pancreatic cancer. These cells have their origin from both the neuroendocrine cells and excocrine part of the pancreas.


It has very low 5 year survival rate. It ranks seventh cancer which has higher fatality rate.

Structure of Pancreatic Cancer

The pancreas is an elongated organ that is located at the back of the belly. It has head, tail and body.

The head is widest part of the pancreas and it is often present nearer the duodenum that is the first part of the small intestine.

The body continues from head.

The tail is located nearer to the spleen which is present in the left side of the abdomen.

Exocrine: the exocrine part of the pancreas secreate digestive enzymes.

Endocrine: this secreate the hormones which are taken to the distant organs. The islet of Langerhans takes part in this.


The pancreatic cancer occurs due to the over activation of the oncogenes and inactivation of the tumour suppressor gene.

Deregulation of certain molecules happens such as EGFR, Akt, NF-κB .

Activation of ras oncogene plays an vital role in the development of the pancreatic cancer.

The point mutation and the amplification of  ras genes also produce a considerable effect.

These above process results in the activation of the cyclo oxygenase pathway which might inturn leads to the activation of the prostaglandins. These prostaglandins aids in the cell growth.

Amplification of the Akt2 and MYb  genes results in pancreatic cancer.

Up-regulation of cyclin D1 has been found in pancreatic cancers and over-expression of cyclin D1 is associated with poor prognosis. 

Clinical signs & symptoms

Belly pain

Back pain

Weight loss

Loss of appetite


Differential Diagnosis


It is the removal of a small amount of tissue for examination under the microscope. A biopsy is the confirmatory test for pancreatic cancer.

Fine needle aspiration:

In this type of biopsy the physician moves the fine needle  through the abdomen and take the tissue needed for the diagnosis.

Endoscopic biopsy:

In this type of biopsy, the physician uses an endoscope an hollow tube . light emitting structure to down the small intestine and into the pancreas and tissues are obtained.

Biomarker  testing of the tumour:

The colorectal cancer should be tested for problems in mismatch repair proteins called mismatch repair defect.

Blood test:

Patient with the pancreatic  cancer  tends to show low levels of platelets, white blood cells, red blood cells.  This results in the aneamia in patients. Complete blood count might reveal whether the bleeding is occurring or not.

Computed tomography:

A CT scan takes three dimensional pictures of the abnormal tissues from different angles.

Magnetic Resonance Imaging:

A MRI scan uses the combination of the magnetic and radiowave frequency to view the abnormal tissues.

An dye is injected in the vein or the patient is asked to swallow the dye and the results are observed.


A sound waves to create the picture of the internal organs to find out if the cancer is spread or not.

Abdominal ultrasound:  with the patient symptoms it can be used to view the pancreas. But it cannot reveal the spread of pancreas.

Endoscopic ultrasound: in this method the doctor uses an ultrasound probe, and with the guidance of endoscope it is passed in to the small intestine and then into the pancreas to view the structures.

Endoscopic retrograde cholangiopancreatography: The physiscian uses the endoscope which is the thin, flexible tube with a tiny camera is placed down the small intestine and through the pancreas. The is mainly used when the doctor wants to view the ampulla of vater where the common bile ducts empties in to the small intestine.

If X rays are taken at this time it might show some blockages in the stomach.

Positron emission tomography (PET) or PET-CT scan.:

A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive sugar substance is injected into the patient’s body. This sugar substance is taken up by cells that use the most energy. Because cancer tends to use energy actively, it absorbs more of the radioactive substance. However, the amount of radiation in the substance is too low to be harmful. A scanner then detects this substance to produce images of the inside of the body. With the help of the PET scan one can be able to find out the stage of cancer.

Liver function test:

              The bilirubin levels and the level of other digestive enzymes and liver enzymes such as Alanine transaminase, Aspartate transaminase and Alkaline phosphatase should be checked.

Tumour marker:

  • CA 19-9
  • Carcinoembryonic antigen (CEA)
  • Stages:
  • Stage 0:
  • The cancer is not spread but has potential development of the cancer in the future which is termed as carcinoma insitu.
  • Stage 1:
  • The cancer cells are consider to the localized area. This is also called the early stage cancer
  • Stage 2 and Stage 3:
  • It indicates that the cancer cell has spread to the nearby lymphnodes or tissues.


The 5 year survival rate :

 Stage 0,1,2 is 34%

Stage 3 – 12%

Stage 4- 3%


Avoid alcohol consumption

Check the blood sugar regularly

Follow the healthy diet

Be physicaly active

Don’t neglect the initial symptoms and have the proper treatment