What causes pancreatic cancer? What are the risk factors?

It is more common in people over the age of 60 and in men. However, the incidence at younger ages is also increasing day by day. Although the cause is not clear, risk factors include smoking, dieting with high fatty foods, alcohol use, diabetes, obesity and high coffee consumption. These reasons I have mentioned are also risk factors for pancreatitis, which means inflammation of the pancreatic gland. Cancer development is relatively easier in patients with long-term pancreatitis. In recent studies, it has been shown that genetic factors are also associated with pancreatic cancer.

What are the symptoms of pancreatic cancer?

Indigestion may present with pain radiating from the stomach to the back, rapid weight loss and jaundice. Sometimes, new onset diabetes can be seen in tumors involving the body and tail of the pancreas, although there is no family diabetes. Rarely, a palpable mass in the stomach area, just below the rib cage, can be detected in the midline. Since the pancreas is located in an area where the nerves pass intensely in the body, there is very severe pain that hits the back in both pancreatitis and cancer.

How is it diagnosed?

Pancreatic cancer should definitely be kept in mind in patients presenting with complaints such as pain, jaundice, and weight loss. High detection of bilirubin showing jaundice in blood tests and CEA and CA 19-9, the tumor markers indicating pancreatic cancer, suggests pancreatic cancer. The mass can be revealed by ultrasonography, computed tomography, and magnetic resonance imaging. The diagnosis is confirmed by examinations called MRI and ERCP, which show the bile ducts, and the pancreas and bile duct are visualized with endoscopy.

How to treat?

The actual treatment of pancreatic cancer is surgery, but only 20-25% of patients can be caught in the operable period. Therefore, when the diagnosis is made, the tests should be completed quickly, and surgery should be performed if the patient is suitable. Chemotherapy and, if appropriate, radiotherapy are added to surgical treatment. In cases where the patient is not suitable for surgery, supportive treatment is performed with chemotherapy.

Which organs does pancreatic cancer spread to?

Pancreatic cancer is one of the tumors with an aggressive course. It often spreads to the lymph nodes around the pancreas, liver and lungs. Important vessels pass right next to the pancreas. Spread to the vessels in this area can also be observed.

Related Articles:

• Large Intestine Cancer
• Gastric Cancer
• Breast Cancer
• Thyroid Cancer

Pancreatic Cancer yazısı ilk önce Assoc. Professor Soykan Barlas üzerinde ortaya çıktı.

• Detection of a single and hard nodule in the thyroid gland,
• Male patient over the age of 50,
• Detection of nodules in a patient younger than 15 years old,
• Fast growing nodule,
• Hard lymph node in the neck,
• Having received radiotherapy for any reason to the neck,
• Family history of thyroid cancer.

What are the Types of Thyroid Cancer?

Thyroid cancer is divided into 5 different groups. These are;

• Papillary thyroid cancer; It is the most common type of thyroid cancer with 70-75%. It is more common in women between the ages of 20-50. When treated, it provides the best life span. It can spread to the lymph nodes in the neck, so the thyroid gland and the lymph nodes on the side of the tumor are also cleaned during surgery.

• Follicular thyroid cancer; It is detected at a rate of 10-15%. It is more common in women over the age of 50. It is generally seen in patients who have been followed up for nodular goiter. The problem with follicular type cancer is that the cell taken from needle biopsies cannot be determined whether it is cancer or not. The probability of having cancer is around 20%, but surgery is usually decided to avoid risk.

• Hurthle cell cancer; It is relatively rare. It is usually detected over the age of 60. It is more aggressive compared to the papillary and follicular types, so all thyroid tissue is cleaned together with the lymph nodes around it in surgery.

• Medullary thyroid cancer; It is seen at a rate of 5-10%. It can be found alone or in families with other disorders. When this type of thyroid cancer is encountered, the patient should be investigated for other disorders. When found alone, the treatment is to remove the thyroid gland with the surrounding lymph nodes.

Anaplasticthyroid cancer; It is detected at a rate of 5%. It is the most aggressive of all thyroid cancers. It appears as a hard mass in the neck and may cause hoarseness and difficulty swallowing. When diagnosed, it may not be surgically removed.

Do I have goiter or thyroid cancer? How will I understand?

There are nodules in the thyroid gland in goiter and thyroid cancer. The important thing is to distinguish whether these nodules are benign or malignant. The structure, size and blood supply of the nodules are determined by ultrasound to the thyroid gland. Diagnosis can be supported by scintigraphy. Different or enlarged nodules are easily detected with intermittent and regular ultrasonography. If these features of the nodule or, if it is more than one, of the nodules raise suspicion, a piece is taken with a needle and examined in the laboratory. The piece taken will most likely make the diagnosis. The most important point to be considered here is that the needle biopsy of the thyroid gland should be performed under ultrasound guidance, not blindly. Otherwise, biopsy can be taken from the wrong area and may cause unnecessary biopsy repetitions.

