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Metastases in the pancreas
Last reviewed: 23.04.2024
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The pancreas (pancreas) is the most important organ of the human digestive system. Enzymes produced by this gland help to assimilate the fats and carbohydrates of the food you eat and help to reduce the acidity of the gastric juice. In addition, the pancreas produces hormones such as insulin and glucagon, thanks to which the normal level of sugar in the blood is maintained.
In the prevalence among adult cancers, the pancreatic cancer is in sixth place and can give metastases to other organs.
[Symptoms of metastases in the pancreas
It should be noted that metastases in the pancreas for cancer of other organs - a phenomenon quite rare. It is believed that most often the pancreas is affected by metastases in stomach cancer. With sarcoma, melanoma, hepatoma, chorionepithelioma (cancer of female genital organs), lung cancer, ovaries, mammary glands and prostate gland - metastasis to the pancreas is much less common.
And according to the latest studies, the greatest number of cases of metastatic lesion of this gland is associated with renal cell carcinoma (kidney adenocarcinoma) occurring in patients.
Often as a metastasis, doctors diagnose a primary pancreatic tumor, and also take for tumor metastases in the pancreas a tumor tissue that grows into it from the nearby organs (the same stomach) or the affected lymph nodes (for example, retroperitoneal).
The first signs of the presence of metastases in the pancreas are back pain in the stomach, reduction and loss of appetite, a significant decrease in body weight, as well as general weakness and anemia.
With oncological kidney disease, even in the case of resection or complete removal of the affected organ, solitary (single) metastases to the pancreas can be observed. In this case, this pathological process in the patient's body is not immediately apparent, but after a rather long time from the moment of surgical intervention.
Where does it hurt?
Metastasis in pancreatic cancer
Metastases in pancreatic cancer (pancreatic carcinoma, polymorphic cell sarcoma, reticulosarcoma, adenocarcinoma, psammocarcinoma, basal cell and anaplastic cancer) are detected much less frequently than with oncology of other organs. But if they arise, it is already in the early stages of the disease.
In the first place, metastases appear in the lymph nodes adjacent to the organ in the abdominal cavity (paraaortic, mesenteric and iliac), as well as in retroperitoneal lymph nodes. These are lymphogenous metastases, which account for 75% of metastases in pancreatic cancer.
Hematogenous metastasis - when cells from the focus of a tumor are carried around the body with a blood stream - the liver, lungs, kidneys and even bones are exposed. Sometimes secondary neoplasms connect with the main focus, and such large enough tumors are well palpated. Often, doctors diagnose these metastases in pancreatic cancer as stomach cancer, because its symptoms are similar to those of pancreatic cancer, the clinical picture of which is unclear.
However, oncologists note that only with pancreatic cancer - because of the rapid decline in appetite and increased disintegration of proteins and fats in the body - a patient can lose in a month from 12 to 18 kg of his weight. The first signs of the disease also include causeless jaundice and diarrhea. In this case, pain can be felt throughout the epigastric region, but the most typical localization is in the epigastric region or in the left hypochondrium (with recoil into the lumbar region).
Diagnosis of metastases in the pancreas
Doctors do not hide the fact that the diagnosis of metastases in the pancreas, as well as of all malignant tumors in this organ, is quite complicated. To identify the disease resort to various methods of examination.
On the basis of a blood test, deviations in the content of bilirubin and other components can be detected. With the help of a fine needle aspiration biopsy, a piece of tissue is taken, the study of which allows the histologist to put the correct diagnosis.
In the diagnosis of metastases in the pancreas, magnetic resonance imaging (MRI) of the abdominal cavity, computed tomography (CT), endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasound are widely used.
The most common method for diagnosing pancreatic diseases (as well as the gall bladder, bile duct and liver) is ultrasound tomography (UZT).
Ultrasound and computerized X-ray tomography of the pancreas can detect a tumor with a size of 2-3 cm. And with the help of ERCP, oncologists determine the extent of the spread of the lesions of the biliary and pancreatic ducts, which, with a given tumor location, are enlarged, and the gall bladder itself is enlarged.
What do need to examine?
How to examine?
Treatment of metastases in the pancreas
When choosing the most effective treatment for metastases in the pancreas, specialists take into account a number of factors: the type of primary cancer, the age of the individual patient, its general condition, the site of localization and the size of metastases, as well as the technique of primary cancer therapy in the patient.
Among the methods of treatment of metastases in the pancreas, the most common are: surgical intervention, radiotherapy (complex with surgical intervention), chemotherapy, radiotherapy (radiotherapy).
The most modern method for controlling metastases is radiosurgery of a stereotaxic type, which is performed with the help of a cyberknife. Such bloodless and painless for patients operations are performed without a single incision and anesthesia.
It should be noted that the usual surgery for the treatment of metastases in the pancreas for oncological disease of the gland itself is usually not carried out.
Chemotherapy in the treatment of metastases in the pancreas is performed with the aim of regressing the tumor after surgery. This treatment takes several months, but it helps to restrain the growth of cancer cells and prevents their further spread. With this method of treatment, such drugs as gemcitabine, irinotecan, fluorouracil, doxorubicin, etc. Are used. Chemotherapy alleviates the condition of patients and allows them to prolong their life.
Radiation therapy is not used as an independent method for the treatment of metastases in the pancreas, because of the severe complications that accompany the destruction of the tumor site. However, this method is recognized by oncologists as effective in the treatment of pancreatic cancer, since cells of this type of tumor are very sensitive to radio emission. With a similar diagnosis, radiation therapy is used before surgery, and after it (intraoperative). Radiation therapy helps to reduce the size of malignant neoplasm in 60-70% of patients, but with extensive metastases it is a palliative method of treatment.
Palliative treatment of metastases in the pancreas, like any similar treatment for cancer patients, doctors appoint in cases where the chances of recovering from practical are zero. This type of treatment is aimed at improving the comfort of life and consists of taking strong pain medications, antidepressants and other medicines.
Prognosis for metastases in the pancreas
The prognosis for metastases in the pancreas, as in adenocarcinoma of the pancreas itself, is considered unfavorable. For operable tumors, the lethal outcome of the operation is 10-15%, and the five-year survival after surgery is 5-10%. However, operated patients continue to live and live three times longer than those who have not undergone operative intervention.