Diving Deeper: Demystifying Pancreatic Cancer

From Adenocarcinoma to Neuroendocrine Tumors

What is the Pancreas?

To understand the two types of pancreatic cancer, we must first learn the anatomy and physiology of the pancreas. You may be familiar with the pancreas in relationship to type I or type II diabetes. It is located behind the stomach (Ullmann, 2009/2009, p. 319). The head of the pancreas is located near the common bile duct and duodenum of the small intestine and the tail, near the spleen (Ullmann, 2009/2009, p. 319). The pancreas is a glandular, pear-shaped organ that is about 6 inches in length (Institute, 2022: updated 05/05/2023).Here are some fun facts about the physiology of the pancreas:

1. It's an accessory organ in the digestive system

2. It plays a role in the endocrine (hormones) system

3. It contains both exocrine and endocrine glands

• Exocrine glands secrete pancreatic juices (enzymes) for digestion.

• Endocrine glands produce hormones such as insulin and glucagon that help stabilize blood sugar levels.

4. 95% of pancreatic cancers begin in exocrine cells.

(Institute, 2022: updated 05/05/2023)

The exocrine glands secrete digestive enzymes into the intestines to help breakdown food (Society, 2019). This is known as chemical digestion (Rowden, 2023).

Types of Pancreatic Cancer

According to the American Cancer Society (2019), there are two types of pancreatic cancers: (1) adenocarcinoma and (2) neuroendocrine tumors; also known as PNETs. These are larger classifications of pancreatic cancer that include subgroups that are named according to the cancer cell's location.

Pancreatic Adenocarcinoma is the most common of the pancreatic cancer types which make up about 95% of exocrine cancers (Society, 2019). More often, the cancer begins in the exocrine ducts (Society, 2019). It is rare for these cancers to originate from the cells that produce pancreatic enzymes; this is known as acinar cell carcinomas (Society, 2019). Other rare exocrine cancers include adenosquamous carcinomas, squamous cell carcinomas, signet ring carcinomas, undifferentiated carcinomas, undifferentiated carninomas with giant cells, and ampullary cancer (Society, 2019). According to the research (2019) amupullary cancer describes cancer that begins in the ampulla of Vater.

Pancreatic Neuroendocrine Tumors (PNETs)

Also referred to as islet cell tumors, are found in the pancreas (Society, 2020). They are called islet cells because they are found in clusters within the endocrine ducts (Society, 2020). These islets cells are responsible for the production of insulin and glucagon (Society, 2020). PNETs are classified by grades:

• Grade 1 (low-grade) are like normal cells and multiply slowly.

• Grade 2 (intermediate) have features in between low and high grade tumors.

• Grade 3 (high-grade) are abnormal in structure and multiplies quickly.

(Society, 2020)

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References

Institute, N. C. (2022, May 23). Pancreatic cancer treatment (adult) (pdq®)–patient version -

NCI. Www.cancer.gov; National Cancer Institute. https://www.cancer.gov/types/pancreatic/patient/pancreatic-treatment-pdq#_110

Rowden, A. (2023, July 26). Chemical digestion: Definition, the digestive system, and more.

Www.medicalnewstoday.com; Medical News Today. https://www.medicalnewstoday.com/articles/chemical-digestion#summary This article and its sources were peer-reviewed by Amy Richter, RD, Nutrition.

Society, A. C. (2019, February 11). What is pancreatic cancer? Www.cancer.org; American

Cancer Society. https://www.cancer.org/cancer/types/pancreatic-cancer/about/what-is-pancreatic-cancer.html

Society, A. C. (2020, January 21). What is a pancreatic neuroendocrine tumor?

Www.cancer.org; American Cancer Society. https://www.cancer.org/cancer/types/pancreatic-neuroendocrine-tumor/about/what-is-pnet.html

ThePancreasPatient. (2013). The role and anatomy of the pancreas. In YouTube.

https://www.youtube.com/watch?v=NZ4zcrTzUjA

Ullmann, H. F. (2009). Atas of Anatomy (S. Peter, Ed.; M. Croasdale, A. Drummond, D.

Hefford, J. Philips, & K. Taylor, Trans.; English, p. 319). Elsevier. (Original work published 2009)