The incidence of pancreatic cancer is about 10/100,000 per year. Due to aggressiveness of this tumor and difficulty of early diagnosis, mortality is almost equal to morbidity (10/100,000).
Pancreatic cancer is fifth leading cause of cancer death in both men and women (after lung, colon, breast and prostate cancer). It accounts for 5% of all cancer deaths.
Estimated number of new cases and deaths from pancreatic cancer in 2005:
Pancreatic cancer is slightly more common in men than in women, especially in younger people.age
The peak incidence occurs at age of 67 to 79 years, rarely up to 40 years.race and ethnicity
Blacks are at greater risk than whites (50% higher risk). Black men have highest incidence of pancreatic cancer in world.Geography
The statistics of incidence and mortality from pancreatic cancer is same throughout world. The reasons for small regional and ethnic differences in incidence of pancreatic cancer are unclear, but they may be related to trends in decreasing tobacco use in certain groups and regions. The incidence is highest in industrialized societies and Western countries. In Japan, risk was even higher with smoking, where risk could be 10 times higher for men who smoked one to two packs a day.
This risk is related to tobacco-specific nitrosamines.
In Japan, risk is even higher with smoking: men who smoke one to two packs a day are 10 times more at risk.genetic factors
Pancreatic cancer is a genetic disease. K-ras activation point mutations have been found in more than 80% of resected pancreatic cancers. In addition, tumor suppressor genes p16, p53 and DPC 4 are often inactivated in this disease.
Family pancreatic cancer has been associated with following genetic syndromes: hereditary pancreatitis, ataxia-telangiectasia, hereditary non-polyposis colorectal cancer (HNPCC), familial atypical mole syndrome (FAMM), Peutz-Jeghers syndrome, and familial breast cancer. Families with mutations in p16 gene may have a higher risk of developing pancreatic cancer than families without these mutations.diet
A diet rich in fat and meat is considered a risk factor. A diet high in salt, dehydrated foods, fried foods, refined sugar, or soy can also increase risk of pancreatic cancer.
N-nitroso compounds, especially those found in processed meats, have been shown to reliably cause pancreatic cancer in various experimental animals. This has yet to be proven in humans.
Research reveals link between fried meat and pancreatic cancer. Grilled meat contains potential carcinogens such as heterocyclic amines and polycyclic aromatic hydrocarbons, compounds not found in meat prepared by other methods.
Reduced incidence of pancreatic cancer is associated with high consumption of vegetables, citrus fruits, fiber, and vitamin C. The link between dietary intake of citrus fruits and reduced risk of pancreatic cancer is particularly intriguing following recent observations that limonene, a natural product found in citrus fruits, is potent an inhibitor of interest in K-ras oncoprotein.
It should be noted that smoking and diet are estimated to be responsible for at least 40% of cases, making it a preventable disease.Controversial Risk Factors
The association of pancreatic cancer with alcohol, diabetes, and caffeine as causative factors has not been established. Most patients with pancreatic cancer develop diabetes for first time, which is a consequence, not a cause, of pancreatic cancer.alcohol caffeine diabetes
Most patients with pancreatic cancer develop new diabetes, which is a consequence, not a cause, of pancreatic cancer. A meta-analysis of studies published between 1975 and 1994 showed that pancreatic cancer is increasingly common in patients with long-term diabetes. The mechanisms underlying association between pancreatic cancer and diabetes are unclear, however, diabetic condition appears to promote growth of pancreatic cancer in animal models.Previous surgery
Chronic pancreatitis and hereditary pancreatitis are risk factors for pancreatic cancer. Some reports suggest that chronic pancreatitis is associated with a 15-fold increased risk of pancreatic cancer.Symptoms and signs 1. Abdominal pain (80%)
Abdominal pain is first symptom in almost 80% of cases, and prognosis is poor. The pain is usually due to invasion of tumor into adjacent celiac plexus, making surgery impossible. Abdominal pain is usually chronic, aching and radiates to upper back.2. Anorexia (65%) 3. Weight loss (60%) 4. Early satiety (60%) 5. Dry mouth and sleep problems (55%) 6. Jaundice (50%)
On other hand, jaundice is first symptom in 50% of cases and usually has a good prognosis compared to pain. This is because jaundice occurring early in disease leads to a possible diagnosis of pancreatic cancer, and abdominal pain is a vague symptom. This is why tumors around ampulla and tumors inside common bile duct and pancreas cause biliary obstruction early in disease and prognosis is better. In contrast, adenocarcinomas originating in pancreas that do not involve part of pancreatic duct are often not diagnosed until they become locally advanced or metastatic. Few patients with pancreatic cancer have potentially resectable disease in absence of extrahepatic biliary tract obstruction.7. Complaints about gastrointestinal tract (30%).
Other symptoms include nausea, vomiting, and constipation. Exocrine pancreatic insufficiency occurs due to obstruction of pancreatic duct, which usually results in malabsorption, fat production, and minor changes in stool frequency.8. Sign of cachexia
The important signs are those that indicate that surgical resection is not possible. These measures include:
Other important symptoms include deep vein thrombosis.