Pancreatic Cancer

Pancreatic cancer is a serious disease that occurs when cancerous cells first form in the tissues of the pancreas. It is not yet known what causes pancreatic cancer; however, risk factors for the disease include cigarette smoking and having diabetes. In most cases, there are no early symptoms of the cancer. When symptoms of pancreatic cancer develop, they may include jaundice, unexplained weight loss, and fatigue. At this time, pancreatic cancer can be cured only when it is found at an early stage and only if the patient is healthy enough to have surgery.

 

What Is Pancreatic Cancer?

Pancreatic cancer is a disease in which cancer cells first form in the tissues of the pancreas.
 

Pancreatic Cancer: Understanding the Pancreas

The pancreas is a gland that is about 6 inches long and is shaped like a thin pear lying on its side. The wider end of the pancreas is called the head, the middle section is called the body, and the narrow end is called the tail. The pancreas lies behind the stomach and in front of the spine.
 
The pancreas has two main jobs in the body. The first job is to produce juices that help digest (break down) food. The second job is to produce hormones, such as insulin and glucagon, which help control blood sugar levels. Both of these hormones help the body use and store energy that it gets from food. The digestive juices are produced by exocrine pancreas cells, and the hormones are produced by endocrine pancreas cells.
 

Types of Pancreatic Cancer

Approximately 95 percent of pancreatic cancer cases begin in the ducts that carry pancreatic juices (exocrine cells). Pancreatic cancer is also called cancer of the pancreas or carcinoma of the pancreas.
 
A rare type of pancreatic cancer may begin in the cells that make insulin and other hormones. This type of cancer is called pancreatic islet cell cancer.
 
(Click Pancreatic Islet Cell Cancer for more information about this rare form of pancreatic cancer.)
 
For the remainder of this article, the term "pancreatic cancer" refers to cancer that begins in the ducts that carry pancreatic juices (exocrine cells).
 
When pancreatic cancer spreads (metastasizes) outside the pancreas, cancer cells are often found in nearby lymph nodes. If the cancer has reached these lymph nodes, it means that cancer cells may have spread to other lymph nodes or tissues in the abdomen, liver, or lungs.
 
When cancer spreads from its place of origin to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary tumor. For example, if pancreatic cancer spreads to the liver, the cancer cells in the liver are pancreatic cancer cells. The disease is metastatic pancreatic cancer, not liver cancer, and it will be treated as pancreatic cancer.
 

Pancreatic Cancer: Causes and Risk Factors

No one knows the exact cause of pancreatic cancer. Doctors can seldom explain why one person will get pancreatic cancer and another person will not. However, it is clear that this disease is not contagious.
 
Pancreatic cancer research has shown that people with certain risk factors are more likely than others to develop pancreatic cancer. A risk factor is anything that increases a person's chance of developing a disease.
 
Examples of risk factors for pancreatic cancer include:
 
 
(Click Pancreatic Cancer Causes for more information about risk factors for pancreatic cancer.)
 

Signs and Symptoms of Pancreatic Cancer

Possible pancreatic cancer symptoms include:
 
  • Jaundice (yellowing of the skin and whites of the eyes)
  • Pain in the upper or middle abdomen and back
  • Unexplained weight loss
  • Loss of appetite
  • Fatigue.
 
These possible symptoms of pancreatic cancer are not sure signs of the disease. Other pancreatic diseases and health problems can also cause these symptoms. People with possible symptoms of pancreatic cancer should see a doctor as soon as possible -- only a doctor can diagnose and treat the problem.
 
(Click Pancreatic Cancer Symptoms for more information about the symptoms of pancreatic cancer.)
 

Diagnosing Pancreatic Cancer

Pancreatic cancer is difficult to detect and diagnose for the following reasons:
 
  • There are usually no noticeable signs or symptoms of the disease in the early stages of pancreatic cancer
 
  • The signs of pancreatic cancer, when present, are similar to those of many other illnesses
 
  • The pancreas is hidden behind other organs (such as the stomach, small intestine, liver, gallbladder, spleen, and bile ducts).
 
