- Published June 2, 2018 November 13, 2018
- 4 minutes to read
Not so long ago, it was not possible to diagnose pancreatic cancer at the initial stages of development due to the absence of characteristic symptoms. However, modern diagnostic methods contribute to the detection of the disease at an early stage.
How the first signs and symptoms of colon cancer appear
- Maxim Dmitrievich Gusakov
- Published October 21, 2018 November 9, 2018
The CA-125 marker is found in 50% of patients with cancer. However, it can also be positive with the development of ovarian cancer.
The CA-19-9 marker is found in 10 percent of healthy people and in 70-85% of patients with pancreatic cancer. In addition, its growth is also noted in the case of malignant lesions of the stomach, liver and colon. Normally, its amount is 37 u / ml.
When exceeding more than 100 appears almost one hundred percent probability of a malignant process. If the value of the tumor marker is 1000 U / ml, then the tumor neoplasm has reached more than 5 centimeters in size.
Indicators of general and biochemical analysis of blood in the initial stages of the disease may not have significant deviations from the norm. As the tumor progresses, the concentration of platelets in the composition of the blood fluid begins to increase, as well as signs of anemia of the normochromic type.
Check the presence of an inflammatory reaction can also be on the erythrocyte sedimentation rate. As a rule, it will be quite high.
According to the biochemical analysis, the following changes are determined:
- daily level increases bilirubin as a result of squeezing the bile duct,
- AsAT rises, phosphatase, ALAT,
- marked growth C-reactive protein, amylase, elastase, lipase, ribonuclease,
- against a background of abnormal suction decreases albumen and cholesterol.
Changes in performance are most often observed when metastasis on the urinary system. If there are suspicions about the development of a malignant tumor process, blood fluid should also be examined for the presence of tumor markers.
This method for the diagnosis of pancreatic cancer is considered one of the most common and is often used to examine a patient on an outpatient basis.
It is used in the study of patients with symptoms of jaundice, as one of the signs of the cancer process. The technique makes it possible to identify neoplasms of large size and expansion of the pancreatic and bile ducts, as a possible symptom of lesion of the organ head.
The probability of obtaining a reliable negative result is 99%, and the sensitivity of this diagnostic method to the cancer process is from 45 to 95%.
Spiral computed tomography
Thanks to the use of modern spiral computed tomographs, this method is considered one of the most accurate. With it you can install:
- a place localization malignant neoplasm
- probability defeats vessels not only of those that belong to the body itself, but also nearby,
- stage the course of the disease
- dimensions tumors
- involvement lymphatic nodes in the pathological process.
Layer-by-layer computer scanning makes it possible to obtain a three-dimensional image of the affected organ. If a pancreas tumor is suspected, in most cases the study is conducted using a contrast agent.
Intravenous administration of iodine-containing substances allows you to better see the vessels and tissues of the body, as well as determine the extent of the changes with maximum accuracy.
Computer examination plays an important role in deciding on the further choice of therapeutic interventions.
How is the disease manifested
The first signs of cancer are characterized by pain, which indicates that the tumor has invaded the nerve endings. The intensity of the pain is different. This will be discomfort or acute attack. Localization of the syndrome depends on the part of the lesion of the organ, head, body or tail of the gland.
Episodic painful sensations appear between the shoulder blades, in the region of the navel and in the lower back. The strength of pain in the pancreas is capable of changing, it all depends on what position the body is in.
The patient also appears dislike for heavy dishes, increases sensitivity to alcoholic drinks, caffeine and pills.
Pathology at an early stage is accompanied by such signs:
With intestinal indications, the symptoms of pancreatic cancer are of different course. Cancer is diagnosed with clarifying signs that are associated with the abdominal area.
- Feces have a fatty deposit.
- Emptying a pale shade.
- Sharply reduced weight.
- All the time tormented by heartburn.
- Unreasonable bloating.
- Frequent diarrhea.
- Soreness in the abdomen.
Chronic fatigue and fatigue are also present in pancreatic cancer. Analyzes of the patient will help identify tumor formation and the presence of metastases.
In case of a breakdown of the discharge system, a dark color of the urine is observed. A common symptom is the appearance of pain in the area of the pancreas. At the same time, many patients are faced with weight loss, as a result of which they put a wrong prediction. The decrease in body weight has no connection with this symptom, since it occurs as a result of changes in pancreatic activity.
