Pancreatic Cancer

Everything You Need To Know About Pancreatic Cancer,

Did Steve Jobs die of pancreatic cancer – Search (bing.com)
Over the past decade, the incidence of pancreatic cancer is seen to be on the rise.
It is one of the major types of cancer and is only behind lung and colon cancer in mortality rate. Even with new advancements, effective screening tests for pancreatic cancer are still not devised. Dr Ryke Geerd Hamer: How Unresolved Trauma Causes Cancer (alternative-cancer-care.com)

German New Medicine Emotions and Types of Cancer Chart – Search (bing.com)

Steve Jobs relationship with his daughter – Search (bing.com)

Steve Jobs Emotional Conflict in his Life – Search (bing.com)

Steve Jobs Stanford Speech – Search (bing.com)

The following blog post Cosmic Journey | Cancer Quick Facts (solitarius.org)
Illustrates the connections between organs and emotional issues. It combines Hamer’s correlations as well as some of my own. As a disclaimer, you must remember that not
all patients will follow what is in this chart. While it is a very helpful guide, individual assessment is necessary.

Definition
In simple words, pancreatic cancer can be defined as uncontrolled, un-programmed,
rapid cellular division of the pancreatic tissue, resulting in a malignant mass of cells,
which can be differentiated from normal cells by the loss of structural integrity and
architectural configuration of the cells.
Pancreas sits behind the stomach. It is an accessory organ serving in the digestive
function of the body. It has two types of functions. The endocrine function serves to release the pancreatic hormones, insulin and glucagon.
These hormones are significant regulators of glucose metabolism. The exocrine function of the pancreas serves to release digestive enzymes into the small bowel. These enzymes help in digestion of protein, carbs and fat components of the food.

Types Of Pancreatic Cancer
Depending upon the functional cell involvement, pancreatic cancer
can be divided into two main types. The exocrine tumors are more common.
Pancreatic adenocarcinoma accounts for more than 90% of all pancreatic cancers. 
It is the proliferation in the ductal elements of the pancreas, which feed pancreatic enzymes into the gut. One of its subtypes is the acinar cell carcinoma. This type of cancer results from proliferation of one type of cell, which releases fat-digesting enzymes.
The neuroendocrine pancreatic cancers are less common in occurrence. These involve the hormone-secreting cells of the pancreas called islets. Depending upon the specific cell undergoing proliferation, the subtypes include:

Insulinoma: which secrete excessive insulin.
Glucagonoma: which secretes glucagon.
Gastrinoma: which secrete excessive gastrin.
Nonfunctional islet cell tumor: no hormones.
The tumors, which are neuroendocrine in origin, are generally
slow-growing and less fatal than the tumors of exocrine origin.

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Mechanisms Underlying Development of Pancreatic Cancer.
Like all cancers, the root cause of the disruption is unclear. However, it can be seen
that underlying pancreatic illness, like chronic pancreatitis, has increased chances of developing into a malignant tumor. Recurrent attacks of pancreatitis, which is the inflammation of the pancreas, can result in cells accumulating genetic mutations. These mutations then unleash the malignant potential of cells. The cellular checkpoints which ensure proper multiplication of cells, are lost. The cells not only increase in number, but also fail to differentiate. This means that the new cells are unable to be functional.

Epidemiology of Pancreatic Cancer.
Pancreatic cancer is a disease of old age. It is not a frequent diagnosis in the adult population. The risk increases with age in an elderly population. There is an association, however weak, between gender and pancreatic cancer. Males seem to have stronger chances of contracting this type of cancer. The reason can be attributed to a number of environmental factors which expose men more than women. The incidence of pancreatic cancer is seen higher in Europe.

The pancreas is an organ located behind the stomach.
It releases enzymes that help with digestion, as well as hormones that help regulate blood sugar levels.
If you have pancreatic cancer, you won’t be able to feel a lump or mass when you press on the outside of your abdomen. You may not have any symptoms until the cancer has already spread. Unlike breast, colon, and prostate cancers, pancreatic cancer isn’t routinely found with screening tests. People aren’t generally tested because no screening test for pancreatic cancer has been proven to save lives.
Pancreatic cancer is sometimes called a silent disease because it’s hard to spot early, the stage when it’s most treatable. Besides knowing the symptoms, knowing the risk factors for pancreatic cancer is your best protection against this disease. For example, your chances of developing pancreatic cancer are significantly higher if:

you have a family history of the cancer
you’re a smoker
you’re obese
you’re exposed to certain pesticides and chemicals on a regular basis.

