Is the gallbladder part of the endocrine system. Pancreatic Cancer: Understanding the Pancreas, Its Functions, and Cancer Development

07.08.202327.06.2023 by alexxlab

What is the pancreas and how does it function. How does pancreatic cancer develop and who is at risk. What are the different types of pancreatic cancer and their symptoms. How common is pancreatic cancer and what are the risk factors.

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The Pancreas: Anatomy and Function

The pancreas is a vital organ that plays crucial roles in both the digestive and endocrine systems. Located in the upper abdomen, this leaf-shaped gland measures approximately 15 centimeters (6 inches) in length. It is positioned behind the stomach, in close proximity to the liver, gallbladder, and small intestine.

Pancreatic Structure

The pancreas consists of three distinct parts:

Head: The wide end of the pancreas
Body: The middle section
Tail: The thin end of the pancreas

This unique structure allows the pancreas to perform its diverse functions efficiently.

Dual Functions of the Pancreas

The pancreas serves two primary functions within the body:

Exocrine function: Production of digestive enzymes
Endocrine function: Secretion of hormones, including insulin

Understanding these functions is crucial for comprehending the development and impact of pancreatic cancer.

The Exocrine Pancreas: Digestive Juice Production

The exocrine pancreas is responsible for producing digestive juices that play a vital role in breaking down food. These juices contain enzymes that aid in the digestion of proteins, carbohydrates, and fats.

How do pancreatic digestive juices reach the small intestine? The pancreatic duct, a tube-like structure, carries these juices from the pancreas to the duodenum (the first part of the small intestine). Here, they mix with partially digested food, facilitating further breakdown and absorption of nutrients.

The Endocrine Pancreas: Hormone Production

The endocrine pancreas consists of specialized cells that produce and release hormones directly into the bloodstream. The most well-known of these hormones is insulin, which plays a crucial role in regulating blood sugar levels.

How does insulin regulate blood sugar? When blood glucose levels rise, the pancreas releases more insulin. This hormone helps cells absorb glucose from the bloodstream, effectively lowering blood sugar levels. Conversely, when blood sugar levels are low, the pancreas reduces insulin production.

A deficiency in insulin production or the body’s inability to use insulin effectively can lead to diabetes, a chronic condition affecting millions worldwide.

Pancreatic Cancer: Types and Development

Pancreatic cancer occurs when abnormal cells in the pancreas begin to divide and grow uncontrollably, forming a tumor. This malignant growth can invade surrounding tissues and potentially spread to other parts of the body.

Types of Pancreatic Cancer

There are two main types of pancreatic cancer, classified based on the cells from which they originate:

Exocrine pancreatic cancer: Arising from cells that produce digestive enzymes, this is the most common type of pancreatic cancer.
Endocrine pancreatic cancer (Pancreatic neuroendocrine tumors): Developing from hormone-producing cells, these tumors are less common but can have distinct symptoms and treatment approaches.

Why is it important to distinguish between these types? The origin of the cancer affects its behavior, symptoms, and treatment options. Accurate diagnosis is crucial for developing an effective treatment plan.

Symptoms and Diagnosis of Pancreatic Cancer

Pancreatic cancer often develops without noticeable symptoms in its early stages, making early detection challenging. As the disease progresses, various symptoms may emerge.

Common Symptoms

Jaundice (yellowing of the skin and eyes)
Abdominal or back pain
Unexplained weight loss
Loss of appetite
Changes in bowel habits
New-onset diabetes

How are these symptoms related to pancreatic function? Many of these symptoms result from the tumor interfering with normal pancreatic functions or obstructing nearby structures. For instance, a tumor in the pancreatic head may block the bile duct, leading to jaundice.

Diagnostic Approaches

Diagnosing pancreatic cancer often involves a combination of techniques:

Imaging studies (CT scans, MRI, PET scans)
Blood tests
Endoscopic ultrasound
Biopsy

Why is early diagnosis crucial? Early detection of pancreatic cancer significantly improves treatment outcomes and survival rates. However, the deep location of the pancreas and the often vague nature of early symptoms make early diagnosis challenging.

Epidemiology of Pancreatic Cancer

Understanding the prevalence and risk factors of pancreatic cancer is essential for both medical professionals and the general public.

Incidence and Prevalence

In the United Kingdom, pancreatic cancer ranks as the 10th most common cancer, with approximately 10,500 new cases diagnosed annually. This statistic underscores the significant impact of this disease on public health.

How does age affect pancreatic cancer risk? Pancreatic cancer predominantly affects older individuals, with more than 45% of diagnoses occurring in people aged 75 and over. It is relatively uncommon in individuals under 40 years old.

Demographic Factors

Several demographic factors influence the incidence of pancreatic cancer:

Age: Risk increases with advancing age
Socioeconomic status: In England, higher incidence rates are observed in more deprived areas
Ethnicity: The disease is more common in White populations

Why do these demographic factors matter? Understanding these patterns helps in targeting screening efforts and allocating healthcare resources more effectively.

Risk Factors for Pancreatic Cancer

While the exact causes of pancreatic cancer remain unclear, several risk factors have been identified through extensive research.

Modifiable Risk Factors

Smoking: A significant risk factor, responsible for about 20-30% of pancreatic cancer cases
Obesity: Excess body weight increases pancreatic cancer risk
Diet: High consumption of red and processed meats may elevate risk
Alcohol consumption: Heavy alcohol use is associated with increased risk
Chronic pancreatitis: Long-term inflammation of the pancreas raises cancer risk

Non-Modifiable Risk Factors

Age: Risk increases with advancing age
Genetic factors: Certain inherited gene mutations increase susceptibility
Family history: Having close relatives with pancreatic cancer elevates risk
Diabetes: Long-standing diabetes may increase pancreatic cancer risk

How can understanding these risk factors help in prevention? While some risk factors cannot be changed, awareness of modifiable risks can guide lifestyle choices that may reduce pancreatic cancer risk.

Treatment Approaches for Pancreatic Cancer

Treatment for pancreatic cancer depends on various factors, including the cancer’s stage, location, and the patient’s overall health. A multidisciplinary approach is often employed to provide comprehensive care.

Surgical Options

Surgery remains the primary curative treatment for pancreatic cancer, but it is only possible in about 20% of cases due to late-stage diagnosis. Common surgical procedures include:

Whipple procedure (pancreaticoduodenectomy)
Distal pancreatectomy
Total pancreatectomy

Why is surgery not always an option? Many pancreatic cancers are diagnosed at an advanced stage when the tumor has already spread beyond the pancreas, making surgical removal unfeasible.

Non-Surgical Treatments

For patients who are not candidates for surgery or as adjuvant therapies, other treatment options include:

Chemotherapy: Using drugs to kill cancer cells or stop their growth
Radiation therapy: Using high-energy beams to destroy cancer cells
Targeted therapy: Drugs that target specific abnormalities in cancer cells
Immunotherapy: Stimulating the body’s immune system to fight cancer cells

How do these treatments work together? Often, a combination of these approaches is used to maximize treatment effectiveness and improve patient outcomes.

Living with Pancreatic Cancer: Support and Quality of Life

A diagnosis of pancreatic cancer can have profound physical, emotional, and psychological impacts on patients and their families. Comprehensive care extends beyond just treating the disease itself.

Supportive Care

Supportive care is crucial in managing symptoms and improving quality of life. This may include:

Pain management
Nutritional support
Psychological counseling
Palliative care

How does supportive care enhance treatment outcomes? By addressing symptoms and side effects, supportive care can improve patients’ ability to tolerate treatment and maintain a better quality of life.

Clinical Trials and Research

Ongoing research and clinical trials offer hope for improved treatments and outcomes. Patients may have the opportunity to participate in trials testing new therapies or treatment combinations.

Why are clinical trials important for pancreatic cancer? Given the challenging nature of pancreatic cancer treatment, clinical trials can provide access to cutting-edge therapies and contribute to the advancement of medical knowledge.

In conclusion, understanding the pancreas, its functions, and the complexities of pancreatic cancer is crucial for both medical professionals and the general public. While pancreatic cancer remains a formidable challenge, ongoing research, improved diagnostic techniques, and innovative treatment approaches offer hope for better outcomes in the future. Awareness of risk factors and symptoms, combined with regular health check-ups, can contribute to earlier detection and potentially more successful treatment of this serious disease.

What is pancreatic cancer? | Cancer Research UK

The pancreas is a gland that produces digestive juices and hormones. Pancreatic cancer is when abnormal cells in the pancreas start to divide and grow in an uncontrolled way and forms a growth (tumour).

The cancer cells can grow into surrounding blood vessels or organs such as the small bowel (duodenum). And may spread to other areas of the body.

The pancreas

The pancreas is part of the digestive system.

The pancreas is quite high up in your abdomen. It lies across your body where your ribs meet at the bottom of your breastbone, just behind your stomach. It is about 6 inches (15 centimetres) long and shaped like a leaf.

The pancreas has 3 parts:

the wide end is called the head
the thin end is called the tail
the bit in the middle is called the body

The pancreas is a large gland that makes digestive juices and hormones, including insulin. The digestive juices flow down a tube (pancreatic duct) into the duodenum. The duodenum is the first part of the small bowel and is joined to the stomach.

