Pancreatic Cancer from Detection to Treatment

What is Pancreatic Cancer?

Pancreatic cancer starts in the pancreas - an organ behind the stomach that helps with digestion and blood sugar control.

It is often diagnosed late because symptoms usually appear after the disease has advanced.

1. Initial Detection / Screening
Unlike breast, prostate, or colorectal cancer, there is no standard population-wide screening for pancreatic cancer.

Symptoms
Jaundice
Abdominal or back pain
Weight loss, loss of appetite
New-onset diabetes
Nausea, vomiting, fatigue

Initial tests
Blood tests
Tumor marker CA 19-9

2. Diagnostic Testing

Imaging
CT scan
MRI/MRCP
Endoscopic ultrasound

Biopsy
• EUS-guided fine-needle aspiration
• Endoscopic retrograde cholangiopancreatography

Pathology
Confirms diagnosis
Cancer type

3. Staging

Staging scans
CT chest/abdomen/pelvis
PET-CT in select cases
Laparoscopy

Staging categories
Resectable
Borderline resectable
Locally advanced | unresectable
Metastatic

4. Treatment Options

➛ Surgery

Whipple procedure
for tumors in pancreatic head.

Distal pancreatectomy
for tumors in body/tail.

Total pancreatectomy
entire pancreas removed | rare.

➛ Radiation Therapy

Sometimes combined with chemotherapy for borderline or locally advanced tumors.

➛ Chemotherapy

Regimens
FOLFIRINOX
Gemcitabine ± nab-paclitaxel

➛ Targeted Therapy & Immunotherapy

PARP inhibitors
Checkpoint inhibitors
Clinical trials

5. Palliative & Supportive Care

Biliary stents | via ERCP
to relieve jaundice.

Celiac plexus nerve block
for severe abdominal pain.

Nutritional support
Psychological support

6. Follow-Up and Survivorship

After surgery/chemo:
➛ CT scans every 3-6 months for first 2 years, then every 6-12 months.
➛ CA 19-9 blood marker to monitor recurrence.

Long-term lifestyle:
Nutrition
Diabetes management

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