When a neoplasm develops in the pancreas, the patient can have changes of a nervous nature.
The nervous system is dependent on the presence of toxins and toxins in the blood. Iron pancreas takes part in the filtration of harmful elements. The emergence of education in her area leads to a violation of this work, there is a clamping of the bile ducts, the ingress of bile contents into the tissue. As a result, depression of nerve cells is recorded, which is characterized as follows:
- patient anxiety increases,
- suffering from insomnia or the patient gets tired quickly,
- the body is inhibited, the manifestation of reflexes is also slow.
Manifestations on the skin phenomenon common. It is possible to change the shade of the skin, if there is a lesion of the cervix of the pancreas or other forms of cancer.
The main manifestation on the skin is jaundice. When the work of the organ changes, bile is not normally held, which leads to intoxication of the body, jaundice of the epidermis. The skin of the patient manifests itching in any part of the body. When itching there is no rash, but it grows as pathology forms and may not stand out until the last, as a sign that accompanies cancer.
When the disease is neglected, when the pancreatic formations diverge and on adjacent organs, metastases develop, other signs are also observed.
- Liver is impaired.
- Poorly digested foods.
- In the peritoneum accumulation of fluid is observed.
When the formation covers the blood vessels, leading to their impulse, internal blood loss is recorded. This complication becomes a factor in the development of anemia. If the cancer goes to the lungs, the patient has a painful coughing attack that cannot be relieved by anti-cough, shortness of breath, blood-coughing.
Metastases of the bones lead to pain in the spine, legs and arms. At the last stage of the development of the disease, the patient completely loses his ability to work, pains are disturbing all the time, it is difficult to overcome cancer poisoning.
With the development of diabetes is fixed:
- dryness in the mouth,
- urine is excreted in large amounts
- night going to the toilet.
During childbirth, the clinical development of pancreatitis depends on the stage of changes in the pancreas. When an acute organ swelling occurs, the flow is often mild. If pancreatonecrosis is a hemorrhagic course, the situation of patients is extremely difficult. Pancreatitis in pregnant women often manifests itself in a painless form, characterized by shock and signs of damage to the central nervous system.
Diagnosis of pancreatic cancer at an early stage
To determine pancreatic cancer in stage 1, functional and laboratory techniques are used.
Ultrasound is the most convenient and common method. This is a convenient and harmless procedure that allows you to inspect even children without causing complications.
More detailed testing is carried out using other methods:
- CT scan
- MR pancreatocholangiography,
- Endo-ultrasound - ultrasound in ultrasound mode through the stomach wall,
- ERP - this study is used in rare cases due to the increased threat of complications,
- biopsy - taking puncture tissue for testing.
These methods are used to detect pancreatic cancer, the magnitude of the tumor, to identify metastases in other organs.
At the onset of cancer during the analysis of blood changes in the pancreas from the norm are not observed. With the development of education is formed the presence of:
- increased ESR.
From laboratory methods, in addition to clinical methods, there are:
In a biochemical study, pancreatic cancer is diagnosed by detecting increased alkaline phosphatase and transaminase, hypoalbuminuria and hypoproteinemia.
The procedure is accessible, informative and safe. Thanks to the ultrasound, it is possible to observe that the cancer manifests itself:
- expansion or contraction of the choledochus, Wirsung duct,
- violation of the density and structure of the tissue, the presence of education,
- change of size and redistribution of the pancreas.
Computed tomography is a reliable method of radiation study, in order to reveal formations from 3 cm. The patient is exposed to high radiation pressure, therefore the procedure is carried out according to strict prescriptions.
Thanks to MRI, a tumor of 2 cm is detected. A magnetic field is applied, therefore this method is safer relative to CT. At the same time there are limitations in the procedure, the presence of implants of metallic origin.
This method of diagnosis is considered the most reliable in identifying the cancer process in the gland. To verify the diagnosis, take tissue from the formation for microscopic examination.
How to inspect in later stages
If the doctor suspects cancer of 2-4 degrees, the choice of examination passes according to the standard. Initially, the patient is interviewed and examined. The survey clarifies the estimated time of the course of the disease in the patient’s view, the presence or absence of operations in the patient, possible cases of cancer in relatives. It is also important to clarify about bad habits, such as smoking and drinking alcohol. Labor employment is also being clarified, since there are professions that can cause cancer.
