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Manohar Parrikar Dies At 63 After Battling Pancreatic Cancer: Know The Causes, Symptoms & Treatment

Goa Chief Minister Manohar Parrikar, who had been suffering from pancreatic cancer, succumbed to death at the age of 63.

It is estimated that 3 to 5 per cent of people who are diagnosed with pancreatic cancer often live longer than 5 years. Pancreatic cancer ranks as the fourth or fifth most common cause of cancer mortality.

According to the Indian Journal of Surgery, the incidence of pancreatic cancer in India is 0.5-2.4 per 100,000 men and 0.2 -1.8 per 100,000 women[1] .

Function Of Pancreas

The pancreas is an organ which is about 6 inches long situated behind the stomach, near the gall bladder. It plays an important role in the digestion process by producing enzymes that the body requires for digesting carbohydrates, protein and fats.

The pancreas contains two glands that produce pancreatic juices, insulin and hormones. The two glands are

a. Endocrine glands: A small cluster of cells that release hormones like glucagon and insulin into the blood. The main function is to manage blood sugar levels [2] .

b. Exocrine glands: They are responsible for secreting juices and enzymes that aid in digestion[3] .

What Is Pancreatic Cancer?

Pancreatic cancer occurs when there is a growth of abnormal cells in the tissues of the pancreas. When the abnormal cells start accumulating it can form into a tumour, which spreads easily to other organs and can be quite difficult to detect in its early stages. It is usually diagnosed in the advanced stages.

According to the United States National Cancer Institute, 9.4% people (both men and women) are diagnosed with pancreatic cancer at an early stage, while the 5-year survival for localized disease was 29.3% during 2006-2012. 52% of all cases were diagnosed at the distant stage with the 5-year survival rates of 2.6% [4] .

Types Of Pancreatic Cancer

Pancreatic cancer which begins in the gland cells lining the ducts of the pancreas is called pancreatic exocrine cancer or pancreatic adenocarcinoma. The cancerous cells can be malignant or benign [5] .

Endocrine pancreatic cancer is another type of pancreatic cancer which forms in the hormone-producing cells also known as the neuroendocrine cells of the pancreas. This type of cancer is called islet cell tumours which are uncommon and rare [6] .

Causes And Risk Factors Of Pancreatic Cancer

The actual cause of pancreatic cancer is unknown. However, there are some factors which increase the risk of pancreatic cancer. These include the following:

  • Smoking and chewing tobacco can up your pancreatic cancer risk [7] .
  • About 70% of chronic pancreatitis are due to heavy alcohol consumption [8] .
  • People who have had certain types of cancer like stomach cancer, mouth cancer, kidney cancer, breast cancer, testicular cancer have an increased risk of pancreatic cancer.
  • Genetic factors [9]
  • Diabetes, body weight, diet and physical activity also triggers the risk of pancreatic cancer [10]

Other medical conditions such as inflammation of the pancreas, hereditary pancreatitis, stomach ulcer, Helicobacter pylori infection, diabetes, tooth or gum disease, infection caused by hepatitis viruses also increase the risk factor of pancreatic cancer.

Symptoms Of Pancreatic Cancer

  • Pain in the upper abdomen
  • Jaundice
  • Back pain
  • Weight loss
  • Loss of appetite
  • Nausea and vomiting
  • Gallbladder or liver enlargement
  • Diabetes
  • Blood clots
  • Fatigue and depression

Diagnosis Of Pancreatic Cancer [11]

The doctor will ask about your family history, symptoms and will conduct a physical exam. He or she will carry out blood tests, urine tests and stool tests and other tests like CT or MRI scans, an endoscopic ultrasound, and biopsy to check for pancreatic cancer.

After the diagnosis, the doctor will assess the stages of cancer.

Stages Of Pancreatic Cancer

Stage 0: The cancerous cells are present in the top layers of pancreatic duct cells and haven't spread inside the tissues.

Stage 1: The tumours have developed in the pancreas.

Stage 2: The tumours have spread to nearby abdominal tissues.

Stage 3: It has spread to blood vessels and lymph nodes.

Stage 4: It has spread to other organs like the liver.