Pancreatic cancer typically spreads rapidly to nearby organs. It is seldom detected in its early stages. But for people with pancreatic cysts or a family history of pancreatic cancer, some screening steps might help detect a problem early. One sign of pancreatic cancer is diabetes, especially when it occurs with weight loss, jaundice or pain in the upper abdomen that spreads to the back. Treatment may include surgery, chemotherapy, radiation therapy or a combination of these.

8 Signs that You have Cancer – YouTube

Some major symptoms are:
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Jaundice

Jaundice occurs in about 50% of pancreatic cancer cases. Your eyes and skin may turn yellow, and you may feel itchy. You may also feel sick, lose your appetite and lose weight, and feel tired and thirsty. Jaundice can be a symptom of pancreatic cancer at an earlier stage. Jaundice is caused by the buildup of bilirubin, a component of bile produced by
the liver. This can occur when a tumor blocks the bile duct connecting the pancreas to the liver.
If you develop jaundice, your doctor or nurse will assess whether you need a biliary
stent or drain. A biliary stent is a small tube that is inserted into the bile duct to relieve the blockage. A biliary drain is a small tube that is inserted through your skin into the bile duct and drains the bile into a bag.
The doctor or nurse will also treat any symptoms of jaundice. For example, they may give you medication to control any sickness or itching. While jaundice can be a symptom at any stage of pancreatic cancer, when pancreatic cancer is diagnosed early, patients may be eligible for surgery, which offers the best chance for long-term control of the disease.
This is why it’s important to know the symptoms and listen to your body.

Back pain
Approximately 70 percent of patients with pancreatic cancer go to the doctor initially
due to pain. This pain is often described as beginning in the stomach area and radiating around to the upper back. It can be worse after eating or when lying down. Sitting forward can sometimes relieve the pain. At first the pain may come and go, but over time it may become more constant. If any of the organs (pancreas, liver or gallbladder) in the abdomen are inflamed or enlarged the area may also be tender to touch. Pain is caused by the cancer affecting nerves or organs near the pancreas. It can also be a result of a tumor causing a blockage in the stomach or duodenum (top part of the small intestines).
A specific palliative step for managing pain in pancreatic cancer may include a nerve block of the celiac nerve plexus (located in the back/abdomen area where many patients feel pain with pancreatic cancer) via injection with alcohol or other agent. Other possible interventions to relieve pain are subarachnoid or epidural blocks  (both in the spinal space).

Greasy or clay colored stools
A condition called steatorrhea (stools that are large, pale, oily, floating and smelly) is a common symptom of diseases of the pancreas. It happens because the cancer affects the production of the enzymes needed to digest food, particularly high fat food. Undigested food passing quickly through the body can also cause diarrhea & subsequent weight loss.

Your doctor often orders these imaging tests to diagnose pancreatic cancer:
Computed tomography (CT scan)
Magnetic resonance imaging (MRI)
Ultrasound
Positron emission tomography (PET scan): Radioactive glucose injected into the veins is absorbed by cancer cells. PET scans may help determine the degree of pancreatic cancer spread.
If imaging studies detect a mass in the pancreas, a pancreatic cancer diagnosis is likely, but not definite. Only a biopsy can diagnose pancreatic cancer. 
Biopsies can be performed in several ways:

Percutaneous needle biopsy
Endoscopic retrograde cholangiopancreatography (ERCP)
Endoscopic ultrasound

Itchy skin
Pancreatic cancer patients may experience itching if their tumor blocks the bile
duct and causes jaundice. When excess bilirubin builds up in the skin, it also tends to cause itchiness and irritation. Some cancer treatments may cause itching or rashes over the entire body or in isolated areas. This may be result from a hypersensitivity reaction during chemotherapy infusion. Visit your healthcare provider as soon as possible in case you are having an itchy skin or a rash.

Weight loss

Losing a lot of weight for no particular reason can be a sign that something is wrong. People may also notice a loss of appetite or changes in what they feel like eating. Pancreatic cancer can affect the ability of the pancreas to produce digestive enzymes
that help to digest food, especially high fat food. This means that the body can’t digest
food properly or get the nutrients it needs, leading to weight loss. Cancer & Cachexia.