During the examination of the patient pay attention to the skin. In pancreatic cancer, the sclera and skin turn yellow, although the symptom is not considered major. Also overdrying of the skin, brittle nails, dull hair. These symptoms indicate a fall in hemoglobin, which often develops in cancer. When cancer poisoning is detected, a cachexia is formed in the patient. If the patient’s neglected case does not manifest a desire to look around, it gives monosyllabic answers, there may be irritability and aggressiveness.
How to examine the pancreas? At the time of inspection palpable organs of the abdominal wall. The pancreas itself feels difficult, it is due to its anatomical placement, but a large tumor and an enlarged spleen with the liver is possible. When touched, the reaction to the inspection is also taken into account.
Then the patient is prescribed a series of diagnostic measures that will help to check the pancreas for cancer.
Blood and urine tests
According to the degree of increase in the growth of the formation, symptoms of normochromic anemia appear, the volume of platelets increases. The presence of inflammation is indicated by an increased rate of ESR, which is greatly elevated in cancer.
A blood test for pancreatic cancer reflects a number of changes.
- Increased alkaline phosphatase, bilirubin.
- When the bile duct is compressed, the bilirubin coefficient increases every day. In case of complete obstruction, an increase of 10–16 mg / dL is recorded daily.
- Individual victims show an increase in amylase, elastase, lipase, and ribonuclease.
- Due to a change in food absorption, cholesterol and albumin are lowered.
Changes in analyzes are most often detected when tumors disperse to the organs of the urinary system. When cancer is suspected, the blood is examined for tumor markers.
In the last course of pancreatic cancer, thanks to this study, it is possible to trace:
- the location of the malignant course
- the magnitude, the stage of divergence on the organs, which are located near,
- the involvement of lymph nodes in the process of malignancy,
- damage to the pancreatic vessels and those near it.
Thanks to the stratified scanning of the computer, the images are obtained; the pancreas is represented on them from 3 sides. With fear of cancer, contrast enhancement is often used.
When iodine-containing medications are injected into a vein, the visibility of tissues and blood vessels is enhanced, which makes it possible to more accurately view all the disorders and their stage. According to the results of CT make a decision on the implementation of surgical intervention.
Positron emission tomography
Before conducting a PET examination, a radioactive substance is injected into the patient’s body with a negligible radiation coefficient.
Cancers can absorb radiation, because the radioactive component accumulates in them, and the next study using a computer makes it possible to identify these places.
Thanks to the technique, tumors with a small amount are detected. The method is also convenient when finding a secondary appearance of cancer.
This technique is considered the most accessible, the manipulation is carried out in any clinic. Often, based on the results, it is the ultrasound that makes the decision to send the patient for another examination at the oncologic dispensary.
In 30% of cases with the help of ultrasound it is impossible to see the organ, it is cohesive with excess weight, abdominal dropsy, as the organ is placed.
Percutaneous transhepatic cholangiography
ChCHHG is carried out if the patient has jaundice, and the factors of its occurrence could not be determined by other methods. Examination of the bile channels is carried out then, as a biopsy will be carried out and a contrast agent is injected.
The following X-ray photographs will show the position of the channels that are being examined, the blocking factor — stones or the growing formation of a non-cancerous or dangerous course.
Such a procedure is prescribed before the surgical treatment of pancreatic cancer, since this is an opportunity to see how much work is ahead of the surgeon.
Endoscopic retrograde cholangiopancreatography
ERCP - a method of examination of the bile ducts and pancreas. This method is able to accurately show the squeezing or contraction of the tested channels.
If necessary, with the manipulation in the ducts put the walls that relieve the patient from jaundice. And also sometimes take tissue samples to conduct histological examination.
Informative methods for the detection of pancreatic cancer. During the diagnostic period, a three-dimensional picture of such organs is created immediately:
The gland ducts are scanned. An obvious symptom of cancer is the presence of stenosis, manifested by narrowing of the bile and pancreatic channels.
Because cancer is often diagnosed at a late stage, its treatment is problematic. Surgical methods, chemotherapy, radiation therapy, hormonal treatment are used. With the help of surgical techniques reveal cancer education, more common in the body.
