Among all known types of cancer, pancreatic adenocarcinoma refers to a moderately common disease. However, among the malignant formations of this particular organ, it occurs most often. This form of cancer implies the involvement in the pathological process of glandular cells that line the organ and begin to atypically divide, forming a tumor.
The disease can be localized in absolutely any part of the gland, however, it often clogs the excretory ducts. Impaired functioning of the pancreas can lead to very serious consequences for the whole body.
Disease feature
Pancreatic adenocarcinoma is a complex cancerous tumor affecting the cells of the glandular epithelium. They line the pancreatic duct. As a result, gradually epithelial tissue is replaced by fibrous.
A closer look at the tumor reveals a soft, dense ball of white color. It does not have a specific shape. Growing, the tumor begins to cover the entire pancreas and gradually switches to adjacent organs in the form of metastasis.
The pancreas consists of 3 parts, and a tumor can appear in any of them. Further, cancer cells spread through the lymph nodes and bloodstream to neighboring organs. Basically, the pathology affects the gastrointestinal tract and the respiratory system of a person.
Main types
Depending on the features of the atypical cell construction, the development of the neoplasm can be quite unfavorable. Forms of the disease are determined after histological examination. In particular, they distinguish such species as:
- highly differentiated;
- low grade;
- undifferentiated;
- scirrhosis.
Highly differentiated pancreatic adenocarcinoma is characterized by the fact that minor changes occur, the disease develops very slowly. In addition, there are absolutely all conditions and opportunities for successful treatment.
Low-grade pancreatic adenocarcinoma has a high rate of division. The tumor grows very quickly and the treatment is rather difficult. A moderately differentiated pancreatic adenocarcinoma is characterized by the fact that its treatment is impossible and will not bring any result at all. Cells divide very quickly, and there is a huge risk of complications. Metastases penetrate adjacent organs.
The most common type of neoplasm is ductal adenocarcinoma of the pancreas. It is formed when cells of the main duct of this organ are damaged, which produces enzymes and juice involved in the digestion process. A similar tumor develops much faster than other types and rapidly metastasizes. This whole process is accompanied by intense pain and almost leaves no chance for a cure.
Stages of the disease
Treatment largely depends on the stage of the malignant process. Any type of cancer is characterized by 4 stages of development. At the first, the tumor has a small diameter and does not protrude beyond the border of the “pancreas”.
With stage 2 pancreatic adenocarcinoma, the neoplasm reaches a size of more than 2 cm, but does not grow into adjacent organs and does not give metastases.
The third is characterized by germination in nearby tissues, and the onset of metastasis is also observed. Stage 4 pancreatic adenocarcinoma is characterized by the rapid spread of metastases in adjacent organs.
Causes of occurrence
Oncologists associate the occurrence of pancreatic adenocarcinoma with risk factors such as:
- violation of diet;
- bad habits;
- hereditary factor;
- stomach surgery;
- oncogenic substances;
- sedentary lifestyle.
The development of a tumor can provoke the consumption of harmful foods and non-compliance with the frequency of food intake. This causes inflammation of the gland, which is complicated by cancer. The consumption of alcohol and smoking adversely affects the functioning of this body.
All these factors are only probable causes that can trigger the formation of adenocarcinoma. It is not known exactly what causes the disease.
The main symptoms
Pancreatic adenocarcinoma is dangerous because it almost does not manifest itself in the initial stages of the course. A person often feels as usual and does not consult a doctor. Only with the further development of the tumor do suspicions arise regarding its presence. With different localization of the neoplasm, the symptoms will vary somewhat. The first signs will be such as:
- loss of appetite and aversion to food;
- weight loss;
- fatigue, severe weakness;
- chronic state of depression.
With the formation of an adenocarcinoma of the pancreatic head , signs such as:
- aching pains in the intestines and stomach;
- feeling of heaviness;
- yellowing of the skin;
- constant feeling of thirst;
- temperature rise.
As the adenocarcinoma of the pancreas grows, it is well felt. At the same time, many adjacent organs increase in size. Stage 4 pancreatic adenocarcinoma becomes incurable. At the very last stage, with rapid metastasis, there are more and more new signs of the course of the disease, which largely depend on which organ is affected. If metastases enter the liver with pancreatic adenocarcinoma, signs of liver failure appear. And if in the intestines, then obstruction will develop and there will be internal bleeding.
Anemia and anorexia also develop at this stage. One of the reasons for sharp weight loss is considered a metabolic disorder, as well as weak immunity. Thrombosis and thrombophlebitis are characteristic.
Diagnostics
In order to recognize the course of adenocarcinoma, such types of studies are conducted as:
- ultrasound;
- tomography;
- blood chemistry;
- angiography;
- laparoscopy.
Ultrasound will determine the presence of a neoplasm, its size and localization. Also, the doctor can conduct an examination of nearby structures and find in them secondary foci of inflammation, if they reach large sizes.
Tomography refers to the most informative examination method, without which it is impossible to make a correct diagnosis. Such a research method accurately shows the localization of the neoplasm, its degree of germination in the organs, the exact size and the presence of metastases.
