Pancreatic cancer is one of the less studied yet fatal causes of death in modern society. In essence, most of these causes are exocrine tumors (McCance & Huether, 2014). These tumors do not have the ability to secrete hormones. Consequently, they do not cause signs and symptoms. Therefore, they are difficult to diagnose. Pancreatic neuroendocrine tumors are less common in nature as compared to others. Nevertheless, they have the potential to create a better prognosis. The tumors interfere with normal functioning of the pancreas. The following paper explores different aspect of pancreatic cancer.
Pathophysiology and Epidemiology of Cancer
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Statistics indicate that an estimated number of 200,000 people die every year from pancreatic cancer (Jemal et al., 2009). However, the highest incidents and mortality rates that arise from pancreatic cancer emanate from developed nations. In the United States, specifically, pancreatic cancer has been rated as the 4th cause of death related to cancer, while in Europe, it is the 6th. The highest rate of pancreatic cancer mortality is massive among blacks as compared to the white population of the USA. The burden of pancreatic cancer is likely to increase over time because of the lifestyle of people. Research indicates that the pathogenesis of pancreatic cancer is complex (Dragovich, 2016). In essence, multiple subsets of genes undergo genetic changes through activation or inactivation that facilitates the progress of pancreatic cancer. For instance, the activation of oncogenes and the inactivation of tumor suppressors have the ability to start and cause the progress of the disease. Cell signaling pathways that include EGFR, Akt, AND nf undergo deregulation, hence enhancing the pathogenesis of cancer. The activation of oncogenes occurs through the process of mutation and amplification. Specifically, the ras gene accounts for an estimate 90% of pancreatic cancer. It is the point mutation that generates the active form of ras. Ras binds to GTP and offers uncontrolled signals that promote uncontrolled cellular growth.
Genetic and Environmental Factors
Genetic and environmental factors predispose an individual to pancreatic cancer. In essence, the DNA of cells is crucial in controlling the cellular activities. They contain the oncogenes and tumor suppressor genes. The oncogene is the gene that helps the cell in growth, division, and its longevity. The tumor suppressor genes help in cell division and the repair of mistakes of the DNA (McCance & Huether, 2014). There are gene mutations that that affect the oncogenes and the tumor suppressor. There are inherited gene mutations from parents that increase the risk of pancreatic cancer, but there are also acquired gene mutations. These emanate from the exposure to cancer causing chemicals. However, some of the DNA gene mutations are sporadic. In other words, they are non-inherited. For instance, the mutations that occur in genes p16, TP53, KRAS, BRAF, and DPC4 are not inherited (Poruk, Firpo, Adler, & Mulvihill, 2013). Age and gender are also risk factors. For examples, men are at a higher risk of developing pancreatic cancer as compared to women. Moreover, the risk of getting pancreatic cancer increases with age. Patients older than 45 year of age have the tendency to develop the condition. In fact, about two-thirds of the patients are above 65 years old. Furthermore, there are other environmental factors such as tobacco use (Jemal et al., 2009). Thuse, the risk of developing pancreatic factors is twice as high among smokers in comparison to non-smokers. Research indicates that between 20%-30% of pancreatic cancer are caused by tobacco smoking (Kim & Ahuja, 2015). Being obese is another risk factor. In fact, an estimated 20% of obese people have the likelihood of developing pancreatic cancer (Kim & Ahuja, 2015). The workplace exposure to certain chemicals also predisposes one to developing pancreatic cancer.
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Mechanisms of Prevention, Early Detection, and Early Intervention in the Target Population
Pancreatic cancer is quite difficult to detect, especially in its initial stages. However, there are laboratory tests that can point out to the disease. These are the CBC count, hepatobiliary test, serum amylase, and tumor markers (Kim & Ahuja, 2015). There are also imaging studies that aid in the early detection of pancreatic cancer. Moreover, the early detection of pancreatic cancer gives room for interventions, but there are also early prevention methods for pancreatic cancer. First, individuals must lead a healthy lifestyle. For instance, the target population should avoid the use of tobacco and alcohol. Secondly, they should keep a healthy weight, while obese individuals should be physically active and take part in physical exercise. Those who work at factories should also avoid being exposed to chemicals.
Clinical Manifestations and Treatment Options
The clinical manifestation of pancreatic cancer varies from one individual to another. However, there are primary signs of clinical manifestations. First, a significant weight loss might be the first sign of cancer while midegastric pain is another common sign, but in some cases, the pain radiates to the lower back region (Poruk et al., 2013). Those who have suffered from diabetes in the previous year also experience its recurrence. The other clinical manifestation is the painless obstructive jaundice, whereas some patients experience pruritus and depression. In some cases, advanced intra-abdominal disease might develop in the patients suffering from pancreatic cancer. Surgery remains the primary way for the management of pancreatic cancer (Dragovich, 2016). More to say, three surgical options are available for the patients suffering from pancreatic cancer. These are distal pancreatectomy, total pancreactomy, and the whipple procedure. However, chemotherapy and radiotherapy are inevitable.
The discussion points out to the different aspects of pancreatic cancer that remains the 4th leading causes of deaths in the USA. The role of oncogenes and tumor suppressor genes in the pathogenesis of the disease is evident. Nevertheless, early detection is key for its intervention. Various clinical manifestations allow diagnosing pancreatic cancer. However, surgery remains the primary mode of management of this disease.