What is the pancreatic cancer?
The pancreas is a body organ located in the abdominal cavity, between the stomach and the vertebral column. Anatomically, it is divided in three parts, a head (the biggest one), a body, and a tail. The pancreas is an endocrine gland that produces several important hormones, such as insulin, which regulates the levels of sugar in the blood. It is also a digestive organ that synthesizes several digestive enzymes that are secreted into the small intestine through the biliary duct.Pancreatic cancer develops when some cells often located in the head of the pancreas start dividing in an uncontrolled manner, a term often referred to as neoplasia. Pancreatic cancer represents 2% of all new cases of neoplasia. In Italy, its incidence is 10 cases in 100,000 people per year; in the United States, it is currently the fourth leading cause of cancer death.
About 70% of pancreatic tumors originate in the head of the pancreas, specifically in the pancreatic duct that carries the digestive enzymes. Tumoral cells spread very easily to the nearby lymph nodes and to the lungs and the liver. Sometimes pancreatic tumor cells reach the peritoneum (a membrane that forms the lining of the abdominal cavity) and cause peritoneal carcinomatosis. In other cases, the tumor stays unnoticed until it becomes big enough to obstruct the ducts. All of the above, together with critical localization of the pancreas near other vital organs, make pancreatic tumors one of the most difficult tumors to treat. Despite 15-20% of pancreatic tumors are removable by surgery, only 19% of those patients will survive during the first year. One reason for these statistics is that the diagnosis is often made after a long period in which the carcinoma has remained silent. Several diagnostic tools are available to confirm a case of pancreatic cancer: echotomography, spiral computed tomography scan (which is becoming the diagnostic technique of choice to better investigate the characteristics of the tumor), endoscopic retrograde cholangiopancreatography (ERCP), Magnetic Resonance Imaging (MRI), and endoscopic ultrasonography. Although there are currently no markers from blood that can be used for an accurate diagnosis, research efforts are geared towards identifying the most sensitive and specific ones. Some of most common markers used are CA19-9 (carbohydrate antigen 19-9, also called cancer antigen 19-9), CEA (carcinoembryonic antigen), and CA-125 (carbohydrate antigen 125 or cancer antigen 125).