Another tube (duct) joins the duodenum. The bile duct comes down from the gallbladder and liver and joins the duodenum right next to the pancreatic duct. The place where the two ducts join and meet the bowel is called the ampulla of Vater.

Watch this 2 minute video to explain what the pancreas is.

Transcript

The pancreas is a leaf shaped organ tucked under the liver, close to the gallbladder, stomach and bowel.

It is part of both the digestive and endocrine systems.

The pancreas lies across your body just behind your stomach. It is about 15 centimetres long.

The pancreas has three parts.

The wide end is called the head.

The middle is called the body.

The thin end is called the tail.

The pancreas is a large gland. It makes hormones which regulate the level of sugar in your blood. One of these hormones is Insulin. This is the endocrine function of the pancreas.

The pancreas also makes digestive juices

The juices flow down a tube called the pancreatic duct into the first part of the small bowel.

The bile duct joins the small bowel right next to the pancreatic duct.

The place where the 2 ducts join and meet the bowel is called the ampulla of Vater.

Digestive juices contain enzymes that help you to break down food in the bowel.

This is called the exocrine function of the pancreas.

Cancer that starts in the cells that make digestive juices is called exocrine pancreatic cancer. This is the most common type of pancreatic cancer.

Cancers that start in the cells that make insulin and other hormones, are called endocrine pancreatic cancers or Pancreatic neuroendocrine tumours.

Close to the pancreas there are lymph nodes that are part of our immune system and help us fight infections.

Lymph nodes are often the first place cancer cells reach when they break away from a tumour.

For information about pancreatic cancer go to cruk.org/cancer-types

What does the pancreas do?

The pancreas produces digestive juices and insulin, as well as other hormones to do with digestion.

The part which produces the digestive juices is called the exocrine pancreas. The part which produces hormones, including insulin, is called the endocrine pancreas.

Cancers that develop from these two parts can behave differently and cause different symptoms.

What does the digestive system do?

The digestive system breaks up and digests food. After about 2 hours in the stomach, the partly digested food moves into the beginning of the duodenum.

When the food reaches the duodenum, the pancreas releases its digestive juices which flow down the pancreatic duct and mix with the food.

The juices contain enzymes that help to break down the food into very small fragments. These fragments are absorbed into the body through the small bowel.

The pancreas and insulin

The pancreas makes insulin. Specialised cells within the pancreas releases insulin directly into the bloodstream.

Insulin keeps the level of sugar (glucose) in the blood at a stable level. This means that the body cells get enough sugar, but not too much. The pancreas makes and releases more insulin if the level of sugar in the blood is high. If the level is too low, it releases less.

You have a condition called diabetes if you don’t make enough insulin.

How common is pancreatic cancer?

Around 10,500 people are diagnosed with pancreatic cancer in the UK each year. It is the 10th most common cancer in the UK.

Who gets pancreatic cancer?

Pancreatic cancer is more common in older people. More than 45 out of 100 people diagnosed (more than 45%) are aged 75 and over. Pancreatic cancer is uncommon in people under 40 years old.

In England, pancreatic cancer is more common in people living in more deprived areas. It is more common in White and Black people than in Asian people and in people of mixed or multiple ethnicity.

Cancer Incidence from Cancer Intelligence Statistical Information Team at Cancer Research UK (2016-2018 UK average)
Accessed November 2022
Cancer of the Pancreas: European Society Medical Oncology Clinical Practice Guidelines
M Ducreux and others
Annals of Oncology, 2015, last updated March 2019. Volume 26, Supplement 5, v56 to v68
The Human Body Book
R Walker and S Parker
DK Publishing, March 2019
Ross and Wilson Anatomy and Physiology in Health and Illness (13th Edition)
A Waugh and A Grant
Elsevier, 2018
Anatomy and Physiology. The unity of form and function (2nd Edition)
K S Saladin
McGraw Hill, 2001

Last reviewed:

05 Dec 2022

Next review due:

05 Dec 2025

Abstract

The endocrine system comprises glands and tissues that produce hormones for regulating and coordinating vital bodily functions. Â This article â the sixth in an eight-part series about the endocrine system â outlines the endocrine function of the gastrointestinal tract and the role that endocrine glands and tissues play in regulating digestion, as well as describing their wider physiological functions.

Authors: James Taylor is a lecturer in anatomy and physiology; John Knight is associate professor in biomedical science; both at the College of Human and Health Sciences, Swansea University.

This article has been double-blind peer reviewed

Scroll down to read the article or download a print-friendly PDF here (if the PDF fails to fully download please try again using a different browser)

Click here to see other articles in this series

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