Fight against pancreatic cancer

By Dr Olivia Dalla Costa

As a physician, I have always been passionate about helping patients with cancer. Being on the Board of the John E Sabga Foundation allows me to direct this passion towards pancreatic cancer, one of the most difficult of all cancers to treat and thus one of the most deadly.

Learning about this disease and the steps that can be taken to reduce one’s risk is crucial in the fight against pancreatic cancer.

The World Health Organization (WHO) has listed Trinidad and Tobago in the top 30 per cent for pancreatic deaths globally, a concerning statistic for our small island.

Pancreatic cancer is one of the most fatal cancers because it is often detected after it has already spread to other organs. Therefore, it is extremely important to recognise the symptoms early.

Signs and Symptoms

One of the more subtle signs of pancreatic cancer would be a new diagnosis of, or suddenly uncontrolled diabetes. Because the pancreas helps to control blood sugar, if blood sugar becomes uncontrolled this may be a sign that the pancreas is not functioning properly.

Some other common symptoms to be aware of are as follows:

• Jaundice (yellowing of the eyes and skin). Since this is common in advanced pancreatic cancer, it can often be the first sign that something is wrong
• Pain, most commonly in the upper abdomen +/- radiating to the back. Pain is the body’s way of indicating that something is wrong and should not be ignored
• Unexplained weight loss, i.e., when weight is lost without intention, of 10 lbs or more, or 5 per cent of body weight over a 6–12 month period
• Loss of appetite
• Pale, greasy stools. A change of bowel habit from the norm is always a concern and should be investigated accordingly
• Refractory nausea and vomiting
• Generalised weakness

If you or anyone you know is experiencing any of the signs and/or symptoms described above, your doctor should be consulted as soon as possible.

Diagnosis

The diagnostic process is multi-factorial and will involve a range of investigations which may include blood test, imaging such as US, CT, MRI, PET.

Patients will also need to have a biopsy for histological diagnosis in order to determine which type of pancreatic cancer has been detected. Even though most pancreatic cancers are adenocarcinoma, this is not always the case, and a biopsy is needed to distinguish between types, which allows for the design of a treatment protocol.

Treatment

Surgery – Once there is early detection, surgery can be undertaken to remove the pancreatic cancer. This would be the ideal option as it would give patients the best hope for survival. Unfortunately, many of the patients diagnosed with pancreatic cancer are not candidates for surgery as the cancer is too advanced at diagnosis.

Chemotherapy – A form of medical treatment of pancreatic cancer which utilises drugs to help kill cancers. These drugs can be injected into a vein, taken orally or a combination of both can be used. In patients with advanced pancreatic cancer, chemotherapy may be used to control cancer growth, relieve symptoms, and prolong survival.

Radiation – Another form of medical treatment which utilises high-energy beams, such as those made from X-rays and protons, to destroy cancer cells. Radiation can also be used before and after surgery, or in combination with chemotherapy.

Palliative (supportive) Care – Palliative care is not the same as hospice or end-of-life care. Palliative care is specialised medical care that focuses on providing relief from pain and other symptoms of a serious illness such as pancreatic cancer. This can be invaluable in improving the quality of life for a patient.

Coping and Support – Being diagnosed with any cancer can be devastating. It is important to find ways of coping; ask for help from friends and family, find someone to talk to, connect with other cancer survivors.

Prevention and risk reduction

While there is no one clear change that can prevent pancreatic cancer, there are  lifestyle changes that can reduce the  risk of developing pancreatic cancer.

Maintain a healthy weight – Obesity is a risk factor for many cancers and chronic disease such as hypertension, diabetes, and heart disease.

Stop smoking – Smoking harms nearly every organ and organ system in the body, diminishing a person’s overall health causing numerable cancers such as pancreatic, lung, colon, bladder, oesophagus, larynx, mouth, and  throat to list a few.

Reduce alcohol intake – All types of alcoholic drinks, including red and white wine, beer, cocktails are linked to cancer. The more alcohol is consumed, the higher the risk of cancer.

Choose a healthy lifestyle – A healthy diet and regular exercise reduce the risk of cancer and chronic disease, leading to increased longevity.

Local resources

Within Trinidad and Tobago, there are resources offered for assistance with screening and diagnosis. The Trinidad and Tobago Cancer Society provides screening and counselling services. The Caribbean Cancer Research Initiative offers a navigation service which helps guide patients through the process of diagnosis and cancer treatment.

November was Pancreatic Cancer Month. To contact John E Sabga Foundation, call Lisa Ghany 708-0273, Operations Consultant