The pancreas is an important part of the body which helps in the process of digestion. It also produces insulin which is essential for maintaining the balance of glucose in the body. Carcinoma of the pancreas is the 4th cause for death in the USA and UK, and other countries. Alcohol is the most common risk factor for pancreatic cancer. It is known to cause chronic inflammation of the pancreas and cancer occurs as a sequel. Similarly cigarette smoking is also an identified risk factor for cancer of the pancreas. Studies have shown a higher prevalence of pancreatic cancer in those who are obese. Higher incidence is also seen in people who eat smoked or processed meat. Diabetes is also said to be a risk factor for carcinoma of the pancreas. Though it is controversial whether it is a causative factor or result of pancreatic cancer. About 10% cases are postulated to be genetic in origin. A person having pancreatic cancer can have other family members affected by it. But this is not a clearly established risk factor. More men as compared to women are affected by pancreatic cancer. The prevalence rises with increasing age. Cancer of the pancreas like any other cancer is silent in the early stages. It is often detected when it is advanced and beyond cure. Usually there is pain in the upper part of the abdomen, which is often excruciating and tends to spread to the back. One gets relief by bending forwards. Pain is often associated with nausea and loss of appetite. Chronic loss of appetite affects the nutritional status of the person leading to marked asthenia. Patients mostly develop diabetes due to the pancreatic dysfunction, which causes further suffering and complications. The tumor can spread to involve the liver and bile duct. If this happens he can develop jaundice, nausea and vomiting, thus further compounding the sickness. The stomach may be involved causing further pain and vomiting. It can also spread via the blood or lymphatics to distant organs like brain or back bone. The diagnosis is suspected clinically. Blood tests like serum amylase support the diagnosis. It is confirmed by imaging techniques like ultrasound, CT scan and MRI (magnetic resonance imaging). A biopsy done helps to know the stage, i.e. the extent of the cancer which helps in deciding the management. Once diagnosed, it is usually too late to do any active treatment. If possible selective surgery is done to remove the tumor. But in most of the cases the patient is given chemotherapy. This kills the cancer cells but also kills the normal cells of the body, damaging tissues. Along with it, the chemotherapeutic drugs also cause acute gout, loss of hair and baldness and other adverse effects which become distressful. In some cases chemotherapy is combined with radiotherapy where cancer cells are killed by radiation. But radiation tends to burn the normal tissues as well. It damages the bones and surrounding structures. Ultimately in spite of all treatment, the patient suffers much and dies a slow painful death. It is wise to prevent pancreatic cancer, rather than suffering from it. It is very important to take a balanced diet to prevent pancreatic and even any cancers. The diet should include fresh vegetables, fruits, whole grains, cereals and healthy meat like fish. Preferably freshly prepared meals should be taken. Fast foods and ready to eat instant foods should be avoided. Alcohol and smoking should be avoided. Regular physical exercise keeps the body physically fit and prevents obesity, thus reducing the risk of pancreatic cancer. After following these preventive measures, one has a very low probability of pancreatic cancer. Dr. Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital
