Pancreatic cancer: Is the disease hereditary?

Pancreatic cancer is development of malignant (cancerous) cells in the tissues of the pancreas. The pancreas is an organ of the digestive system in the abdomen and plays an important role in converting food into fuel for the body’s cells.

Pancreatic cancer is the fourth most prevalent disease to cause mortality. It is the tenth most common cancer in men and the eighth most common in women. It is very difficult to detect pancreatic cancer, hence it goes undetected until it reaches an advanced stage. Exocrine tumors (includes Ductal adenocarcinoma), neuroendocrine tumors and cystic neoplasm are the three forms of tumors that develop in the pancreas.

Pancreatic cancer can also run in the family. Pancreatic cancer that are hereditary account for 10% of cases. This indicates that the patient has an inherited gene mutation. Most pancreatic tumors are caused by acquired mutations as opposed to inherited mutations. Parents cannot convey these mutations to their children. However, occasionally, mutated DNA is passed down from parent to child, and we refer to these as germline mutations. It is possible that these mutations cause hereditary pancreatic cancer. This is the only known technique to pass on pancreatic cancer.

Symptoms of hereditary pancreatic cancer

The signs and symptoms of pancreatic cancer are commonly ignored. Some of the symptoms include pain in upper abdomen or back often spreading from the stomach to back, loss of appetite or weight loss, jaundice—yellowing of the skin and eyes becoming yellow, skin itching, pancreatic adenocarcinoma, and fatigue.

What can a person do if they have history of pancreatic cancer in the family?

People who have a family history of pancreatic cancer are referred to a geneticist. The doctor performs a genetic test to see if there is a faulty gene that can lead to pancreatic cancer. If a faulty gene is discovered, the person should see a doctor on a regular basis so that any malignant cell growth can be detected early.

Diagnosis

Pancreatic mass is identified with using abdominal imaging using Ultrasound Abdomen or CTScan abdomen, however pancreatic cancer can only be identified with a biopsy, which involves removing real tissue from the tumor. Several techniques can be used to perform biopsies:

• CTscan guided biopsy of pancreatic mass
• Endoscopic ultrasound -flexible tube with camera and ultrasound probe on it goes from mouth into the small intestine close to the pancreas to collect images and take biopsy
• In certain subset of patients like suspicious pancreatic duct narrowing and inconclusive diagnosis by EUS biopsy can perform Endoscopic retrograde cholangiopancreatography (ERCP)brush cytology.

Treating pancreatic cancer can be challenging if diagnosed at a later stage. However, people with a family history of pancreatic cancer must go for an early diagnosis to ensure optimal treatment options.

The author is a medical-consultant, Medicover Hospital, Navi Mumbai. Views expressed are personal.

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