Complications Of Pancreatic Cancer

  • Abdominal and back pain - When the tumour starts growing, it puts pressure in the nerves of your abdomen, causing pain.
  • Weight loss - Pancreatic cancer may make you lose your appetite, resulting in weight loss. Also if you have nausea or vomiting, you will have difficulty in eating.
  • Bowel obstruction - When the tumour grows and presses into the small intestine. It can block the flow of digested food from your stomach into your intestines causing an obstruction in the bowel.
  • Jaundice - When the tumour blocks the liver's bile duct, it causes jaundice. The symptoms are yellow skin and eyes, and dark-coloured urine.

Treatment Of Pancreatic Cancer

Early detection and effective treatment increase the survival rate of this disease. However, currently the available treatment options for pancreatic cancer are limited and they depend on the stage of cancer, person's age and health [12] .

  • Surgery - If the tumour is confined in one area, surgery is recommended by the doctor. If the tumour is in the head and neck of the pancreas, the surgeon removes the whole pancreas, along with a portion of the stomach, tissues, and lymph nodes.

To treat islet cell or neuroendocrine tumours, doctors will perform a distal pancreatectomy which involves removing the pancreas tail and other parts of the pancreas. In another surgical procedure called total pancreatectomy, the surgeon removes the entire pancreas and spleen.

  • Radiation therapy - This therapy destroys the cancerous cells by using high-energy rays. It works by either shrinking or destroying the cancer cells. Radiation therapy is used in combination with other treatments like surgery and chemotherapy. It reduces the pain or digestive problems when there is a blockage in the bile duct.
  • Chemotherapy - Chemotherapy is the use of cancer-killing medication for the prevention of growth of cancerous cells. These medicines interfere with the cell division process that causes the cancerous cells to grow and spread. But there are side effects of chemotherapy like hair loss, nausea and vomiting and fatigue.

Ways To Prevent Pancreatic Cancer

  • Stop smoking and chewing any tobacco products.
  • Choose a healthy diet full of colourful fruits and vegetables.
  • Maintain a healthy weight and exercise daily.
View Article References
  1. [1] Thapa P. (2015). Epidemiology of Pancreatic and Periampullary Cancer.The Indian journal of surgery,77(5), 358-361.
  2. [2] Cecil R. L. (1909). A Study Of The Pathological Anatomy Of The Pancreas In Ninety Cases Of Diabetes Mellitus.The Journal of experimental medicine,11(2), 266-290.
  3. [3] Keller, J., & Layer, P. (2005). Human pancreatic exocrine response to nutrients in health and disease.Gut,54(suppl 6), 1-28.
  4. [4] Howlader N, Noone AM, Krapcho M, Miller D, Bishop K, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA. SEER Cancer Statistics Review, 1975-2013, National Cancer Institute. Bethesda, MD, 2016.
  5. [5] Sellam, F., Harir, N., Khaled, M. B., Mrabent, N. M., Salah, R., & Diaf, M. (2015). Epidemiology and risk factors for exocrine pancreatic cancer in a Northern African population.Journal of gastrointestinal cancer,46(2), 126-130.
  6. [6] Larsson, L. I. (1978). Endocrine pancreatic tumors.Human pathology,9(4), 401-416.
  7. [7] Lowenfels, A. B., Maisonneuve, P., Whitcomb, D. C., Lerch, M. M., & DiMagno, E. P. (2001). Cigarette smoking as a risk factor for pancreatic cancer in patients with hereditary pancreatitis.Jama,286(2), 169-170.
  8. [8] Talamini, G., Bassi, C., Falconi, M., Sartori, N., Salvia, R., Rigo, L., ... & Vaona, B. (1999). Alcohol and smoking as risk factors in chronic pancreatitis and pancreatic cancer.Digestive diseases and sciences,44(7), 1303-1311.
  9. [9] Lowenfels, A. B., & Maisonneuve, P. (2006). Epidemiology and risk factors for pancreatic cancer.Best practice & research Clinical gastroenterology,20(2), 197-209.
  10. [10] Lowenfels, A. B., Maisonneuve, P., Cavallini, G., Ammann, R. W., Lankisch, P. G., Andersen, J. R., ... & International Pancreatitis Study Group. (1993). Pancreatitis and the risk of pancreatic cancer.New England Journal of Medicine,328(20), 1433-1437.
  11. [11] Takhar, A. S., Palaniappan, P., Dhingsa, R., & Lobo, D. N. (2004). Recent developments in diagnosis of pancreatic cancer.BMJ (Clinical research ed.),329(7467), 668-73.
  12. [12] Ilic, M., & Ilic, I. (2016). Epidemiology of pancreatic cancer.World journal of gastroenterology,22(44), 9694-9705.

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