From the Guidelines
Pancreatic adenocarcinoma can lead to numerous serious complications, including obstructive jaundice, severe abdominal and back pain, digestive problems, weight loss, venous thromboembolism, gastric outlet obstruction, diabetes, depression, and anxiety, ultimately resulting in a poor quality of life and high mortality rate, as evident from the high incidence of cancer-related death among men and women in the United States 1.
Common Complications
- Obstructive jaundice due to bile duct blockage, causing yellowing of skin, dark urine, and itching
- Severe abdominal and back pain as the tumor invades surrounding nerves
- Digestive problems, including malabsorption and pancreatic exocrine insufficiency, requiring pancreatic enzyme replacement therapy
- Weight loss and cachexia, often requiring nutritional support
- Venous thromboembolism, sometimes necessitating prophylactic anticoagulation
- Gastric outlet obstruction, causing nausea, vomiting, and early satiety
- Diabetes, requiring glucose monitoring and insulin therapy
- Depression and anxiety, requiring supportive care
Disease Progression
As the disease progresses, metastasis to the liver, lungs, and peritoneum often occurs, worsening prognosis, with a 5-year survival rate of less than 5% for all stages 1.
Management
The management of pancreatic adenocarcinoma involves a multidisciplinary approach, including surgery, chemotherapy, and palliative care, with a focus on improving quality of life and reducing symptom burden, as recommended by the NCCN Guidelines for Pancreatic Adenocarcinoma 1.
Palliative Care
Palliative care is an essential component of the management of pancreatic adenocarcinoma, aiming to alleviate distressing symptoms, improve quality of life, and support patients and their families, as emphasized by the American Society of Clinical Oncology clinical practice guideline for metastatic pancreatic cancer 1.
From the Research
Complications of Pancreatic Adenocarcinoma
The complications of pancreatic adenocarcinoma can be severe and varied. Some of the common complications include:
- Biliary or duodenal obstruction 2
- Gastric outlet syndrome 2
- Bleeding and thromboembolic diseases 2
- Pain 2
- Depression and fatigue 2
- Pancreatic exocrine insufficiency and malnutrition 2
- Metastatic spread to the liver, peritoneum, or lungs 2
Treatment-Related Complications
Treatment for pancreatic adenocarcinoma can also lead to complications, such as:
- Systemic recurrence within 2 years of surgery 3
- Difficulty in delivering postoperative treatment, with up to 50% of patients not receiving intended treatment 3
- Toxicity from chemotherapy and radiation therapy 4, 3, 5, 6
Disease-Related Complications
The disease itself can cause significant complications, including:
- Locally advanced or metastatic disease at diagnosis, which can lead to poor survival rates 4, 6, 2
- Weight loss, loss of appetite, nausea and vomiting, and general weakness 2
- Abdominal or back pain 2
- Jaundice 2
Multidisciplinary Management
A multidisciplinary approach to management is recommended, including: