Dr Kieron Lim
Senior Consultant Gastroenterologist
MBBS (University of London), MRCP (UK), FRCP (Edinburgh), FAMS (Gastroenterology)
What Is Pancreatic Cancer?
Pancreatic cancer is a malignancy that begins in the tissues of the pancreas, an organ that plays a dual role in digestion and blood sugar regulation. The pancreas has exocrine cells, which produce digestive enzymes to break down food, and endocrine cells, which release hormones like insulin and glucagon into the bloodstream.
How Does Pancreatic Cancer Develop?
Pancreatic cancer develops when genetic mutations cause pancreatic cells to grow uncontrollably, forming a tumour. These mutations may result from environmental factors, chronic inflammation, or inherited genetic predispositions, though the precise cause remains unclear in many cases.
What Are the Risk Factors for Pancreatic Cancer?
The exact cause of pancreatic cancer is unknown, but several risk factors increase the likelihood of developing it:
Tobacco carcinogens damage pancreatic cells, doubling the risk of pancreatic cancer.
Long-standing or new-onset diabetes is linked to higher risk, as pancreatic dysfunction affects insulin production.
A history of pancreatic, ovarian, or colon cancer, especially with BRCA1/2 mutations, increases risk.
Long-term pancreatic inflammation, often from alcohol or gallstones, can lead to cancer.
Excessive drinking contributes to pancreatitis and cancer risk.
Excess body weight, particularly abdominal fat, is associated with increased risk.
What Are the Symptoms of Pancreatic Cancer?
Unfortunately, pancreatic cancer symptoms are often vague and nonspecific, contributing to its late diagnosis. Recognising these signs is key to seeking timely medical attention.
Common symptoms include:
Fatigue
Persistent tiredness is common, resulting from the body’s response to the tumour and its metabolic demands. This fatigue can greatly impact daily activities and quality of life.
Jaundice
Yellowing of the skin and eyes occurs when a tumour blocks the bile duct, preventing bile from reaching the intestines. This can also cause itchy skin, dark urine and pale stools.
Weight Loss
Unexplained weight loss is frequent, often due to impaired digestion from insufficient pancreatic enzymes or the cancer’s high metabolic demands.
Belly or Back Pain
Pain in the abdomen or back may be constant or intermittent, worsening after meals or when lying down. It often results from the tumour pressing on nearby organs or nerves.
Nausea and Vomiting
These symptoms can arise if the tumour affects the stomach or intestines, disrupting normal digestion. They may also occur as side effects of treatments like chemotherapy.
Diabetes
New-onset diabetes, particularly in older adults, can be an early sign of pancreatic cancer, as the tumour may impair insulin production.
Blood Clots
Pancreatic cancer increases the risk of blood clots, which can form in veins and lead to serious complications if untreated.
Gallbladder or Liver Enlargement
A blocked bile duct can cause the gallbladder to enlarge, and cancer spreading to the liver may result in liver enlargement, causing abdominal swelling or discomfort.
What Are the Stages of Pancreatic Cancer?
Stages of Pancreatic Cancer
What Are the Types of Pancreatic Cancer?
Pancreatic cancer is categorised into two primary types.
Exocrine Pancreatic Cancer
Adenocarcinoma
The most common form, arising from the cells lining the pancreatic ducts. It is aggressive and often diagnosed at advanced stages.
Squamous Cell Carcinoma
A very rare subtype originating in squamous cells, which are not normally found in the pancreas.
Adenosquamous Carcinoma
A mixed tumour with both glandular (adenocarcinoma) and squamous cell features. It is rare and generally more aggressive than adenocarcinoma.
Colloid Carcinoma
A rare subtype characterised by large amounts of mucin. It tends to have a better prognosis than adenocarcinoma due to a lower likelihood of spreading.
