What is the cause of back pain in advanced pancreatic cancer

Pancreatic cancer refers to adenocarcinoma of the exocrine pancreas, a common pancreatic tumor with high malignancy, rapid development and poor prognosis, accounting for about 10% of digestive tract malignancies. Pancreatic cancer can occur in any part of the pancreas, of which 60% is pancreatic head cancer, 20% is pancreatic body and tail cancer, and 10% is diffuse cancer. About 90% of pancreatic cancers are ductal adenocarcinomas originating from the glandular duct epithelium.

It is estimated that by 2020, there will be approximately 420,000 new cases of pancreatic cancer and 410,000 deaths each year. By 2030, pancreatic cancer may become the second leading cause of death from malignant tumors.

Data from the National Cancer Center also show that pancreatic cancer accounts for approximately 2.42 million cases of malignant tumors and 18.9 million cases in China each year.

Pancreatic cancer is more common in middle-aged and elderly people, and is more common in men than in women.

In recent years, the incidence and mortality of pancreatic cancer have increased year by year. Compared with 10 years ago, there is a clear trend of increasing numbers of young pancreatic cancer patients, with high malignancy and poor prognosis.

Pathogenesis of pancreatic cancer

Genes and environment are two important factors when it comes to the causes of cancer, and pancreatic cancer is no exception.

Many modern unhealthy lifestyles, such as smoking, unbalanced diet, and obesity, are important risk factors for pancreatic cancer.

1. Smoking and chronic pancreatitis increase the risk of pancreatic cancer.

2. Step 2. Family history of cancer is an important risk factor.

3. Obesity is gradually recognized as an important risk factor for pancreatic cancer.

4. A long history of diabetes is a risk factor for pancreatic cancer.

5. Oral microbial infection is also a risk factor for pancreatic cancer.

Three danger signs to prevent pancreatic cancer

1: Upper abdominal discomfort and pain

60 patients with pancreatic cancer had some initial symptoms. The clinical diagnosis was upper abdominal pain and indescribable discomfort, stuffiness, sometimes light, sometimes heavy, sometimes absent, usually more obvious at night. The pain may involve the upper chest, back, sitting posture, body bending forward or knees bending forward, and the pain can be relieved.

2: Loss of appetite and weight loss

Studies have shown that loss of appetite, nausea and vomiting, changes in bowel habits and weight loss are the four early symptoms of pancreatic cancer. Loss of appetite was the first symptom in 10 cases, and weight loss was the first symptom in some.

3. Jaundice

Late clinical manifestations, but 14 patients had this as the first symptom. Clinically, most patients with jaundice often have varying degrees of abdominal pain.

Diagnosis of Pancreatic Cancer

Many patients are diagnosed late with pancreatic cancer and lose the best chance for treatment. Therefore, early diagnosis of pancreatic cancer has become a very important clinical issue.

Persistent upper abdominal pain, radiating pain to the back and lower back, obvious at night, aggravated when lying on the back, and pain relieved by sitting curled up or forward, etc., are highly suggestive of pancreatic cancer and require further laboratory tests and other auxiliary examinations.

If pancreatic cancer is suspected, contrast-enhanced CT or MRCP should be performed. Endoscopic ultrasonography-guided fine-needle aspiration biopsy can help with diagnosis, especially in patients who are unresectable by chemotherapy and radiation therapy. PET-CT can help identify distant metastases.

The early symptoms of pancreatic cancer are not very obvious. There are three more prominent symptoms: (1) anorexia, indigestion and weight loss; (2) abdominal discomfort or pain. About half of the patients have abdominal pain as the first symptom, and about 20% of the patients have abdominal pain that radiates to the back and left shoulder. The pain worsens when lying on the back and is relieved when sitting, bending over, lying on the side, or bending the knees; (3) jaundice, manifested as yellowing of the skin and sclera. The above symptoms can also occur in hepatitis or biliary diseases, so it is not uncommon for early pancreatic cancer to be misdiagnosed as hepatitis, cholecystitis, or cholelithiasis.

The above are general symptoms. The symptoms of pancreatic cancer vary with the location of the disease. Pancreatic head cancer can easily compress the common bile duct, block bile secretion, and cause bile to seep into the blood. It is most likely to cause jaundice, liver enlargement, and lighter stool color, which appears like white clay. Therefore, pancreatic head cancer is relatively more likely to be discovered in the early stages. Pancreatic body cancer symptoms are mainly pain, because the pancreatic body is adjacent to the celiac plexus, and lesions can easily invade the nerves. The pain is intermittent or continuous and worsens at night. Pancreatic tail cancer symptoms are more hidden, and pain is rare. In addition to general weight loss, fatigue, loss of appetite, and indigestion, it sometimes manifests as an abdominal mass, which can be easily misdiagnosed as a left kidney disease. Pancreatic cancer has a radiating point, which is left back pain, so the back pain will be obvious.