Among all known cancers, pancreatic adenocarcinoma is 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 lining the organ and beginning to divide atypically, forming a tumor.
The disease can be localized in absolutely any part of the gland, but often clogs the excretory ducts. Violation of the functioning of the pancreas can lead to very serious consequences for the whole body.
Feature of the disease
Adenocarcinoma of the pancreas is a complex cancerous neoplasm that affects the cells of the glandular epithelium. They line the pancreatic duct. As a result, epithelial tissue is gradually replaced by fibrous tissue.
On closer examination of the tumor, you can see a soft, dense ball of white color. It does not have a specific shape. Growing, the tumor beginscover the entire pancreas and gradually passes to nearby organs in the form of metastasis.
The pancreas consists of 3 parts, and a tumor can appear in any of them. The cancer cells then spread through the lymph nodes and bloodstream to neighboring organs. Basically, the pathology affects the human gastrointestinal tract and respiratory organs.
Main species
Depending on the features of atypical cell construction, the development of a neoplasm can be quite unfavorable. Forms of the disease are determined after a histological examination. In particular, there are such types as:
- highly differentiated;
- poorly differentiated;
- undifferentiated;
- scirrhous.
Highly differentiated pancreatic adenocarcinoma is characterized by the fact that minor changes occur, the disease develops very slowly. In addition, there are absolutely all the conditions and opportunities for successful treatment.
Poorly differentiated adenocarcinoma of the pancreas is characterized by a high rate of division. The tumor grows very quickly and treatment is quite difficult. Moderately differentiated adenocarcinoma of the pancreas 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 into nearby organs.
The most common type of neoplasm is pancreatic ductal adenocarcinoma. It is formed when the cells of the main duct of this organ are damaged, which produces enzymes and juice involved in the digestion process. Such a tumor develops much faster than other types and rapidly metastasizes. This whole process is accompanied by intense pain and leaves almost 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. In the first case, the tumor has a small diameter and does not protrude beyond the border of the "pancreas".
At stage 2 pancreatic adenocarcinoma, the neoplasm reaches a size of more than 2 cm, but does not grow into adjacent organs and does not metastasize.
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 to nearby organs.
Causes of occurrence
Oncologists associate the occurrence of pancreatic adenocarcinoma with risk factors such as:
- malnutrition;
- bad habits;
- hereditary factor;
- stomach surgery;
- oncogenic substances;
- sedentary lifestyle.
Provoke the development of a tumor can be the consumption of harmful foods and non-compliance with the frequency of meals. This causes inflammation of the gland, which is complicated by cancer. Consumption adversely affects the functioning of this organliquor and smoking.
All these factors are only likely causes that can trigger the formation of adenocarcinoma. It is not known exactly what causes the disease.
Main symptoms
Adenocarcinoma of the pancreas 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 go to the doctor. Only as the tumor develops further, 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 food aversion;
- weight loss;
- fatigue, severe weakness;
- chronic state of depression.
When adenocarcinoma of the head of the pancreas is formed, the following signs join the general symptoms:
- aching pain in the intestines and stomach;
- heavy feeling;
- yellowing of the skin;
- constant feeling of thirst;
- temperature increase.
As the adenocarcinoma of the pancreas grows, it is well palpable. At the same time, many adjacent organs increase in size. Stage 4 pancreatic adenocarcinoma becomes incurable. At the very last stage, with rapid metastasis, more and more new signs of the course of the disease appear, which in many respectsdepends on which organ is affected. If metastases enter the liver with pancreatic adenocarcinoma, there are signs of liver failure. 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 rapid weight loss is considered to be a metabolic disorder, as well as a weak immune system. Thrombosis and thrombophlebitis are characteristic.
Diagnostics
To recognize the course of adenocarcinoma, such types of research are carried out as:
- ultrasonic;
- tomography;
- biochemical blood test;
- angiography;
- laparoscopy.
Ultrasound will determine the presence of a neoplasm, its size and localization. Also, the doctor can examine nearby structures and detect secondary foci of inflammation in them if they reach large sizes.
Tomography is one of the most informative examination methods, without which it is impossible to make a correct diagnosis. A similar research method accurately shows the localization of the neoplasm, the degree of its germination in the organs, the exact size and the presence of metastases.
