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The Undoubted Causes of Pancreatic Cancer
The causes of pancreatic cancer will help uncover ways to prevent the disease, in which the incidence slightly exceeds the mortality rate. This is a male tumor, women suffer three times less often and at a much more solid age. Diagnosis in Europe is better, and therefore the incidence is higher.
To date, no single root causes of the disease have been identified, but some pathological conditions significantly increase the risk of pancreatic malignant disease.
Tobacco smoking doubles the risk of a malignant tumor of the gland; in every fourth person who smokes, tobacco becomes the main cause of the disease. The probability of pancreatic cancer is directly dependent on the duration of the bad habit and the volume of daily cigarette servings.
The second proven cause of morbidity is type 2 diabetes, not congenital, but acquired. In a diabetic, the risk of a malignant tumor is increased by 60% and after the 50th anniversary of every 100th diabetic, pancreatic cancer is diagnosed.
The third reason is chronic pancreatitis of any etiology, it increases the probability of tumor pathology by 20 times. Inflammation leads to intraepithelial neoplasia, and for most patients this is a direct route to cancer. With neoplasia, the cells divide too quickly, losing the ability to recover if damaged, the slender architectonics of the glandular tissue is lost. The same proliferative processes in the aggravated form occur in a malignant neoplasm.
Heredity as a Cancer Cause
Every 50th patient with chronic pancreatitis has a hereditary form of inflammation of the gland, with it the probability of a malignant regeneration of the pancreas increases by 50 times, and the disease is diagnosed in four out of ten people suffering from pancreatitis. If with this genetic background, and even smoke, then a malignant neoplasm will appear at a younger age. And the gene that is unable to stop the synthesis of the enzyme trypsin, produced in excess and causing the digestion of pancreatic cells, which leads to the formation of neoplasia, is to blame.
Every 20th patient with pancreatic cancer has a hereditary tumor. With a parent suffering from cancer, the probability of his descendant becoming ill is doubled when both parents are sick — six times, if three first-line relatives are sick — 30 times. But what genes regulate family transmission, while not exactly determined.
In the US, the incidence of pancreatic oncopathology in African Americans is half that of whites, which may be due to genes.
Suspicious but Not Proven Risk Factors
Animal protein rich and poor in plant components nutrition has long been suspected as the cause of pathology, but in clinical studies have not produced conclusive evidence. It is believed that the effect of meat is exacerbated by coffee, but no scientific basis was found for this hypothesis.
Nevertheless, among those who came from regions with a low incidence of immigrants who live long enough in a country with a high incidence, the possibility of becoming ill is compared with the local population. And the reason — the inevitable change in diet.
It is assumed that pathology is associated with obesity, but for the time being this is also an unconvincing hypothesis.
Infectious diseases also contributed to the causes of pancreatic neoplasms, by analogy with the fundamental role of the hepatitis virus in the initiation of liver cancer. But for the development of a pancreatic tumor, the role of Helicobacter pylori infection has not yet been proven.
There is an assumption that for the pancreas the removal of the stomach or gallbladder does not pass without a trace.
Diagnosis of pancreatic cancer should confirm or reject the malignant nature of the disease, find out its prevalence and exact localization in the gland. If there is an unconditionally operable tumor, verification — morphological confirmation of cancer can be performed during surgery.
What Pancreatic Cancer Diagnostics is Necessary?
The pancreas is available for examination by ultrasound, there are not very well visible tumors in the tail, because they are blocked by other hollow organs of the gastrointestinal tract. The large fatty tissue of the abdominal wall and cavity, which is typical for men, and intestinal gas formation prevent the examination. Ultrasound diagnostics reveals neoplasm over a centimeter.
A neoplasm smaller than a centimeter reveals a combined diagnostic method, endoscopic ultrasound, when an inside optics scan and an ultrasound scan are performed simultaneously. Moreover, the gland can be examined both from the stomach with the duodenum, from the biliary or pancreatic duct and the abdominal cavity during laparoscopy. Endosonography allows to take material for microscopy from suspicious formation with a thin needle.
Good prospects for the diagnosis of pancreatic pathology with MRI with contrast and X-ray CT (CT), and spiral CT with angiography will clearly reveal the relationship of cancer with nearby large vessels.
When is Diagnostics with Biopsy Necessary?
A biopsy allows taking a piece of tumor tissue for examination to eliminate all doubts about the nature of the tumor. If an operation is planned, then the preoperative biopsy can be waived and the material for microscopy can be taken already during the intervention. When a tumor is not removed for chemotherapy or radiation, it is necessary to accurately diagnose the malignant process, so a biopsy is required.
In addition, in 5% of cases a malignant tumor in the pancreas has a structure other than cancer and requires a different treatment. Unfortunately, none of the diagnostic methods can give an exact answer «what is it», except for research under a microscope. Biopsy of the pancreas is performed under the control of ultrasound or CT and does not pose a danger to the patient.