Steve Jobs, the father of Apple, and Nobel Laureate Steinman, both died from different types of pancreatic cancer; (to be precise, the one Jobs had replaced was pancreatic neuroendocrine tumor), Patrick, the actor in “The Man and the Ghost”, the famous tenor Pavarotti, Huang Ju, former Vice Premier of the State Council and member of the Politburo Standing Committee, and Shen Tianxia, the fat lady of Hong Kong… All died of pancreatic cancer.
What kind of malignant tumor is pancreatic cancer?
A first look at pancreatic cancer
Generally speaking, pancreatic cancer has no special symptoms in the early stage, but usually manifests itself in the late stage, which makes early diagnosis very difficult. In fact, pancreatic cancer is not only “favored” by celebrities, but also has a general treatment effect compared to other tumors, so there is no exception for these celebrities who unfortunately have pancreatic cancer.
In fact, there are two types of tumors that occur in the pancreas, the most common being pancreatic adenocarcinoma that originates from the ducts of the pancreas, which is commonly referred to as “pancreatic cancer”. The other type is the endocrine pancreatic tumor (the type of pancreatic cancer that Steve Jobs got), which originates from the hormone-secreting cells of the pancreas.
What are the common symptoms of pancreatic cancer?
1.Abdominal pain
Pain is the main symptom of pancreatic cancer, regardless of whether the cancer is located in the head or the tail of the body of the pancreas. In addition to pain in the middle abdomen or left upper abdomen or right upper abdomen, a few cases complain of pain in the left and right lower abdomen, around the umbilicus or the whole abdomen, or even testicular pain, which can be easily confused with other diseases. When cancer involves visceral peritoneum, peritoneum or retroperitoneal tissues, there may be pressure pain in the corresponding area.
2.Jaundice
Jaundice is an important symptom of pancreatic cancer, especially pancreatic head cancer. Jaundice is obstructive in nature, accompanied by deep yellow urine and clay-like stools, and is due to the invasion or compression of the lower end of the common bile duct. Jaundice is progressive and is unlikely to subside completely, although there can be slight fluctuations. The temporary reduction of jaundice is associated with the remission of inflammation around the jugular abdomen in the early stage, while in the late stage, the jaundice produced by the jugular abdomen tumor is more likely to fluctuate due to the ulceration and decay of the tumor invading the lower end of the common bile duct. Jaundice from pancreatic body tail cancer appears only when it reaches the head of the pancreas. Some patients with pancreatic cancer develop jaundice late in life due to liver metastases. About 1/4 of the patients have a combination of intractable pruritus, which is often progressive.
3. Gastrointestinal symptoms
The most common symptoms are loss of appetite, followed by nausea, vomiting, diarrhea, constipation or even black stool, and often steatorrhea. The loss of appetite is related to the lower end of the common bile duct and the pancreatic duct being blocked by the tumor, and the bile and pancreatic juice cannot enter the duodenum.
Obstructive chronic pancreatitis of the pancreas leads to poor exocrine function of the pancreas, which also inevitably affects appetite. A small number of patients present with obstructive vomiting. About 10% of patients have severe constipation. Diarrhea due to pancreatic exocrine dysfunction: steatorrhea is an advanced but rarer manifestation. Upper gastrointestinal bleeding can also occur in pancreatic cancer, manifested as vomiting blood and black stool. Embolism of splenic vein or portal vein due to tumor invasion, secondary to portal hypertension, and occasionally ruptured hemorrhage of esophagogastric fundic varices are also seen.
4.Loss of weight and weakness
Unlike other cancers, pancreatic cancer often has wasting and weakness in the early stage.
5. Abdominal mass
The abdominal mass is the result of the development of the cancer itself and is located where the lesion is. Chronic pancreatitis can also be felt as a mass, which is not easily distinguished from pancreatic cancer.
6. Symptomatic diabetes mellitus
The initial manifestation of the disease in a few patients is the symptom of diabetes mellitus, that is, diabetes mellitus occurs before the main symptoms of pancreatic cancer, such as abdominal pain and jaundice, so that the accompanying wasting and weight loss are mistaken as the manifestation of diabetes mellitus, and pancreatic cancer is not considered. This means that pancreatic cancer may have occurred on top of the original diabetes mellitus.
7. Thrombophlebitis
Patients with advanced pancreatic cancer may develop thrombophlebitis or arterial thrombosis.
8. Psychiatric symptoms
Some patients with pancreatic cancer may show mental symptoms such as anxiety, impatience, depression and personality change.
9. Ascites
It usually appears in the late stage of pancreatic cancer and is mostly caused by the peritoneal infiltration and spread of cancer. The ascites may be bloody or plasma, and the hypoproteinemia of advanced cachexia may also cause ascites.
10.Other
In addition, patients often complain of fever and obvious weakness. There may be high fever or even chills and other symptoms similar to cholangitis, so it is easy to be confused with cholelithiasis and cholangitis. Of course, when there is biliary obstruction combined with infection, there may also be chills and high fever. Some patients may also have small joint redness, swelling, pain, heat, subcutaneous fat necrosis around the joint and unexplained testicular pain. The supraclavicular, axillary or inguinal lymph nodes may also become enlarged and hard due to metastasis of pancreatic cancer.
Why pancreatic cancer is difficult to detect
1. Unlike esophagus and gastrointestinal tract, pancreatic cancer can be detected visually through gastrointestinal microscopy at the earliest stage and precancerous lesions.
There are no obvious symptoms and signs in the early stage of pancreatic cancer, and when symptoms appear, it is easy to be ignored, and it is usually detected only by CT and ultrasound examinations.
The cause of pancreatic cancer is still unclear and may be related to many factors: genetics, smoking, alcoholism, chronic pancreatitis, diabetes, etc.
Tips to remind you
1. Don’t ignore the signs and symptoms easily
Although there are no specific symptoms in the early stage of pancreatic cancer, some clues can be found by careful analysis. For example, in the early stage of pancreatic cancer, patients often have unexplained progressive obstructive jaundice, unexplained anorexia and weight loss of more than 10%, and unexplained pain in the upper abdomen or lower back.
There are also symptoms such as unexplained dyspepsia with normal digestive tract on barium meal examination, recent onset of diabetes mellitus without any factors causing its onset, sudden onset of unexplained steatorrhea, spontaneous onset of pancreatitis (extra attention should be paid if the patient is a smoker) and unexplained thrombophlebitis of the lower limbs.
2.Regular medical examination
People over 40 years old should have an annual abdominal ultrasound and tumor marker examination. There is no specific clinical preventive measure for pancreatic cancer, but only prevention against possible causes and risk factors, as well as attention to improving the health quality of the body.
A healthy lifestyle can reduce the chances of pancreatic cancer. Quit drinking and smoking, advocate a low-fat, low-protein, high-fiber and high-vitamin diet, eat more fresh fruits and vegetables, and at the same time, lead a regular life, pay attention to the combination of work and rest, and strengthen physical exercise to improve the resistance of the body.