When conducting a biochemical analysis, the degree of decompensation of the work of the "pancreas" is assessed. Adenocarcinoma is always accompanied by a severe disruption in the functioning of anatomical structures. However, it should be noted that it performs a very important function, so the replacement type of therapy oncologistsappointed after receiving accurate examination results.
Angiography is a technique aimed at accurately examining the walls of blood vessels, which is used to detect the blood supply to the tumor. Laparoscopy refers to a surgical manipulation intended for diagnosis and treatment, which makes it possible to assess the general condition of the affected organ.
Cancer is diagnosed only after a biopsy followed by a histological examination.
Features of treatment
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:
- duodenum;
- head "pancreas";
- part of the bile duct;
- gall bladder;
- part of the stomach;
- near lymph nodes.
All these manipulations include not only the 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 entire tumor or only part of it is removed. After the intervention, complex therapy is used, including radiation and chemotherapy to eliminate metastases and prevent the development of relapses. After that, constant supervision by an oncologist, periodic testing, and the rejection of bad habits are required.
Feature of this type of tumorresistance of malignant cells to chemicals is considered, so polychemotherapy with heavy metals and cytostatics is completely useless.
Treatment may include hormone therapy, painkillers, antidepressants, and enzyme preparations. Only this will prolong the life of the patient.
Treatment with therapeutic methods alone is impossible due to the structural features of the tumor. After treatment, there is a high probability of relapse, so therapy should be carried out throughout life.
Medicated treatment
It is impossible to eliminate a malignant neoplasm only through the use of medications. Cancer detection mostly occurs at later stages. This requires the use of more radical methods, including radiation therapy, chemotherapy, immunotherapy.
Chemotherapy helps slow tumor growth and reduce the chance of metastases spreading. It is prescribed before the operation to eliminate the progression of the tumor. It is also used after excision of the neoplasm to eliminate the remaining cancer cells.
Radiotherapy is a painless procedure. A feature of the procedure is the effect on the affected area. With its help, you can 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 impact is to reduce the intensity of metastasis and the likelihood of re-development of the neoplasm.
Operating
Surgical treatment is one of the main measures to combat neoplasms. It allows you to completely eliminate the tumor, removing the lesion. Surgery is almost always performed, at all stages of the course of cancer. The only contraindication is the large size of the tumor and its ingrowth into nearby organs. At the fourth stage, the cancer is considered inoperable.
The surgical method is selected by the specialist separately after the diagnosis. To eliminate the formation, resection and gastrectomy are used. If complete or partial removal of the affected organ is impossible, then auxiliary techniques are used. These include laser therapy and stenting.
Severe complications remain during the operation. These include abscesses and anastomotic failure. During the rehabilitation period, the opening of 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 patient's quality of life and reduce existing clinical manifestations. With an inoperable tumor, the doctor performs a gastrostomy, that isartificial introduction of the alimentary canal into the stomach. This allows you to feed the patient and prolongs his life.
Sometimes a bypass fistula is formed, allowing you to create a kind of channel for the passage of food. If the stomach is completely blocked, then by using a laser, the neoplasm is cut, which makes the patient feel better and allows him to eat. Additional impact is not carried out. Palliative care is the only way to prolong a patient's life.
Forecast
In 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 survival prognosis. Among all patients, approximately 70-80% feel fine for 5 years.
In 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 unsatisfactory, and the number of patients who survive is 15-20%. This is due to the prevalence of the malignant process in nearby organs and systems. At stage 4 pancreatic adenocarcinoma, the prognosis is unfavorable and approximately only 8-12% of patients can live no more than 5 years.
Prophylaxis
Even with timely diagnosis and properly selected treatment, the prognosis remains rather disappointing. This is an irreversible form of cancer. Distinctivea feature of pathology is a latent course. Timely therapy makes it possible to slightly increase the chances of a successful recovery. Even in the case of a complete cure, patients must be transferred to replacement therapy. They have to take enzymes, hormonal drugs and many other drugs all the time.
It is very important to carry out the prevention of this disease in order to prevent the development of a malignant process. As preventive measures, there will be the elimination of all kinds of risk factors and a timely visit to the doctor. Any warning signs of indigestion can 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.