If a person has possible symptoms of pancreatic cancer, doctors will typically need to perform a physical exam, ask about the patient's personal and family medical history, and recommend additional tests and procedures. This will help the doctor to make a pancreatic cancer diagnosis.
 
Exams and tests used to make a pancreatic cancer diagnosis may include:
 
  • Lab tests
  • Computed tomography (CT) scan
  • Ultrasound
  • Endoscopic retrograde cholangiopancreatography (ERCP)
  • Percutaneous transhepatic cholangiography (PTC)
  • Biopsy.
 
After the doctor makes a pancreatic cancer diagnosis, he or she will need to know the stage, or extent, of the disease in order to plan the best treatment. Pancreatic cancer staging is a careful attempt to find out the size of the tumor, whether the cancer has spread, and if so, to what parts of the body.
 
(Click Pancreatic Cancer Diagnosis for more information.)
 

Pancreatic Cancer: Staging

Tests and procedures that are used to stage pancreatic cancer are usually done at the same time as a pancreatic diagnosis.
 
Specific stages of pancreatic cancer include:
 
  • Stage 0 (carcinoma in situ)
  • Stage I
  • Stage II
  • Stage III
  • Stage IV
  • Recurrent.
 
(Click Stages of Pancreatic Cancer for more information.)
 

Treatment of Pancreatic Cancer

At this time, pancreatic cancer can only be cured if the cancer is found at an early stage (before it has spread) and only if the patient is healthy enough to have surgery. However, pancreatic cancer treatment other than surgery may be able to control the disease and help patients live longer and feel better.
 
When a pancreatic cancer cure or treatment of the disease is not possible, some patients and their doctors choose palliative therapy. Palliative therapy is used to improve the quality of a person's life by controlling pain and other problems caused by the disease, but it will not cure the cancer
 
Factors that may influence the treatment for pancreatic cancer include:
 
  • The stage of the cancer (see Stages of Pancreatic Cancer)
  • The location where the tumor started
  • Whether the cancer has spread outside the pancreas
  • The patient's age and general health.
 
In general, pancreatic cancer treatments include:
 
 
Treatment of pancreatic cancer generally begins a few weeks after the diagnosis, which will give the patient time to talk with his or her doctor about treatment choices, get a second opinion, and learn more about the disease.
 
(Click Pancreatic Cancer Treatment for more information about the treatment of pancreatic cancer.)
 

Pancreatic Cancer: Prognosis

The pancreatic cancer prognosis will depend on factors such as the following:
 
  • Whether or not the tumor can be removed by surgery
 
  • The stage of the cancer (the size of the tumor and whether the cancer has spread outside the pancreas to nearby tissues or lymph nodes or to other places in the body)
 
  • The patient's general health
 
  • Whether the cancer has just been diagnosed or whether the cancer has recurred.
 
(Click Pancreatic Cancer Prognosis for more information.)
 

Statistics Concerning Pancreatic Cancer

The American Cancer Society (ACS) predicted that 33,730 Americans (17,150 men and 16,580 women) would be diagnosed with pancreatic cancer in 2006. The ACS also estimated that 32,300 American men and women would die of pancreatic cancer in that same year. The overall five-year relative pancreatic cancer survival rate for 1995-2001 was 4.6 percent.
 
(Click Pancreatic Cancer Statistics for more statistics on pancreatic cancer.)
 

Pancreatic Cancer: Summary

Key information about pancreatic cancer includes the following:
 
  • Pancreatic cancer is a disease in which malignant (cancer) cells form in the tissues of the pancreas
 
  • Smoking can affect a person's risk of developing pancreatic cancer.
 
  • Possible signs of pancreatic cancer may include jaundice, pain, and weight loss
 
  • Pancreatic cancer is difficult to find and diagnose early
 
  • Lab tests, CT scans, and ultrasounds are some of the tests that are used to detect, diagnose, and stage pancreatic cancer
 
  • Some of the factors that affect prognosis (chance of recovery) and treatment options for pancreatic cancer include the stage of the disease and the patient's general health.
Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD