PANCREATIC CANCER; THE SILENT, THE AGGRESSIVE, THE FATAL

If you use an iPhone, iPod or iPad, then you must know Steve Jobs the former chief executive officer (CEO), and co-founder of Apple Inc. who died on October 5, 2011 aged 56 years.

He was quite wealthy and, no one would expect him to die at such a young age. This confirms the saying that “money can not buy life”.

Nevertheless, his death can not be entirely attributable to the disease, but he displayed a level of ignorance for one of his calibre. He was diagnosed with Cancer and refused treatment for 9 whole months and, rather sourced for alternative healthcare. That was tantamount to Suicide(wikipedia).

Today, I want to create awareness of this dangerous disease. One of the most aggressive cancers. In fact, like one of my teachers would say, it is one of the fastest ways to die. Gives no prior notice, it just hits and death is in weeks.

Overview of the Pancreas

The pancreas is one of the organs in the body responsible for the secretion of some enzymes, hormones like Insulin which helps in carbohydrate metabolism and utilization. It is located in the abdomen.

Cancer of the pancreas

Cancer of the pancreas is on the rise. It’s a very aggressive tumour and it occurs quite frequently in West Africa. Most patients present with advanced disease.

The peak age of occurrence is 65-75 years. However it has been found in much younger age (Steve was 45 years when he was diagnosed in 2003)

Risk factors

It has a familial background in 10% of patients. With those with at least first two relatives with ca Pancreas, the risk increases by 18-57 fold!

Chronic pancreatitis: This is the inflammation of organ. And the principal cause is Chronic alcohol abuse

Cigarette smoking

Diets rich in fat and protein

Diabetes Mellitus (it occurs twice as frequently in diabetics as in the general population)

Presentation

• Loss of appetite and unexplained weight loss of about 11kg over a few weeks are usually the first and most constant symptoms of this cancer.

• Pain is prominent in 80% of cases. It is characteristically a dull ache,  located in the centre of the upper part of the abdomen (epigastrium) which is felt more severely while lying flat with head up (supine). Ache is also aggravated by food intake, or the pain may just be a persistent back pain.

• Jaundice (Yellowish discoloration of the eyes) is the 3rd most encountered symptom occurring in over 75% of cases.

These are the 3 main symptoms. Others may include

• Diarrhoea, retching and vomiting
• Liver enlargement which may be as a result of spread to the liver
• Though rare, but there could be psychiatric manifestations like depression and paranoid psychosis.
• Passage of blood in stool or dark coloured stool.

Once any of these are noticed, please see a physician fast.
The prognosis of this cancer is poor and there are some available screening tools (tumour markers).

Diagnosis

A high-resolution abdominal ultrasound scan or CT abdomen (with contrast) are readily available for picking out this cancer.

Treatment

Surgery and chemotherapy. Patients with jaundice need operative treatment without delay (Steve refused this for complete 9months. Who knows maybe he would have survived because he had a milder variant of this cancer, not the most aggressive types). Jobs was first diagnosed in 2003, he chose to pursue alternative therapies, including acupuncture, herbal, diet and fruit juice therapy and spiritual consultations. Many of these therapies he found on the internet. An act he regretted till death(wikipedia). Please don’t be like Steve.

The prognosis is poor. But with early intervention after surgery, median survival is about 11-20months and without surgery 6months. Contrary to what some believe, pancreatic cancers can be treatable. Early detection of the disease greatly contributes to the likelihood of successful treatment. Unfortunately, pancreatic cancer can be difficult to detect in its early stages when treatment has been known to be most successful. In addition to pancreatic cancer treatments such as surgery and chemotherapy, new clinical trials are being conducted every day to help combat advanced-stage disease.

Prevention

1. Adequate medical check up: U.S. Supreme Court Justice Ruth Bader Ginsburg who died on September 18, 2020 at age 87 due to complications related to pancreatic cancer. She was first diagnosed with early stage pancreatic cancer in 2009. She had no symptoms of the disease at the time – it was discovered during a regular checkup. She was an inspiration to cancer fighters.

This shows that the importance of regular medical check up can never be over-emphasised

2. Avoidance of alcohol and cigarette smoking

3. Health diet: A healthful diet can contribute to maintaining a healthy pancreas

Disclaimer: This isn’t for diagnostic purposes.