What Is The Cause Of Cancer of The Pancreas?
The cause of pancreatic cancer is largely not known, although in the case of ductal-type cancer (see below) there is an association with smoking tobacco. There is also an increased risk in patients with chronic pancreatitis and Hereditary Pancreatitis. Pancreatic cancer also occurs in certain familial cancer syndromes such as Peutz- Jeghers Syndrome, Breast and Ovarian cancer Syndromes, Familial Atypical Mole and Melanoma Syndrome and Familial Adenomatous Polyposis. Rarely there are families with Familial Pancreatic Cancer.
Are There Different Types Of Pancreatic Tumors?
Pancreatic tumors can be solid tumors or those containing fluid (cystic). The solid tumors are usually adenocarcinomas even though rarely they can be of other types. There is also a special type of pancreatic tumor called neuroendocrine tumor (PNET). The type of tumor decides the long-term outcome and at times even the treatment.
Cystic Tumors may be benign or malignant & may be confused with pancreatic pseudo cysts (pronounced ‘Sue-doe-cyst’) that occur because of inflammation of the pancreas called pancreatitis. Hence it is important to confirm the nature of content of the cyst. The content of the cyst can be rather watery and this type of cystic tumor is called serous cyst adenoma. It is non- malignant and has very little cancer potential.
The fluid of the cyst can be filled with mucin and this type of cystic tumor can be a mucinous cyst adenoma or cyst adenocarcinoma or intraductal papillary mucinous tumor. These are cancerous or have potential to become cancerous. These are the common varieties of cystic tumors. There are some uncommon ones too. The success rate of treatment of cystic tumors is better than the results of treatment of common pancreatic cancer.
What Is A NET & PNET?
NET stands for neuroendocrine tumor. Neuroendocrine cells are special types of cells commonly located in the linings of gastrointestinal tract (esophagus to rectum), bronchus (airway) and pancreas. They are located elsewhere too. Tumor arising from these cells is called a neuroendocrine tumor or NET. The neuroendocrine cells secrete various hormones depending on their location. However not all NETs secrete tumors. Those that secrete hormones present due to the various effects of these hormones
PNETs short for pancreatic neuroendocrine tumors. These tumors may arise from the endocrine cells in the islets of Langerhans in the pancreas (islet cell tumors) or so called neuroendocrine cells either in the pancreas or ampulla of Vater (carcinoid tumors) or the duodenum (gastrinomas). The success rate of treatment of these PNETs is much better than the results of treatment of other types of pancreatic cancer.
PNETs can secrete one of six or more different hormones causing different types of illness (or syndrome) and are called functioning neuro- endocrine tumors. Also neuroendocrine tumors may not secret any hormones and are then called non-functioning neuroendocrine tumors. Endocrine tumors can affect individuals at any age and they can even arise in small babies.
Tumors that release excess insulin are called insulinoma. These tumors are nearly always benign, meaning non-malignant and non- cancerous. Tumors that release excess gastrin are called gastrinoma and occur in the pancreas and in the duodenum. These tumors are mostly cancerous. Other types of functioning neuro- endocrine tumors are called glucagonomas, VIPomas, somatostatinomas & PPomas and are usually malignant or cancerous.
PNETs may be inherited and the two main types of hereditary pancreatic neuroendocrine tumors are found in multiple endocrine neoplasia type 1 (MEN-1) & von Hippel-Lindau disease (VHL), but also in the rare disorders of neuro- fibromatosis type 1 and tuberous sclerosis.
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