November marks Pancreatic Cancer Awareness Month, while November 15th is World Pancreatic Cancer Day – initiatives that were designed to raise awareness surrounding pancreatic cancer; a condition that affects as many as 5,000 Canadians each year and over 330,000 people on a global scale. Because it is one of the toughest cancers to fight, organizations like Pancreatic Cancer Canada and Pancreatic Cancer Action are dedicated to saving lives and attacking this deadly illness through not just awareness, but also with research, community support, advocacy – and, perhaps most importantly, early detection.
So, what is the pancreas, exactly? It’s a six-inch-long, pear-shaped glandular organ that is located in the upper abdomen and lies across your body, behind the stomach, and in front of the spine. It is composed of three different sections: The wide end of the pancreas which is located on the right side (also known as the head), the middle section (also known as the body), and the thinner end which is located on the left side (also known as the tail.) The pancreas also plays two different but equally important functions: The digestive functions and the endocrine functions.
DIGESTIVE FUNCTIONS: Enzymes produced by the digestive glands of the pancreas help to break down food. Once food enters the stomach, the pancreatic exocrine cells release those digestive enzymes that lead into the main pancreatic duct. The pancreatic duct then empties pancreatic juices that contain bicarbonate and enzymes into the duodenum (also commonly referred to as the small intestine.) This then aids in the digestion of protein, fats and carbohydrates.
ENDOCRINE FUNCTIONS: This involves two key hormones – insulin and glucagon – both of which are produced by the pancreas, released into the bloodstream and regulate your blood sugar (glucose) level. Insulin and glucagon, however, both play different roles. While insulin works to lower your blood sugar levels after eating meals, glucagon is what raises those levels in-between the meals you eat.
There are many warning signs and symptoms associated with pancreatic cancer. However, many of these are not easily detectable as pancreatic cancer typically does not produce noticeable symptoms during the early stages. This is also why pancreatic cancer is often referred to as the “silent killer.” Symptoms can also vary depending on where the tumour is located. The symptoms can also be non-specific and may mimic other medical conditions. In later stages of pancreatic cancer, one may notice things such as back pain or upper abdominal pain (which will often feel worse when lying down), nausea and/or vomiting, loss of appetite, unintended weight loss, diarrhea and/or constipation, changes in stool colour (appearing pale or clay-like), jaundice, and itchy skin. People with pancreatic cancer may also develop late-onset diabetes due to the fact that it can impede the pancreas’ ability to produce insulin.
There are also certain risk factors that can increase your chances of developing pancreatic cancer – some of which are modifiable, and some of which are not.
MODIFIABLE risk factors: Smoking, alcohol consumption, diet, and obesity. Research has shown that individuals who smoke are up to three times more likely to develop pancreatic cancer than those who are non-smokers, while individuals who drink daily (at least 2 or 3 drinks per day) were also more likely to develop pancreatic cancer than those who consumed little to no alcohol. Diet and obesity also often go hand in hand. The healthier the foods are that you eat, the healthier you will be. The worse off the foods are that you eat, the worse off your health will be. For example, a diet that is high in cholesterol, processed and fried foods can increase your risk of obesity which then increases your risk of pancreatic cancer. To reduce this risk, make sure your diet is higher in fibre, fruits and vegetables. Dr. Ghahary shares many healthy eating tips here. If you’re looking to lose weight but aren’t quite sure where to begin, check out Dr. Ghahary’s video on YouTube titled ‘ Weight Loss: Setting Goals.’ You can also find more helpful tips by clicking here.
UNMODIFIABLE risk factors: Age (approximately 90% of all individuals who have been diagnosed with pancreatic cancer are over the age of 55), gender (men are more likely to develop pancreatic cancer than women), race (those of African American or Ashkenazi-Jewish decent are more likely to develop pancreatic cancer than other races), genetics (family history of pancreatic cancer), as well as certain medical conditions such as chronic pancreatitis – and, as mentioned, diabetes. Certain environmental factors may also contribute to an increased risk of pancreatic cancer, such as exposure to different chemicals (i.e. pesticides and dyes.)
If it is suspected that you may have pancreatic cancer, your physician will likely send you for contrast-enhanced imaging tests – such as an X-ray, CT scan, MRI, or ultrasound. Using contrast for certain imaging tests is the preferred method as the pancreas is often obstructed and not easily seen. To definitively diagnose pancreatic cancer, a tissue biopsy is usually required, which is usually performed by FNA – also known as Fine-Needle Aspiration. Depending on the stage of pancreatic cancer, there are many different treatment options available to patients, which can include both chemo and radiation therapy, targeted therapy, surgery, and even clinical trials.