During biochemical analysis, the degree of decompensation of the pancreas is evaluated. Adenocarcinoma is always accompanied by a severe violation in the functioning of the anatomical structures. However, it is worth noting that it performs a very important function, which is why oncologists prescribe the replacement type of therapy after receiving accurate examination results.
Angiography is a technique aimed at accurate examination of the walls of blood vessels, which is used to detect blood supply to the tumor. Laparoscopy refers to surgical manipulation intended for diagnosis and treatment, which makes it possible to assess the general condition of the affected organ.
The diagnosis of cancer is established only after a biopsy followed by histological examination.
Treatment features
Treatment of pancreatic adenocarcinoma is mainly carried out by resection of this organ in combination with the use of neurosurgical methods. During the operation, delete:
- the duodenum;
- the head of the "pancreas";
- part of the bile duct;
- gall bladder;
- part of the stomach;
- adjacent lymph nodes.
All these manipulations include not only excision of all damaged tissues, but also the restoration of the integrity of the digestive tract, which is achieved through the use of various anastomoses.
As a result of the operation, the tumor is completely removed or only part of it. After the intervention, complex therapy is used, including radiation and chemotherapy in order to eliminate metastases and prevent the development of relapses. After this, constant monitoring by the oncologist, periodic testing, and also refusal of bad habits are required.
The peculiarity of this type of tumor is the resistance of malignant cells to chemical drugs, so polychemotherapy with heavy metals and cytostatics is completely useless.
The treatment may include hormonal therapy, the use of painkillers, antidepressants, and enzyme preparations are also used. Only this will extend the life of the patient.
Treatment with therapeutic methods alone is not possible due to the particular structure of the tumor. After treatment, there is a high probability of developing relapses, so therapy should be carried out throughout life.
Drug treatment
It is impossible to eliminate a malignant neoplasm only through the use of medications. Cancer detection mainly occurs in the later stages. This requires the use of more radical techniques, including radiation therapy, chemotherapy, immunotherapy.
Chemotherapy helps slow tumor growth and reduce the likelihood of metastasis. It is prescribed before surgery to eliminate the progression of the tumor. It is also used after excision of the neoplasm to eliminate the remaining cancer cells.
Radiation therapy refers to painless techniques. A feature of the procedure is the impact on the affected area. With its help, it is possible to completely destroy malignant cells and reduce pain. In addition, it helps reduce the likelihood of bleeding and stop the spread of metastases.
Immunotherapy is the use of drugs aimed at strengthening the immune system. The purpose of the effect is to reduce the intensity of metastasis and the likelihood of re-development of the neoplasm.
Operation
Surgical treatment refers to the main measure against tumors. It allows you to completely eliminate the tumor, removing the lesion. The operation is almost always carried out, at all stages of the course of cancer. Contraindication is only the large size of the tumor and its ingrowth in adjacent organs. In the fourth stage, cancer is considered inoperable.
The surgical method is selected by a specialist separately after diagnosis. To eliminate the formation, resection and gastroectomy are used. If complete or partial removal of the affected organ is not possible, then auxiliary methods are used. These include laser therapy and stenting.
During the operation, the likelihood of serious complications remains. These include abscesses and the failure of the anastomosis. During the rehabilitation period, bleeding, the occurrence of pyloric stenosis and relapse are possible.
Treatment for metastases
At the last stages of the oncological process with metastasis to adjacent tissues and systems, palliative therapy is indicated. Its goal is to improve the quality of life of the patient and reduce the existing clinical manifestations. With an inoperable tumor, the doctor conducts a gastrostomy, that is, an artificial introduction of the alimentary canal into the stomach. This allows you to feed the patient and prolongs his life.
Sometimes a bypass anastomosis is formed, allowing you to create a kind of channel for the passage of food. If the stomach is completely closed, then by applying a laser, the neoplasm is cut, which facilitates the well-being of the patient and allows him to eat. No additional exposure. Palliative therapy is the only way to prolong the patient's life.
Forecast
With pancreatic adenocarcinoma, the prognosis directly depends on the stage of the oncological process. At the initial stage of development, the tumor is completely removed, which gives a very good prognosis of survival. Among all patients, approximately 70-80% feel normal for 5 years.
At the second stage of oncology, the removal of a malignant neoplasm is incomplete. The prognosis of pancreatic adenocarcinoma is quite favorable and approximately 50% of patients live for 5 years.
At the third stage of oncology, the prognosis is poor, and the number of patients who remain alive is 15-20%. This is due to the prevalence of the malignant process on adjacent organs and systems. At the 4th stage of pancreatic adenocarcinoma, the prognosis is disappointing and approximately only 8-12% of patients can live no more than 5 years.
Prophylaxis
Even with a timely diagnosis and the right treatment, the prognosis remains rather disappointing. This is an irreversible form of cancer. A distinctive feature of pathology is latent leakage. Timely treatment provides an opportunity to slightly increase the chances of a successful recovery. Even in the case of a complete cure, patients are necessarily transferred to replacement therapy. They have to take enzymes, hormones, and many other drugs all the time.
It is very important to prevent this disease in order to prevent the development of a malignant process. As preventive measures will be the elimination of all kinds of risk factors and a timely visit to the doctor. Any warning signs of a digestive disorder may be a symptom of the onset of cancer, so do not ignore a visit to the doctor. Men with bad habits should be especially careful.