Hematemesis


Pancreatic cancer can also present with hematemesis in the early stage of the disease. Hematemesis is upper gastrointestinal (GI) bleeding, typically described as a hemorrhage proximal to the ligament of Treitz. Symptoms consist of coffee ground emesis, vomiting frank blood, melena, and hematochezia. Symptoms of anemia may also be present, including chest pain, weakness, fatigue, syncope, or dyspnea. Visit your doctor immediately so that proper diagnosis can be made starting the treatment.
 
Diabetes

Diabetes can develop if a tumor interferes with the pancreas working properly.
This is because the pancreas normally produces the hormone insulin which the body needs to regulate the amount of sugar in the blood. People with diabetes often feel extremely thirsty, pass more urine than normal, lose weight and feel weak and lacking in energy. Diabetes is particularly associated with pancreatic cancer in older people. If someone over 50 has developed type 2 diabetes within the past two years, with no other explanation, their GP should consider the possibility of pancreatic cancer.

Blood clots

Sometimes, the first clue that someone has pancreatic cancer is a blood clot in a large vein, often in the leg. This is called a deep vein thrombosis or DVT. Symptoms can include pain, swelling, redness, and warmth in the affected leg. Sometimes a piece of the clot can break off and travel to the lungs, which might make it hard to breathe or cause chest pain.
A blood clot in the lungs is called a pulmonary embolism or PE.


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Ascites

Swallowing Difficulty & Ascites (increased abdominal fluid)
Sometimes people get a problem in swallowing the food which is a clue for the pancreatic lump. They might choke or cough when they consume food. Most of the time the food come backward or a person may feel that food is stuck within the throat.
In most patients of pancreatic cancer, there is a tendency to increase the abdominal girth. This happens due to a collection of a large number of the fluid within the abdominal cavity. This state is named as ascites and sometimes also called as the malignant ascites. The right reason for this fluid accumulation is not understood completely. Yet its level and severity may vary according to individuals, but it’s associated with the factor related to the presence of peritoneal or lymphatic metastases.

Unexplained weight loss

Weight loss and muscle wasting (cachexia) are common and occur in over 90% of patients with pancreatic cancer. These phenomena, apart from physiological disadvantages which contribute to fatigue and weakness, often have a pronounced deleterious effect on such factors as a patient’s sense of well-being. Contributors include anorexia, nausea, other gastrointestinal symptoms, depression, the side-effects of chemotherapy, surgery, new dietary constraints, early satiety (sense of stomach fullness), medical procedures and perhaps most importantly the metabolic effects of the pancreatic cancer itself.

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Fatigue

Fatigue can be an early symptom of pancreatic cancer, manifesting even before the diagnosis is made. Sooner or later, the majority of pancreatic cancer patients indicate fatigue as a significant symptom. Typically described as a loss of customary energy levels and even as affecting mental processes, the fatigue of pancreatic cancer can be debilitating.
The range of causes of fatigue under these circumstances is very large and can include such factors as the pancreatic cancer itself, sleeplessness (possibly due to pain or for other reasons), anemia, chemotherapy side-effect, anxiety or depression, medication side-effect (including pain medication), infection, electrolyte disturbance, or dehydration.
The treatment of fatigue is first directed at trying to eliminate any correctable medical
or psychological underlying cause. This may include the adjustment of medications. Attention might be given to those factors which help promote adequate and restorative sleep.

Indigestion

New, unexplained and persistent dyspepsia (indigestion/heartburn) can be a
symptom of pancreatic cancer, particularly in older people. If you are suffering from prolonged indigestion, give a quick visit to your doctor. Treating the underlying cause is necessary but your doctor may prescribe medications like proton pump inhibitors to relieve the symptoms.
Pancreatic enzyme supplements can help manage problems with digesting food, including pain and discomfort. They replace the enzymes that your pancreas would normally produce and break down food.

Diarrhea

Diarrhea can occur with many types of pancreatic cancers. It can also be a sign of a tumor called a VIPoma. This uncommon pancreatic tumor releases a substance called vasoactive intestinal peptide (VIP), which sends more water into your digestive system. Excess water in your intestines can lead to severe, watery diarrhea. Pancreatic cancer can also prevent you from properly absorbing nutrients from the foods you eat, which can also trigger diarrhea. Visit your doctor immediately if you observe any change in bowel habits.

