On World Pancreatic Cancer Day, the Portuguese Society of Gastroenterology (SPG) warns of the importance of early diagnosis of this tumor. Possible ways to reverse late diagnosis and improve outcomes would be through prevention, increased awareness of the disease and its symptoms, and potential screening of target populations.
Because of its location, pancreatic cancer is usually difficult to diagnose. Signs and symptoms are nonspecific or nonexistent in the early stages, which explains why the majority of patients present with advanced disease, and only 20% are candidates for surgical treatment. It can appear as pain in the upper abdomen that radiates to the back, and is worse after meals and in the lying position. Yellowish color of the skin and cloudy urine are the most common symptoms of pancreatic head tumors.
There are several types of tumors, but adenocarcinoma is the most common type of pancreatic cancer (>90%).
The cause of pancreatic cancer is complex and multifactorial, with both genetic and non-genetic factors. Smoking is the main acquired risk factor, followed by obesity. Alcohol consumption, especially in patients with chronic pancreatitis and diabetes diabeticFat intake (especially of animal origin) and a sedentary lifestyle are other modifiable risk factors. Family history is present in approximately 10% of patients, however, less than 5% of cases are associated with hereditary genetic syndromes.
In patients with suspected pancreatic cancer, CT and MRI are often used as initial tests, allowing evaluation of the presence of suspicious lesions, as well as staging of the disease. In patients with specific lesions, ultrasound allows the diagnosis to be confirmed by performing biopsies to obtain histological material.
Treatment should be individualized, taking into account the characteristics of the patient and the tumor itself. The only curative treatment is surgery. In most patients, treatment includes chemotherapy, often alone, or in combination with radiotherapy.
It is also important to deliver a message of hope regarding pancreatic cancer, whose survival rate has continually increased over the past five years. In the past decade, we have seen significant progress in molecular investigation of pancreatic cancer, with the identification of biomarkers of potential diagnostic and prognostic relevance and the reconstitution of new therapeutic targets. Available chemotherapy regimens are increasingly effective.
The Portuguese Society of Gastroenterology launched a campaign entitled “Don’t leave until tomorrow what you can learn about the pancreas todayWith the aim of educating the population about this organ of the digestive system and providing knowledge about other pancreatic diseases (in addition to pancreatic cancer), the incidence of which has increased significantly in recent years.
