A Frequently Missed Cancer – Pancreatic Cancer
Pancreatic cancer is a dreadful disease. The incidence is increasing every year. According to the 2010 Hong Kong Cancer Statistics, there were 513 new cases (around 4.5 cases in every 100,000 persons). The mortality rate is exceedingly high. At the same year, 473 patients died from pancreatic cancer and it is the 6th top cancer death in Hong Kong. The high mortality is due to the late presentation of the disease since pancreas is hidden behind the stomach and deep inside the abdomen, making early detection difficult.
Pancreatic cancer may present as weight loss, stomach pain and jaundice (yellowing of the eyes). When a mass is felt in the upper abdomen, it is already too late.
Those most at risk for developing pancreatic cancer are older person, males, chronic smokers, and people with a family history of the cancer and certain genetic diseases. Patients with underlying chronic pancreatitis, pancreatic cystic lesion, and metabolic syndrome (central obesity, hypertension, hyperlipidaemia and diabetes) are also susceptible. In recent years studies, it has shown that diabetes, especially recent onset of diabetes, may be a risk factor for or related to underlying pancreatic cancer disease.
The aim of treatment for pancreatic cancer is to find it out earlier before it is too late. Therefore, high index of suspicion is needed for those at risk of developing pancreatic cancer, especially when there is persistent and classical symptom.
Blood cancer marker is not useful in detecting early cancer disease. For imaging study, CT scan and magnetic resonance imaging (MRI) are better than ultrasound in detecting the cancer. However, due to the radiation exposure, CT scan is not useful for routine screening. Another advanced imaging technique is endoscopic ultrasound (EUS), which is the current most sensitive test in detecting small tumour disease, in which curative resection is possible.
lifestyle changes can lessen the risk, such as controlling body weight to prevent obesity, and avoiding smoking and heavy drinking, which can cause chronic pancreatitis. Eating more fruit and vegetables daily and less processed and red meat may also help cut the risk.