I have thyroid cancer; how will I be treated?

The treatment of thyroid cancer is surgery. In the treatment, the thyroid gland is removed as a whole, if any, the lymph nodes in the midline of the neck and on the side are also cleaned. Instead of thyroid hormone secreted by the removed thyroid gland, the patient is given a lifelong oral thyroid hormone. In some special patient groups, only radioactive burning treatment can be applied instead of surgery.

Will my voice be muted after surgery? What other complications are there?

Like any surgery, thyroid surgery also has complications. The vocal nerves pass just below the thyroid gland and a 2-3% probability of postoperative hoarseness may be experienced. To prevent this, a device can be used to locate the vocal nerves during surgery and the risk is reduced. Bleeding is another complication that can be seen. There may be low calcium in the blood and contractions in the hands due to the removal of the parathyroid gland in the surgery or the deterioration of its nutrition. But all these risks can be reduced with careful surgery and experience.

Thyroid Cancer yazısı ilk önce Assoc. Professor Soykan Barlas üzerinde ortaya çıktı.

I am woman, then am I at risk?

As we mentioned before, breast cancer is seen at a much higher rate in women. Apart from this, the presence of breast cancer in the family, especially on the mother’s side, is one of the most important factors that increase the risk. So if your mother, aunt or sister has breast cancer, the risk that you are in is increased. Although it is frequently detected over the age of 50, it can be seen even in the 20s. It is a tumor that is affected by the hormonal status. For this reason, the incidence increases in women who have started menstruating at an early age, have never given birth, have given birth but have not breastfeed their children or who have received external hormone therapy. Smoking is another risk factor. Finally, women who have cancer in one breast also have a higher probability of developing cancer in the other breast.

But how do I know if I have breast cancer?

You know your breast best. For this reason, starting from the age of 20, self-examination once a month after bathing is perhaps the most important screening method for early diagnosis. In front of the mirror, first examine your breast by putting one arm behind your head and pressing it gently with your other hand. Then do the same for your other breast. After a while, you will notice even the smallest change in your breast. Other screening methods are mammography and breast ultrasound. Mammography, which will be taken every 2 years after the age of 40 and once a year after the age of 50, gives us valuable information by making a comparison with the old images. Under the age of 40, breast tissue is not very suitable for mammography and ultrasonography is usually used as a screening method.

In recent years, gene mutations and gene tests have come to the fore in breast cancer, as in many types of cancer. Breast cancer coexists with gene mutations such as in BRCA-1 and BRCA-2 genes. If you have a family history of breast cancer, it is very valuable to have these gene tests done. In this way, you will learn how many percent of breast cancer can be seen in you and thus take early measures.

What signs in breast that I should suspect cancer?

You should consult a general surgery specialist without delay in any difference that you may detect during your routine examination. A firm mass that you have just detected in the breast, shrinkage in the nipple, color change or orange peel appearance in the breast, and bloody discharge from the nipple are findings that suggest breast cancer.  Remember that every mass you detect in the breast or any bloody discharge from the nipple does not mean cancer. Suspicious diagnosis must be confirmed by taking biopsies. However, the cost of being late is heavy, so if you have complaints that were mentioned above, please contact your doctor immediately.

How is breast cancer treated?

In fact, the biggest changes in the last period have been experienced in treatment modalities. While much more aggressive treatment modalities were performed on breast cancer 10-15 years ago, much more moderate treatment methods were started to be performed now.In advanced stage cancers, depending on the metastasis of the cancer to the axillary lymph nodes, it may be necessary to remove both the breast and axillary lymph tissue (Modified radical mastectomy; mastectomy + axillary curettage). In breast cancers diagnosed at an early stage, the treatment is to remove only the tumor part of the breast and to examine the sentinel lymph node that shows whether the tumor has passed to the lymph nodes under the armpit (quadrantectomy + sentinel lymph node biopsy).It is decided at the end of this examination whether the underarm glands will be removed.

Other supportive treatment methods in breast cancer are chemotherapy to be applied before or after surgery, post-surgery radiotherapy and hormone therapy. I recommend that you decide on the most appropriate treatment method for you together with your surgeon and oncologist.

Breast Cancer yazısı ilk önce Assoc. Professor Soykan Barlas üzerinde ortaya çıktı.