Reviewed By: Pramod Kerkar, MD, FFARCSI

Are Elevated Liver Enzymes a Sign of Pancreatic Cancer?

An alteration in the levels of liver enzymes have been found in cases of acute or chronic hepatitis, in obstructions of the biliary tract, in cirrhosis, when there is liver cancer, in liver damage caused by alcohol, after an acute myocardial infarction and even if there are muscle injuries, but it has never been discovered an association with pancreatic cancer.

Pancreatic cancer is a disease in which abnormal cells appear in the tissues of the pancreas, an organ located behind the stomach in the abdomen, which produces digestive enzymes and insulin. The pancreas is composed of two different types of tissue, with different functions: the exocrine pancreas (which secretes enzymes into the digestive tract that contribute to break down the fats and proteins) and the endocrine pancreas (which secretes glucagon and insulin into the bloodstream to control blood sugar concentrations). In more than 80% of cases, pancreatic cancer appears in the exocrine pancreas. About 75% of all cancers of the exocrine pancreas occur in the head or neck of the pancreas, 15 to 20% in the body and 5 to 10% in the tail of the pancreas.

Nowadays, it is not clear why pancreatic cancer occurs. It is considered that the majority of pancreatic cancers (90%) are not associated with any risk factor, although for the remaining patients some risk factors have been identified. A risk factor increases the risk of cancer, but it is not enough or necessary for the disease to appear; a risk factor is not a cause itself. Some people with these risk factors can never develop pancreatic cancer and some people without any risk factor can end up suffering from the disease.

The main risk factors for pancreatic cancer identified so far are:

Genes: It is known that some genetic mutations are related to pancreatic cancer. Most pancreatic cancers have mutations in the KRAS (80%), p53 (50%) and p16 genes, which are associated with the control of tumor growth.

Smoking (cigarettes): 25% of patients with pancreatic cancer are, or have been, cigarette smokers for a long time. This habit produces a greater effect if the patient has any of the aforementioned genetic syndromes.

Age: The risk of diagnosing pancreatic cancer increases with age; this condition is diagnosed for the most part between 60 and 80 years of age.

Obesity: There is scientific evidence that the risk of pancreatic cancer can increase slightly with the increase in body mass index, a measure that compares height and weight.

Chronic Pancreatitis: Suffering from chronic pancreatitis for several decades increases the risk of pancreatic adenocarcinoma. This risk is increased by smoking and by genetic factors.

How is it Diagnosed?

Clinical examination: Some of the symptoms that can be detected during the clinical examination of a patient with pancreatic cancer are the following: Jaundice (skin and eyes become yellowish due to an increase in bilirubin concentrations in the blood), abdominal and back pain due to pressure exerted on nearby structures, unforeseen weight loss and lack of appetite are common, digestive problems may occur if the cancer blocks the pancreas duct that joins the common bile duct, blood clots may appear, pancreatitis is an inflammation of the pancreas that may be due to pancreatic cancer, especially in the older people.

Radiological Examination: When pancreatic cancer is suspected, the first step is an abdominal ultrasound. For a better evaluation an endoscopic ultrasound, a multiple detector computed tomography (MDCT); and magnetic resonance imaging (MRI) combined with magnetic resonance cholangiopancreatography (MRCP) have high sensitivity not only to detect cancer, but also to have more information about the pancreatic and bile ducts.

Lab Tests: CA 19.9 is a carbohydrate that can be product of cancer cells of the pancreas and is found in the blood, so some patients with pancreatic cancer may have high concentrations of CA 19.9 (tumor marker), although others may not do it.

Histopathological Examination: It consists in the laboratory examination of the tumor cells by means of the extraction of a sample of the tumor (a biopsy).

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Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: June 7, 2018

This article does not provide medical advice. See disclaimer

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