Pancreatic Neuroendocrine Tumours (PNETs)
PNETs, also called islet cell carcinomas, arise from hormone-producing endocrine cells in the pancreas and account for a small minority of pancreatic cancers. They can be functional (producing hormones) or nonfunctional. PNETs generally have a better prognosis than exocrine pancreatic cancers, especially when diagnosed early, as they tend to grow more slowly and respond differently to treatment.
How Is Pancreatic Cancer Diagnosed and Tested?
Diagnosing pancreatic cancer requires a combination of imaging, laboratory tests, and sometimes invasive procedures to confirm the presence, type, and stage of the disease. These include:
CT scans and MRIs provide detailed views to detect tumours and their spread, while Endoscopic Ultrasound offers high-resolution imaging and allows for biopsies. A PET scan can identify areas of increased metabolic activity, helping to pinpoint cancer spread.
Although not always specific, certain tumour markers can detect pancreatic cancer. Liver function tests can also help assess for jaundice or liver involvement, which can indicate bile duct obstruction or metastasis.
A tissue sample, often obtained via endoscopic ultrasound-guided fine-needle aspiration, confirms the diagnosis and identifies the cancer type.
This is a minimally invasive procedure using a camera to check for cancer spread not visible on imaging.
What Are the Treatments for Pancreatic Cancer?
Treatment for pancreatic cancer depends on the stage, type, resectability and the patient’s overall health. A multidisciplinary approach is often employed, combining surgical and non-surgical options:
Surgical Treatments
Performed by hepatopancreatobiliary (HPB) surgeons, surgical treatments include:
Non-Surgical Treatments
Non-surgical treatments are used for unresectable cancers, as adjuvant therapy, or for symptom management:
Certain medications target specific cancer cell molecules, offering a more precise treatment with fewer side effects.
Palliative Care
Palliative care focuses on improving the quality of life for patients with advanced pancreatic cancer by managing symptoms and providing compassionate support. It is tailored to individual needs and can be provided alongside other treatments.
Can You Prevent Pancreatic Cancer?
While not all cases are preventable, certain actions can reduce the risk of pancreatic cancer:
High-risk individuals, such as those with a family history of pancreatic cancer, may benefit from timely check-ups to detect abnormalities early.
Identifying certain mutations can inform preventive strategies and screening protocols for at-risk individuals.
Quitting smoking, maintaining a healthy weight, limiting alcohol, and managing diabetes can lower risk.
Why Choose Us for Pancreatic Cancer Management in Singapore
Our clinic specialises in the diagnosis and medical management of gastrointestinal conditions, including pancreatic cancer. Led by Dr Kieron Lim, an experienced gastroenterologist in Singapore with over 20 years of clinical expertise, we utilise modern endoscopic and imaging techniques for the early detection and accurate staging of pancreatic cancer. This comprehensive approach is critical for effective management and improving patient outcomes.
Frequently Asked Questions (FAQs)
What is the survival rate of pancreatic cancer?
Can you live without a pancreas?
How painful is pancreatic cancer?
Meet Our Pancreatic Cancer Specialist
Dr Kieron Lim
MBBS, University of LondonMember, Royal College of Physicians (UK)Fellow, Academy of Medicine (Gastroenterology) SingaporeFellow, Royal College of Physicians (Edinburgh)
Dr Kieron Lim, senior consultant in Gastroenterology and Hepatology at Mount Elizabeth Hospital, also serves as Medical Director of the Liver Transplant Programme. With leadership roles in medical committees and as Vice-Chair of the Chapter of Gastroenterologists at the Academy of Medicine (Singapore), Dr Lim is skilled in the management of pancreatic cancer. With his experience in advanced endoscopic procedures and medical management of complex GI cases, Dr Lim is committed to providing effective, multidisciplinary and personalised care for all his patients.
Location
Mount Elizabeth Medical Centre
3 Mount Elizabeth #10-02Singapore 228510
Contact Us
Whatsapp: (65) 9726 0495 | Telephone: (65) 6836 0080
Fax: (65) 6836 0090 | Emergency: (65) 6533 0088
Email: enquiries@kieronlimgastro.sg