Laparoscopy is used to examine the peritoneum and detect the presence of metastasis.
Determination of the possibility of the operation using the laparoscopic equipment of the pancreas is possible at the initial admission. Thanks to technology, a resection of the area of the intestine affected by the tumor through minor incisions in the skin is carried out, following the rules of the ablastics. Laparoscopic surgery can reduce the period after surgery, speed healing and reduce pain. Normal bowel function is restored in a short time.
A difficult method is angiography. Contrast is injected into the artery of the thigh. With the flow of blood, it moves to the pancreas gland, providing a violation.
When there is cancer, arterial deformity is detected, and the pancreatic vessels are displaced and narrowed. When using the equipment, it is possible to detect tumors up to a centimeter.
A biopsy is performed to refute or confirm cancer. To do this, take the material by puncture.
After surgery for pancreatitis, traditional methods help patients to maintain the pancreas in working condition. Before using recipes, consult a doctor.
What is dangerous pancreatic cancer?
High mortality is due to late diagnosis, complications, rapid tumor development and metastasis throughout the body. Some enzymes can enter the bloodstream and be transported throughout the body, causing a state of shock. This greatly complicates the course of the disease and it becomes difficult to eliminate. Oncology is dangerous because in most cases it is inoperable.
In the early stages, prostate cancer proceeds without specific symptoms. The patient may complain of a complex of symptoms that are manifestations of other diseases. So, the first symptoms of a tumor can be:
- pain in the stomach,
- discomfort on the right side between the ribs,
- loss of appetite
- sleep disturbance.
In the presence of these signs it is recommended to consult a doctor!
The symptomatology of malignant tumors of this type is caused by the development of tumors, the proliferation of which puts pressure on all the nearest organs, causing obstruction of the channels and ducts, activation of enzymes. All this leads to poisoning of the body.
This type of cancer is most often diagnosed at very late stages of tumor development. The first manifestations of cancer are the painful sensations that each person has with varying degrees of severity, from discomfort and pressure to acute pain. Prostate cancer is characterized by such exact symptoms:
- painful sensations in the stomach (unrelated to meals),
- weight loss
- lack of appetite
- venous thrombosis,
- sleep disturbance
- violation of the chair,
- itchy skin
- high fever.
Episodic pain occurs in the area between the shoulder blades, in the navel, lower back. The intensity of the pain varies with the position of the body. There is a dislike for heavy food, an increased sensitivity to alcohol, caffeine and pills.
In some varieties of prostate cancer, hepatitis develops, darkening of urine and skin, feces lightens. In some cases, itching of the skin occurs and there is distension of the stomach. Digestion is impaired due to an insufficient amount of enzymes and bile in the intestine. Sometimes there is bleeding.
Pancreatic cancer may be accompanied by jaundice, which manifests itself as follows: the skin turns yellow, the mucous and white of the eyes turn yellow, the urine darkens, the chair becomes discolored, the liver increases, and the skin itches.
Prostate cancer can cause obstruction of the gastrointestinal tract, an enlarged spleen. Education quickly grows and spreads to neighboring organs, so if you detect at least one of the above symptoms, it is very important to consult a doctor as soon as possible.
What does modern pancreatic cancer diagnosis include?
One of the informative and accessible diagnostic methods is ultrasound. The study allows you to see a tumor of any size. This is the safest and most affordable method.
To find out the exact size and location of the tumor it is necessary to make a computer diagnosis. However, this procedure is associated with large doses of radiation, so it can not be carried out unreasonably and often.
An alternative to computer diagnostics is magnetic resonance imaging.
Positron emission tomography helps to clarify the size and location of the cancer. This diagnosis makes it possible to determine the amount of surgery.
The methods of diagnosis of prostate cancer include x-rays of the gastrointestinal tract. It will help determine the deformation and spread of the tumor. To identify mucosal changes using fibrogastroduodenoscopy.
Additional techniques to determine pancreatic cancer at an early stage are:
- cholangiography (perhepatic and percutaneous),
How to independently determine pancreatic cancer?
Independently detecting a pancreatic tumor in oneself is difficult, but the presence of the above symptoms should arouse suspicion and serve as a reason for prompt access to a doctor.