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Upper abdominal pain

As cancer spreads, it can press down on nerves or other organs, causing abdominal pain.
A blockage in the digestive tract can also lead to pain. Most people with pain from pancreatic cancer experience pain in their abdominal region.
If cancer is diagnosed, relieving pain symptoms remains an important part of cancer care and treatment. This may be called palliative care or supportive care. Be sure to talk with your health care team about abdominal pain so that proper evaluation can be done. Moderate pain is treated with a “weak” opioid such as codeine with or without a non-opioid analgesic and with or without another adjuvant agent (such as an anti-anxiety drug). And severe pain is treated with a strong opioid such as morphine with or without a non-opioid analgesic and with or without another adjuvant agent (such as an anti-anxiety drug).

Swelling of legs

Fluid may also build up in your legs and feet, causing swelling. This is called oedema. People sometimes also get oedema in their genitals. Oedema can be uncomfortable and painful and can make it harder for you to move around.
Tell your doctor or nurse if you have any swelling. They may recommend pressure stockings to help control the swelling and suggest some exercises you can do to help the fluid drain away. Putting your feet up, for example on a foot stool, can help. It is also important to look after your skin by moisturizing the swollen areas – ask your nurse what moisturizer to use. Sometimes you may be offered medication called a diuretic to treat the oedema – although this may not make a big difference.

Dark urine

Bile is a yellowish-brown fluid released by your liver. It travels through the common bile duct to the intestines to be removed from your body via stool. When the common bile duct is blocked by a tumor, bilirubin can’t be removed and too much of it builds up in your body.
Excessive accumulation of bilirubin in your body results in its increased secretion
into the urine. Urine turns brown due to presence of excessive amount of bilirubin.
Surgery offers the best chance of controlling pancreatic cancer and its worrisome symptoms for a long time. But, most patients are diagnosed at later stages and are not eligible for surgery.  Chemotherapy is another option available to those who are in a later stage of the disease.

Nausea and vomiting

Nausea (feeling sick) and sickness can occur for several different reasons. A tumor may block the bile duct or press on the duodenum, which obstructs digestion resulting in vomiting. Nausea can also be due to inflammation around the pancreas and jaundice.
Both of these conditions can lead to a chemical imbalance in the body which can make people feel sick.
Nausea and vomiting may be a problem in up to 40% of pancreatic cancer patients. Consequently, the reason for the nausea needs to be sought out and the underlying
cause should be dealt with appropriately by the trained oncologist.
In addition, antiemetic agents may be prescribed to relieve the symptom.

Constipation

Constipation is a frequent complaint in pancreatic cancer patients. Some causes of constipation in pancreatic cancer patients may include low fiber diet, diminished fluid intake, diminished physical activity and postural effects from bed rest. More serious causes may include various metabolic abnormalities and even bowel obstruction.
The treatment should include evaluating and correcting any underlying problems, ensuring adequate fluid intake, increasing physical activity if possible, giving laxative
drug therapy where appropriate and providing enemas as needed.

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Depression

Mild to severe depression can often present itself in the early stages of pancreatic cancer. This is why someone who has never suffered from a severe bout of depression before should express their concerns to their GP. It can often highlight a medical problem in the very early stages.

Enlarged gallbladder

If the common bile duct is blocked, bile can get trapped in your gallbladder.
This causes the gallbladder to grow larger than normal. Your doctor may be able to feel the enlarged gallbladder during an exam. You may also have upper abdominal tenderness.  Understanding when symptoms are a sign of something serious and either diagnosing the disease or confirming a previous diagnosis require expertise from specialists trained and experienced in treating pancreatic cancer

Summary

Pancreatic cancer is known as a “silent disease” because identifiable symptoms are not usually present in the early stages of the disease. Several symptoms commonly associated with pancreatic cancer are pain on eating, jaundice, weight loss, poor appetite, dark urine, swelling of legs, indigestion, diarrhea, diabetes, abdominal pain, back pain, ascites, blood clots and enlarged gallbladder.
Pancreatic cancer is aggressive with few symptoms until the cancer is advanced.
Diagnosis can be made through ultrasound, ERCP, CT scan, MRI and biopsy.
Pancreatic cancer treatment depends on the stage of the disease and the patient’s
general health. Treatments include surgery, chemotherapy, and radiation.

Dr Robert Martin University Louisville – Search (bing.com)

RiP Victoria Albers Obituary (1947 – 2022) RiP

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