Pancreatic cancer: A silent killer

Health Xchange
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Pancreatic cancer has few symptoms at the early stage. (Photo courtesy of Health XChange)

When he passed away on 5 October, Apple's co-founder Steve Jobs drew a lot of attention to pancreatic cancer, the disease that ultimately took his life.

There are several types of pancreatic cancers. Steve Jobs had an uncommon type, called a pancreatic neuroendocrine tumour (PNET). The most common type of pancreatic cancer, called ductal adenocarcinoma, is more aggressive, says professor Pierce Chow, senior consultant at the Department of General Surgery of Singapore General Hospital.

The pancreas is the large elongated organ that lies deep in the upper abdomen, sandwiched between the stomach and the spine.

Why is the pancreas so important? First, it secretes insulin and glucagon, two hormones that regulate the body's blood sugar levels. Secondly, it produces digestive enzymes that help break down food into nutrients for easy absorption.

What are the symptoms to look out for?

Patients are usually diagnosed at the advanced stage, as early stage pancreatic cancer often doesn't have obvious symptoms.

"When a cancerous growth blocks the pancreatic duct, digestive enzymes are not released into the intestinal tract. Notable discomforts include indigestion, bloating, and oily/fatty bowel movements," says Chow.

If the tumour blocks the bile duct, a yellowing of the skin, called jaundice, occurs.

Related article: What offers the best chance of survival for bile duct cancer?

Other potential symptoms that shouldn't be overlooked include the following:

  • Unexplained weight loss
  • Abdominal pain
  • Nausea
  • Itching
  • Loss of appetite

How to lower pancreatic cancer risk

There are two main ways to reduce one's risk of getting pancreatic cancer.

  • Quit smoking

Smoking is the single biggest known risk factor for developing pancreatic cancer. It accounts for 40 per cent of all pancreatic cancers in the U.S.

  • Reduce intake of sugary soft drinks

A US research study on 60,000 Singapore Chinese men and women over a 14-year period has pointed to intake of soft drinks as a risk factor for pancreatic cancer.

Related article: Battling cancer with nutrition - Specialist's Q&A on Health Xchange

The University of Minnesota School of Public Health research team found that those who drank two or more soft drinks every week had an 87 per cent higher risk of developing pancreatic cancer than those who did not.

Other studies have pointed to a high-fat and low-fibre diet, heavy alcohol use, and working in a toxic, chemical-laden environment as risk factors for pancreatic cancer.

Treatment for pancreatic cancer

Surgery offers the best treatment option. However, according to the professor, only one out of five pancreatic cancers can be surgically removed.

For operable pancreatic cancers, the five-year survival rate after curative surgery is about 20 per cent.

"Once the cancer has spread beyond the pancreas, or if the cancer involves major blood vessels, surgery ceases to be a viable option," adds Chow.

For inoperable and advanced pancreatic cancers, the primary care is pain control, improving the quality of life and prolonging life where possible. Radiotherapy and chemotherapy are recommended.

The median survival rate for advanced pancreatic cancer is about three to six months from the time of diagnosis.

Related article: Most common cancers in Singapore

The good news for Singaporeans? While pancreatic cancer (mainly the ductal adenocarcinoma type) is the fourth most common cancer in the U.S., it accounts for less than 2 per cent of cancers diagnosed in Singapore.

By Teresa Cheong for Health Xchange, with expert input from the Department of General Surgery at Singapore General Hospital.

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Health Xchange's articles are meant for informational purposes only and cannot replace professional surgical, medical or health advice, examination, diagnosis, or treatment.