Sometimes the first signs are the severity or discomfort in the stomach, loss of appetite, pain in the right hypochondrium. As the disease progresses, the clinical manifestations become pronounced. At this stage, diagnostic activities by an experienced specialist will help determine pancreatic cancer.
Before contacting an oncologist, specialists should find out what suspicions are about cancer. The patient will tell therapist their discomfort. Most patients make the mistake of describing an incomplete picture of the disease. They omit the presence of symptoms that are not related to the abdomen, for example: an unreasonable fever, rapid fatigue, the possible appearance of blood in the urine. Attention should be paid to such signs; they should not be blamed on a cold or a mild infectious disease.
Early pancreatic cancer provokes the following complex of symptoms:
Pancreatic intestinal manifestations of cancer may be different. Diagnosing pancreatic cancer begins by clarifying the symptoms associated with the abdominal area:
- fatty stool,
- pale stools
- drastic weight loss
- constant heartburn
- causeless bloating
- frequent diarrhea,
- pain in the abdomen.
Dysfunctions of the excretory system are often manifested by darkening of the urine. The most common symptom is pain in the gland area. But most patients also experience a loss of appetite, on the basis of which an incorrect diagnosis is detected. Weight loss is not associated with this symptom, because it is caused by changes in the pancreas.
Nervous disturbances are possible with the development of a tumor. The human nervous system depends on the content of toxins in the blood. The pancreas is partially involved in the filtration process of harmful substances. The appearance of a tumor in its area violates this function, the bile ducts are pinched, and the contents of the bile enters the tissue. As a result, the nerve cells are depressed, which manifests itself as follows:
- patient anxiety increases
- there is frequent insomnia or fatigue,
- body reactions become inhibited, even protective reflexes appear more slowly.
Skin manifestations of the disease - a common phenomenon. There may be changes in skin color in case of damage to the cervix of the pancreas or in other cancers.
Important! It must be remembered that the symptoms of the disease are expressed differently depending on the affected area. The oncologist should be involved in differentiating the symptoms.
The main manifestation of skin rejection is jaundice.
Impaired gland function does not allow for proper bile, as a result, the body is subjected to intoxication, expressed, including yellowness of the outer layers of the epidermis.
The skin begins to itch. An unpleasant feeling can cover any area. Itching is not accompanied by rash, but increases as the disease progresses, and may not be highlighted to the last as a symptom accompanying cancer.
Pancreatic cancer is manifested by changes in the composition of the patient's blood. If you find the following 3 factors, you can talk about the development of a cancer:
- increase in the number of natural hormones-tumor markers,
- increase in blood sugar
- the appearance of an increased number of toxins in the vessels.
Sugar rises in connection with the violation of insulin, for which the pancreas is partially responsible. Along with this, diabetes mellitus may develop, which will lead to a particularly dangerous position of the patient. The increase in toxins is due to the spread of bile. The hormones oncomarkers are produced in enhanced quantities in the diagnosed areas due to the fact that they are most often generated by the tumors themselves. However, even in normal times they are contained in the blood and can sometimes increase for natural reasons.
A blood test is required to detect these hematological symptoms. He is appointed after collecting anamnesis of the external manifestations of the disease.
Types of hardware diagnostics
After collecting the history of the patient is sent for examination. Be sure to do a biopsy to further check the nature of the tissue. For pancreatic cancer, the following procedures are performed:
- spiral computed tomography with double contrast
- biopsy (puncture) with a scan using computed tomography,
- biopsy with control using ultrasound,
- research method for operable PET-CT tumors,
- transabdominal ultrasonography (ultrasound),
- endoscopic retrograde cholangiopancreatography (ERPHG),
- endoscopic ultrasound with biopsy elements, puncture taking.
Innovative and most effective is the diagnostic method using PET-CT. However, it is used in cases of operable cancer. The patient is usually referred for standard biopsy followed by tomography and ultrasound scans. At the same time, neighboring organs are also diagnosed.
A study using ultrasound can be external (without the introduction into the body of auxiliary tools) and internal, that is, by the method of endoscopy. In other words, these are transabdominal and endoscopic studies in oncology of the abdominal cavity.
