Pancreas Health

Located behind the stomach, the pancreas is a small gland connected to the liver and small intestine. It is responsible for producing enzymes that break down cholesterol, protein and fat in the small intestine, as well as producing insulin, which is needed to reduce the amount of sugar in our blood. Diabetes occurs when the pancreas’ ability to produce insulin is damaged.

What is pancreatitis?

Pancreatitis is the swelling of the pancreas. Causes of pancreatitis can be any of the following:

• Gallstones
• Long-term heavy alcohol consumption
• Trauma
• Infection
• High levels of blood fats or calcium
• Hereditary and genetic causes
• Hepatitis B
• Tumours

What are the symptoms of pancreatitis?

There are 2 types of pancreatitis – acute pancreatitis and chronic pancreatitis. Acute pancreatitis is a sudden swelling of the pancreas, often together with severe abdominal pain, and it is most often caused by gallstones. Chronic pancreatitis tends to develop over the years as a gradually growing inflammation that damages the pancreas. More men suffer from chronic pancreatitis than women, and is most often caused by alcohol abuse. Generally, acute and chronic pancreatitis share similar symptoms, except that acute swelling usually has more severe symptoms while chronic pancreatitis symptoms are more gradual. Symptoms of pancreatitis include:

• Upper abdominal pain
• Nausea and vomiting
• Diarrhoea
• Weight loss, especially in chronic pancreatitis
• Jaundice (yellowish skin and eyes)
• Fever
• Nausea and giddiness

Hepatitis can lead to:

• Pancreatic cancer
• Acute pancreatitis can lead to chronic pancreatitis
• Type 2 diabetes

How is pancreatitis treated?

There are different forms of treatment depending on the type of pancreatitis and the severity. When the pancreatitis is caused by gallstones or other forms of blockages in the bile ducts and pancreatic ducts, the obstruction is removed. In extreme cases, the entire pancreas is removed (total pancreatectomy), together with the bile ducts and gall stones. To prevent the onset of diabetes in this case, the pancreas cells that produce insulin are transplanted onto the liver.

What is pancreatic cancer?

While there are a few types of cancer that can occur in the pancreas, most cases involve cancer cells that affect the part of the pancreas that produces digestive enzymes. The Singapore Cancer Registry states that pancreatic cancer is the 5th and 6th most common cause of cancer death in Singaporean males and females respectively. In America, pancreatic cancer is the 4th most common cause of cancer death, with notable victims such as Apple co-founder Steve Jobs and actor Patrick Swayze.

What causes pancreatic cancer?

There are no known causes of pancreatic cancer, but studies have identified some risk factors that can contribute to people suffering from pancreatic cancer:

• Smoking accounts for 40% of pancreatic cancer causes in the US
• Regular intake of soft drinks can account for an 87% higher risk of developing pancreatic cancer
• People over the age of 60 are more likely to develop pancreatic cancer
• Chronic pancreatitis can cause pancreatic cancer
• Diabetic patients are more likely to develop pancreatic cancer
• People who are overweight have a slightly higher risk of suffering from pancreatic cancer

What are the symptoms of pancreatic cancer?

Pancreatic cancer usually does not have recognisable symptoms in the early stage. In addition, the small size of the pancreas means that tumours can be hard to discover with a physical examination. Symptoms of pancreatic cancer are often misdiagnosed as other conditions, and most pancreatic cancer cases are diagnosed in the advanced stage. A complete health screening that includes a CT scan of the abdomen can help to diagnose pancreatic cancer in the early stages. Symptoms of pancreatic cancer include:

• Unexplained weight loss
• Indigestion
• Jaundice

How is pancreatic cancer treated?

Treatment of pancreatic cancer depends on how far the cancer has progressed. In cases where the cancer has been discovered early and is confined to the head of the pancreas, the Whipple procedure can be used to remove the affected part of the pancreas and reattach the remaining pancreas with the bile duct and intestine. Chemotherapy and radiation therapy can also be used to shrink the cancer, reduce the symptoms, and prolong life.

What is a pancreatic cyst?

A pancreatic cyst is a closed liquid sac that is formed on or in the pancreas, often in reaction to swelling. While many cysts are benign and may cause pancreas inflammation, some cysts can be cancerous or pre-cancerous, which means that they can turn cancerous if left untreated.

What are the symptoms of pancreatic cysts?

Pancreatic cysts tend to have little or no symptoms early on in development. Most pancreatic cysts are discovered incidentally as part of health screening, or CT and MRI scans of the abdomen. As the cyst develops, the symptoms below may be experienced:

• Pain in the upper abdomen or back
• Jaundice
• Tea-coloured urine
• Pale stools or diarrhoea
• Swelling in the upper abdomen
• Poor appetite
• Weight loss
• Nausea and vomiting

How are pancreatic cysts treated?

Non-cancerous cysts can be treated using minimally invasive techniques. This involves making small cuts and thin, flexible surgical tools are inserted into the body along with a special, tubular camera that allows the surgeon to see inside the body. These cysts can be drained using these laparoscopic tools to prevent further swelling of the pancreas.

In cases where the cyst is found to be pre-cancerous, part or all the pancreas can be removed to prevent the onset of pancreatic cancer. These procedures can sometimes also be performed laparoscopically. Laparoscopic (keyhole) surgery is a minimally invasive form of surgery that can shorten the recovery time and lessen pain during recovery as it involves small cuts that are required to insert the laparoscopic tools, as opposed to traditional open surgery. The risk of infection can also be reduced as the abdomen is not exposed during surgery.

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