Overview
Pancreatic cancer begins in the pancreas, a roughly fish-shaped organ about six inches long that sits below and behind the lower part of your stomach. The pancreas is responsible for creating enzymes that help digest certain foods, like fats, by releasing these enzymes into the digestive tract through the pancreatic duct and then the bile duct. It is also responsible for creating the hormones insulin and glucagon that regulate blood sugar and releasing them directly into the bloodstream.
There are two main types of pancreatic cancer: exocrine cancer, which usually starts in the ducts that release digestive enzymes into the intestine, and endocrine cancer, which starts in the endocrine cells that control blood sugar. Exocrine cancer, or adenocarcinoma of the pancreas, is far more common than endocrine cancer, or Pancreatic Neuroendocrine Tumors. More than 90 percent of all pancreatic cancer is adenocarcinoma of the pancreas.
Knowing which type of pancreatic cancer you have is important as each type responds differently to treatment and has different symptoms. Neuroendocrine tumors, or islet cell tumors, which make up about seven percent of pancreatic cancers, typically have a better prognosis than most exocrine pancreatic cancers.
Pancreatic cancer is the fourth leading cause of cancer deaths in the United States. It’s estimated that around 60,000 adults will be diagnosed, and 48,000 of those will die from the disease this year. Although treatable if detected at an early stage, most pancreatic cancer is not detected until it has reached a late stage or spread to other parts of the body due to the lack of symptoms. Also, there is no standard test to diagnose pancreatic cancer.
Almost all pancreatic cancer patients are over the age of 65. The average age at diagnosis is 70.
Symptoms
The symptoms of pancreatic cancer include:
- Pain
- Unexplained weight loss
- Loss of appetite
- Jaundice
- Nausea
- Swelling of the pancreas (pancreatitis)
- Recent-onset diabetes
- Fatigue
- Bloating
- Fever
Causes
The exact cause of pancreatic cancer is unknown. Cancer occurs when the DNA inside the cells of an organ mutate as they divide, either through an acquired or inherited mutation. This mutation tells the cells to continue to divide rapidly and spread, which can create either a benign tumor or a malignant cancerous tumor.
Risk Factors
Although the exact cause of pancreatic cancer is unknown, there are several known risk factors, such as:
- Smoking cigarettes is known to cause a variety of cancers, including pancreatic cancer. People who smoke are twice as likely to develop pancreatic cancer as those who don’t smoke.
- Most pancreatic cancer patients are over the age of 60. The chances of developing cancer continue to increase as we age.
- People with recent-onset diabetes or who have had type 2 diabetes for more than five years are at higher risk of developing pancreatic cancer.
- People who are obese are 20 percent more likely to develop pancreatic cancer than those with a normal weight. Even those with extra fat around the abdomen may be at higher risk, even if they are not considered overweight or obese.
- A diet high in fats and sugars can be a risk factor for pancreatic cancer, as well as heavy consumption of alcohol.
- Family history of the disease. If your parents, siblings, or relatives have had pancreatic cancer in the past, you’re at higher risk for developing the disease.
- Chronic pancreatitis. Some research has shown that having a chronically inflamed or swollen pancreas can increase your risk of developing cancer.
- Men are more likely to develop pancreatic cancer than women.
- For reasons that aren’t clear, African Americans are at higher risk for pancreatic cancer than whites.
- Inherited mutations. Certain inherited genetic mutations, such as familial pancreatitis or hereditary breast cancer, can increase the risk of pancreatic cancer.
Survival Rates
According to the SEER database maintained by the National Cancer Institute, the combined relative five-year survival rate for pancreatic cancer is ten percent.
SEER stands for Surveillance, Epidemiology, and End Results. The SEER database groups pancreatic cancer into three stages:
Localized: The cancer has remained inside the pancreas and has not spread to other parts of the body. The relative five-year survival rate for this stage is 39 percent.
Regional: The cancer has spread from the pancreas to nearby structures and lymph nodes. The relative five-year survival rate for this stage is 13 percent.
Distant. The cancer has spread from the pancreas to other organs, bones, or the brain. The relative five-year survival rate for this stage is three percent.
Diagnosing pancreatic cancer can be hard as the pancreas is difficult to reach, and cancers inside the organ tend to be more spread out. Your doctor might recommend some of the following diagnostic procedures:
Physical exam. Your doctor may check your skin and eye color for jaundice, ask about any pain in your abdomen, or ask about your digestive function.
Blood tests. Your doctor may also test your blood for specific antigens caused by tumors in the pancreas or chemicals that indicate a problem in the organ.
Imaging tests. Your doctor might recommend one of several imaging scans, such as a CT scan (computed tomography), a PET scan (positron emission tomography), or an ultrasound to image the pancreas and reveal any tumors.
Biopsy. A biopsy is the only definitive test for pancreatic cancer. A surgeon will remove a piece of the tissue of your pancreas and look at the cells under a microscope to check for abnormalities.
Treatment for pancreatic cancer can include the following:
- Surgery to remove the tumor or cancerous tissue.
- Radiation therapy, or targeting the tumor with high energy x-rays or other energy types.
- Chemotherapy, or using drugs to destroy cancer cells.
- Immunotherapy, or boosting the body’s immune system to fight the cancer.