Pancreatic cancer
Pancreatic cancer is cancer of the pancreas, an organ in your abdomen that helps with digestion. Pancreatic cancer starts as a growth of cells in the pancreas that eventually changes or multiplies into a tumor.1
Types of pancreatic cancer
The pancreas is mainly made up of exocrine cells. Exocrine glands make proteins that help you digest food.1 The pancreas also has endocrine cells that make hormones like insulin and glucagon, which help control blood sugar levels.2
Because of these two cell types, pancreatic cancer can either be exocrine cancer (also known as adenocarcinoma) or endocrine cancer. Each type has different signs, symptoms, risk factors, causes and outlooks. They are also diagnosed and treated differently.1
Exocrine cancers (pancreatic adenocarcinoma)
Exocrine cancers are the most common type of pancreatic cancer. More than 95% of exocrine pancreatic cancers are pancreatic adenocarcinoma. These cancers usually start in the ducts of the pancreas. Other types of exocrine cancers exist, but they’re less common.1,2
Endocrine cancers
When cancer starts in the hormone-producing cells of the pancreas, it is called a pancreatic neuroendocrine tumor (also known as NETs or islet cell tumors). It is much less common than adenocarcinoma.3
Pancreatic cancer symptoms
Pancreatic cancer often doesn’t show symptoms in early stages. Unfortunately, most people with pancreatic cancer don’t notice symptoms until the cancer is more advanced.
When symptoms begin, they can include:4
Symptoms of pancreatic neuroendocrine tumors (the less common form of pancreatic cancer) can vary, but often include jaundice in early stages, along with diarrhea.3
How is pancreatic cancer diagnosed?
Pancreatic cancer is difficult to diagnosis because it’s not an organ your doctor can feel during routine checkups. Pancreatic tumors are also difficult to see on imaging tests. If your doctor suspects pancreatic cancer, they may recommend the following tests:2
Imaging tests
Common imaging tests include:5
- Computed tomography (CT) scan: This is a type of X-ray test that shows the pancreas, may show if the cancer has spread to other parts of your body and help you and your doctor decide what treatment may be best.
- Magnetic resonance imaging (MRI) scan: Provides more detailed images of your body. Your doctor may recommend an MRI if they want to see smaller, distant spots in the liver, for example.
- Ultrasound test: Creates images of the pancreas by using sound waves.
- Cholangiopancreatography: Checks to see if the pancreatic ducts and bile ducts are blocked, narrowed or dilated. This is especially helpful if you have a pancreatic tumor that is blocking a duct.
- Positron emission tomography (PET) scan: Used to find possible areas where cancer has spread. A safe, radioactive sugar solution is injected into your veins to find cancer cells. During the scan, a camera creates pictures of any radioactivity (cancer cells) in your body.
Blood tests
There are many blood tests that can help with the diagnosis and management of pancreatic cancer. They include:5
- Liver function tests: Used when people have jaundice, one of the first signs of pancreatic cancer. Liver function tests can help tell if jaundice is caused by disease in the liver itself or by a bile flow blockage.
- Tumor marker tests: People with cancer have substances in their blood known as tumor markers. Tumor marker tests may be helpful in finding pancreatic cancer, but they are not enough to fully tell if cancer is present.
- Other blood tests: Complete blood count (CBC) or chemistry panels help check a person’s general health and determine if they’re a good candidate for surgery.
Pancreatic cancer treatments
Although pancreatic cancer has a low survival rate, complete remission is possible with early detection and treatment. Pancreatic cancer treatment varies based on the tumor’s location and stage, your overall health and whether the cancer has spread.
Pancreatic cancer treatments include:2
Surgery
The most common way to treat pancreatic cancer is by removing the cancer with surgery. This may involve removing part or all of your pancreas. Surgery is typically recommended when the cancer is only in the pancreas, and your doctor is sure they can remove it all.
Chemotherapy
Chemotherapy drugs kill cancer cells. It may be helpful when pancreatic cancer has spread. It can also be used to shrink the tumor before surgery or to remove any lingering cancer cells after surgery.
Radiation therapy
A common approach to treating pancreatic cancer is radiation therapy, which uses high-energy X-rays to kill cancer cells. It’s also common to combine radiation and chemotherapy before surgery, after surgery or during treatment.
Targeted therapy
Targeted therapy uses medications to target the proteins that control how cancer cells grow and spread in your body. Targeted therapy can be combined with other treatments.
Immunotherapy
Immunotherapy helps your body’s immune system recognize and attack cancer cells. While not effective for most pancreatic cancers, it may be used in rare cases where the tumor has specific genetic changes, such as high microsatellite instability (MSI-H) or mismatch repair deficiency (MMR).6
Can I prevent pancreatic cancer?
Pancreatic cancer cannot be prevented, but there are lifestyle changes you can make that may help lower your risk.7
- Quit smoking
- Limit alcohol
- Avoid red meat and sugar
- Eat fruits, vegetables and whole grains
- Limit exposure to harsh chemicals
- Maintain a healthy weight for your body
Pancreatic cancer risk factors
Common risk factors for pancreatic cancer include:2
- Smoking
- History of diabetes
- Obesity
- Pancreatitis or family history of pancreatic cancer
- Family history of hereditary conditions that can increase cancer risk, like Lynch syndrome and familial atypical multiple-mole melanoma (FAMMM) syndrome
Who should I see if I’m concerned about pancreatic cancer?
If you have a family history of pancreatic cancer, it’s important to talk to your doctor and determine how you should be monitored and any symptoms to look for. Your doctor can refer you to specialists and help you with next steps.