Pancreatic ductal carcinoma is a fast-spreading form of cancer that occurs in the bile ducts connecting the pancreas to the liver and gallbladder. The most common type is adenocarcinoma, with symptoms including jaundice, back pain, nausea, and weight loss. Surgery is the preferred treatment, but if not possible, therapy may include stents, radiation, and pain management. Risk factors include fatty foods, tobacco, obesity, parasites, gallstones, and certain medications.
Pancreatic ductal carcinoma refers to malignant tumors in the bile ducts, a series of pathways that connect the pancreas to the liver and gallbladder. The cells lining these ducts divide more rapidly than cells within the pancreas itself, making pancreatic ductal carcinoma an aggressive form of cancer that could spread rapidly to nearby organs. When abnormal cells develop and invade the walls of the ducts, pancreatic ductal carcinoma occurs.
The most common form of cancer is called adenocarcinoma, which occurs in about 85% of all diagnosed pancreatic ductal carcinomas. The prognosis for this form of cancer depends on where the tumor is located and whether it has spread to the lymph nodes, liver, or veins and arteries of the biliary tract. If caught early, surgery to remove the tumor and resection of the duct using a stent may be done, but ductal pancreatic cancer tends to come back after treatment.
Doctors commonly assess the stage of the cancer when developing a treatment plan. Stage one refers to cancer that is localized and has not spread. Second stage ductal pancreatic cancer may be suitable for surgery as long as the tumor is not attached to major arteries or veins and enough of the liver can be preserved. Stage three cancer means that it has spread to both lobes of the liver or cannot be removed without damaging vital arteries.
Cancer of the pancreatic duct might start out as a benign tumor that gets sick. The bacterial infection could trigger tumor development and changes in the cells in the lining of the duct. Some pancreatic duct cancers have been linked to a contrast dye called thorium dioxide used in the past for medical imaging procedures. Other toxins, such as arsenic, radiation and some chemicals, could also cause cancer in the ducts.
People who eat fatty foods, use tobacco, or become obese face increased risks of pancreatic duct cancer. Some parasites found in Asia could also increase the risk of this type of cancer. It’s also linked to gallstones and ulcerative colitis. Oral contraceptives and drugs used to treat high blood pressure and tuberculosis could increase your risk. However, the researchers found that patients who had surgery to have their gallbladder removed significantly reduced their risk of duct cancer after 10 years.
Pancreatic cancer symptoms include jaundice, which becomes apparent as yellowing of the skin and eyes. Patients usually complain of back pain, which could be mild if only one pancreatic duct is infected. Nausea can lead to weight loss, and diarrhea typically occurs. The disease most commonly occurs in patients over the age of 60.
Diagnosing pancreatic ductal cancer typically involves blood tests to determine liver function. Ultrasound examination may show enlarged or blocked ducts. An abdominal scan could reveal whether the cancer has attached itself to blood vessels and whether the patient is a good candidate for surgery.
If surgery isn’t an option, therapy to manage the disease could include stents infused with radioactive chemicals to extend life. External radiation may also be used, along with procedures to drain the ducts and control pain. Chemotherapy shows little benefit in patients with inoperable cancer of the pancreatic ducts.
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