The first subtype involves the use of the apparatus, the neck of which passes through the front wall of the human abdominal cavity. Using ultrasonic waves, the device reads and transfers the image of the internal organs of the abdominal cavity to the screen. The resulting image is examined for abnormalities: whether a carcinoma or a benign tumor is formed. The main sign of tumor development is the abnormal size and shape of the pancreas.
At endoscopic examination, an apparatus for endoscopy is introduced into the gastrointestinal tract through the mouth and stomach. Because of the increased pain during the procedure, the patient is injected into a state of anesthesia, and the doctor-gastroenterologist always takes all the actions.
CT (computed tomography) in the diagnosis of tumor glands is widely used in medical practice. CT scan is performed using a device with X-rays and a computer that reads the diagnostic data obtained. The rays, passing through the tissues, help to recreate a three-dimensional model of the position of the internal organs. As a result, the specialist receives a full-fledged model of several combined images. Standard CT devices produce images of fuzzy resolution, but oncology centers and regional hospitals buy equipment with enhanced definition characteristics.
Diagnosis with the help of computed tomography allows you to find out the exact location of the tumor or to detect it initially.
Based on the data obtained, the oncologist makes a conclusion about the operability of the neoplasm and, depending on the diagnosis, prescribes: chemotherapy, radiation rehabilitation or another method of recovery.
A biopsy examination involves taking a small piece of patient tissue from a patient’s potential for tumor development. It is usually taken surgically, making a small incision. New technologies now allow for biopsy and by taking a small number of cells with a syringe. When taking a puncture, the tumor area is controlled by translucent settings: ultrasound, x-rays, and tomography. This allows you to accurately position the device for taking tissue.
Endoscopy is also used for punctures, but because of its pain and complexity, they prefer to perform surgery or with a syringe to patients who are initially diagnosed.
Only biopsy and clinical tests to determine the nature of the tissue can help establish an accurate diagnosis. This procedure is mandatory.
Other diagnostic methods
How to check the pancreas without surgery? Another method is positron emission tomography (PET).
PET is considered the most gentle method and is used to determine the operability of the neoplasm. Cancer cells consume an increased amount of energy. This was clarified in oncological studies, and the information was used to create a new technique. A complex of radioactive elements is introduced into the body that do not have a detrimental effect on health. Ordinary tissues and cells do not absorb them, but cancerous tend to take everything that can give energy. Tissues that have absorbed radiation markers are easy to notice upon further examination with CT (the examination will be complex, that is, PET-CT). Cancer is most often diagnosed in this way.
Endoscopic examination is also used for this purpose. The gastroenterologist introduces an endoscope into the body, which leads the catheter into the glands and bile ducts. From this catheter a marker substance enters the body, which appears to be a contrast when examined by X-ray. Based on the promotion of the content of the bile ducts, it is concluded that there are obstacles in them. If something interferes, the probability of a tumor is high.
After this examination, a puncture is taken to determine the nature of the tumor - malignant or benign. Depending on this, the patient is either undergoing treatment with removal, or a course of maintenance therapy until death.
It is used in the development of jaundice in a patient, when it is not possible to establish the causes of its manifestation in other ways. The study of the bile duct is carried out after the procedure of puncture and the introduction of contrast.
For puncture, a flexible and thin Hiba needle is used, which is inserted only after a local anesthetic drug. Depth entering the instrument into the liver should not exceed twelve centimeters. The procedure is considered correct when bile appears. Next, a specialist extracts about 200 milliliters of bile fluid, and injects a contrast agent into the emptied cavity.
Subsequent X-ray examination allows to determine the state of the bile ducts, as well as the cause that provoked clogging (a tumor of a malignant or benign form, the presence of calculus).
In most cases, magnetic resonance cholangiopancreatography is performed immediately before surgery, since this method of diagnosis determines the amount of work required.
This research method consists in collecting a small fragment of a sample of an altered tissue or tumor neoplasm. With his help, there is a likelihood of refutation or an accurate determination of the cancer process.
The biopsy specimen is subjected to histological examination, allowing to identify atypical cells, as well as to establish their structure and type of tumor.
For the collection of material spend puncture of the affected organ. To do this, use a special aspiration needle. To control the process allows the device ultrasound or radiography.
With the localization of malignant tumors, a biopsy is performed using laparoscopy.