Pancreatic cancer palliative care

Usually, healthy cells grow in a controlled manner but when these start to grow at an abnormal and accelerated rate, a tumour is formed. Pancreatic cancer is when this growth occurs in the pancreas which is a large gland in the digestive system.

This form of cancer is mostly found in individuals who are aged 75 or over, with it being uncommon in people under 40.

Pancreatic cancer can be quite difficult to diagnose as it does not cause any symptoms in the early stages. Signs of pancreatic cancer can be quite vague. If you or a loved one are experiencing one or more of the following symptoms, it is important that you speak to your doctor as soon as possible.

Jaundice

The yellowing of skin and whites of eyes can be a sign of pancreatic cancer. This is because a tumour in the pancreas can block the bile duct which causes a build-up of bilirubin (a waste material) in the blood.

Pain in back or stomach

The tumour can push against surrounding nerves and organs which then causes pain in the abdomen or back. Pain may also be due to the tumour blocking the digestive tract.

There are a number of tests which medical professionals can do to diagnose pancreatic cancer. This usually starts with a conversation where they ask more about medical history or whether family members have previously been diagnosed with cancer.

After this, they will usually complete a physical exam which would involve looking at skin and eyes as well as pressing into the abdomen to check for abnormalities in the area surrounding the pancreas, liver and gallbladder.

If they have any concerns they will order more tests, such as:

• Blood, urine or stool tests
• A computed tomography (CT) scan or magnetic resonance imaging (MRI)
• A tissue sample, called a biopsy

In about one in 10 incidences of pancreatic cancer, it is inherited. If you are born with certain genes, there is an increased chance of developing pancreatitis which can lead to cancer of the pancreas. As well as this, if two or more relatives have had pancreatic cancer in the past, it may be recommended that you have regular check-ups as this can be a sign of the disease running in the family.

Although the exact reasons behind pancreatic cancer are unknown, a number of factors have been identified which increase the likelihood, including:

• Being overweight
• Smoking or chewing tobacco
• Having a history of health conditions such as diabetes, chronic pancreatitis or a stomach ulcer

In order to find the best possible treatment for pancreatic cancer medical professionals will take into account different factors such as the stage of the cancer, the position and the type of the cancer.

The options will also largely depend on whether it is possible to remove the cancer through surgery, or working towards slowing the growth of it by having chemotherapy and radiotherapy.

A complex surgery called the Whipple procedure can help to remove tumours, but only if the tumour is confined to the head of the pancreas. The operation removes parts of the pancreas, small intestine and gallbladder.

There are also treatment options to help relieve the symptoms of pancreatic cancer. A stent is a small flexible tube which can be fitted to open the bile duct and reduce the risk of jaundice. This can also be achieved through a bypass surgery which involves cutting the bile duct above the blockage and instead attaching it to the small intestines.

Recovering from the surgery of removing pancreatic cancer can be a long, and sometimes difficult, process. Most individuals experience pain after the operation but this can be managed by prescribed pain-relief medication.

As the operation would have been on the digestive system, the bowel would temporarily stop working which means that they cannot eat or drink for a period of time. However, they will be able to gradually be able to take small sips before eventually moving on to having regular meals again.

As well as this, pancreatic enzyme replacement therapy tablets may be prescribed to help digest food following treatment.