Tumor of the pancreas

Pancreatic cancer ranks fourth among malignant neoplasms of the gastrointestinal tract (after gastric cancer, colon cancer and esophageal cancer) and accounts for 2–3% of all cancerous tumors. Significantly more often observed in men, mainly over the age of 50 years.

Among the urban population, pancreatic cancer is observed more often than among rural residents.

Risk factors

All sorts of factors contributing to the development of pancreatic cancer are known:

  • smoking (in smokers, the disease occurs 3 times more often than in non-smokers);
  • obesity;
  • contact with industrial carcinogens;
  • diabetes;
  • chronic pancreatitis with frequent relapses;
  • alcoholism;
  • burdened heredity.

Clinical picture

The clinical picture of pancreatic lesions depends on the location of the tumor. Tumors are most often located in the head of the pancreas (75% of cases), less often affecting its body and tail.

Symptoms of pancreatic head cancer can be divided into two periods. In the early stage, the disease does not bother the sick, and they do not seek medical help. The first alarming symptom of the disease is most often pain in the epigastric region and hypochondrium, sometimes with irradiation to the back (girdle pain), with increasing intensity at night. In the future, a progressive decrease in body weight without a clear reason, heaviness in the epigastric region after eating, general weakness and loss of work capacity are characteristic.

With a progressive increase in the tumor, the leading symptom of pancreatic head cancer appears – jaundice – a consequence of compression of the common bile duct by the tumor. It starts suddenly, without a previous pain attack, then quickly increases. Skin itching, darkening of urine and discoloration of feces join. In addition to jaundice, severe digestive disorders can occur: loss of appetite, nausea, belching, vomiting, diarrhea, increasing dehydration, cachexia (a sharp decrease in body weight).

Cancer of the body or tail of the pancreas manifests itself in the later stages, since tumors of this localization cause obstructive jaundice in only 10% of cases. Cancer of the body of the gland quickly grows into the mesenteric vessels, the portal vein. Sometimes (10–20%), diabetes mellitus develops due to the destruction of insulin-producing cells. A pancreatic tail tumor often invades the portal vein and splenic vessels, resulting in portal hypertension with an enlarged spleen and other characteristic symptoms. When the tumor is localized in the tail and body of the gland, the pain syndrome is especially pronounced due to the germination of the numerous nerve plexuses surrounding the gland by the tumor. Often the first and only symptom of cancer of the body and tail of the pancreas can be multiple venous thrombosis.

Some rare forms of tumors come from cells that secrete pancreatic hormones, which largely determines the clinical picture of the disease. Thus, a tumor that secretes glucagon leads to an increase in blood sugar and dermatitis. A tumor that secretes insulin leads to a severe decrease in blood sugar, which manifests itself in weakness, cold sweats, loss of consciousness, and in a long course – disruption of the brain.


In the diagnosis of pancreatic tumors, instrumental and laboratory methods are used.

The main instrumental techniques include:

  • ultrasound examination (ultrasound);
  • computed tomography (CT);
  • magnetic resonance therapy (MRI or NMR);
  • endoscopic ultrasound;
  • intraductal ultrasound;
  • retrograde pancreatocholangiography;
  • diagnostic laparoscopy with possible laparoscopic ultrasound;
  • angiographic study.

Ultrasound (ultrasound examination) is the most common and is a publicly available method for diagnosing pancreatic disease. But, unfortunately, the probabilities of ultrasound are not unlimited and not any formation is likely to be detected and evaluated by an ultrasound sensor. This is where modern technology comes to the rescue.

CT (computed tomography), MRI (magnetic resonance therapy) are more informative than ultrasound, but also do not always allow one hundred percent correct diagnosis.

Endoscopic and intraductal ultrasound are varieties of ultrasound, a combination of ultrasound and endoscopic methods, in which the study is performed from the lumen of the stomach and duodenum, to which the pancreas is adjacent. Hence, a clearer image and the likelihood of a more accurate diagnosis of the state of the pancreas.

With intraductal ultrasound (currently the most accurate non-invasive instrumental examination used to diagnose pancreatic neoplasms), an endoscope with a sensor is inserted into the duodenum, the place into which the pancreatic duct flows (Wirsung’s duct) is determined, after which the sensor is advanced and inserted into duct lumen. The study is performed through the pancreatic duct, that is, in close proximity to the gland tissue.

In some cases, angiographic examination, diagnostic laparoscopy is used.

Laboratory methods

Determination of blood parameters that indirectly testify in favor of damage to the pancreas.


  • biochemical blood test;
  • a blood test for tumor markers (indicators, an increase in the level of which in the blood indicates the presence of a particular tumor in the body).

In some cases, despite the use of the listed diagnostic procedures, there are significant difficulties in the differential diagnosis with some forms of chronic pancreatitis (benign pancreatic disease). In such a situation, the final diagnosis is made on the basis of cytological and histological examination of the material obtained from the biopsy.

It should be remembered that the detection of any, even a malignant disease at an early stage improves the prognosis of the upcoming treatment.


Treatment of pancreatic cancer is surgical. In previous years, operations were purely palliative in nature and boiled down to the imposition of one or another anastomosis to drain bile into the intestines. Over the last decades, surgery in this area has made significant progress. In early, uncommon forms of cancer of the head of the pancreas, a complex operation is performed – pancreato-duodenal resection, removing part of the pancreas along with the ducts and duodenum, and then using complex reconstructive techniques to restore the passage of bile and intestinal contents. But such a radical operation is possible only in 10-30% of patients. In case of cancer of the body or tail of the pancreas, the affected part of the pancreas is removed. With common processes and, especially, in the presence of metastases,

Radiation therapy is ineffective. Some progress has been made with chemotherapy.


Pancreatic cancer metastasizes early, often to the regional lymph nodes and liver. It is also possible metastasis to the lungs, bones, peritoneum, pleura, adrenal glands, etc.


With tumors of the pancreatoduodenal zone, the prognosis is serious, because early recognition of these tumors in the bulk of cases is difficult and radical interventions are likely to be performed only in a limited number of cases.

Almost 70% of patients are diagnosed late. The results of treatment of such patients are therefore very poor. In the United States, pancreatic adenocarcinoma ranks 4th in the structure of oncological mortality.


Refusal of smoking. Exclusion of the influence of harmful environmental factors, occupational hazards (asbestos dust). Timely treatment of chronic pancreatitis, diabetes mellitus. Systematic preventive examinations in the presence of cysts and benign tumors of the pancreas, chronic pancreatitis.

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