Your pancreas, an organ in the stomach that helps with digestion, is impacted by pancreatic cancer. Symptoms of pancreatic cancer include fatigue, yellowing of the skin bloating, feeling sick, and lack of appetite. Surgery, chemotherapy, and radiation therapy are among the treatment options. The low survival rate of pancreatic cancer is attributed to the disease’s difficulty in early detection.
What is pancreatic cancer?
When cells in your pancreas mutate (alter) and proliferate uncontrollably, a tumor is formed, which is known as pancreatic cancer. Located between your stomach and spine in your abdomen, or belly, is a gland called the pancreas. It produces the hormones that regulate blood sugar levels as well as the digestive enzymes.
The pancreatic ducts are where the majority of pancreatic malignancies begin. Your pancreas and common bile duct are connected by the main pancreatic duct, also known as the Wirsung duct.
Imaging tests reveal little about pancreatic cancers in their early stages. Because of this, a lot of patients don’t get diagnosed with cancer until it has spread (metastasized). Additionally, pancreatic cancer is notoriously hard to treat because it is resistant to several popular cancer medications.
The focus of current research is on early detection using novel imaging techniques and genetic testing. But there’s still a lot to discover.
Types of Pancreatic Cancer
There are two main types of pancreatic tumors:
- Exocrine tumors: Over 90% of all pancreatic tumors are exocrine tumors. The most common type of pancreatic cancer is adenocarcinoma, which begins in the cells that line your organs.
- Neuroendocrine tumors: Less than 10% of pancreatic tumors are neuroendocrine tumors (NETs). Islet cell carcinoma is another name for an NET.
How common is Pancreatic Cancer?
Approximately 3% of all cancers in the US are caused by pancreatic cancer. It ranks eighth among cancers in women and those assigned female at birth, and tenth among cancers in males who were assigned male at birth.
Pancreatic cancer cases are increasing. According to trends, by 2030 pancreatic cancer will rank as the second most common cause of cancer-related deaths in the US.
Pancreatic Cancer Symptoms and Causes
Regretfully, pancreatic cancer doesn’t exhibit any early-warning symptoms. Once the tumor begins to affect other organs in your digestive system, symptoms usually start to appear.
Pancreatic cancer symptoms may include:
- Jaundice (yellowing of your skin).
- Dark urine (pee).
- Light-colored stool (poop).
- Upper abdominal pain.
- Middle back pain.
- Fatigue.
- Itchy skin.
- Nausea and vomiting.
- Gas or bloating.
- Lack of appetite.
- Blood clots.
- Weight loss.
- New-onset diabetes.
If you have recently developed diabetes or the condition, a painful condition caused by irritation in the pancreas, your healthcare professional may suspect pancreatic cancer.
Pancreatic endocrine cancer symptoms can differ from those of traditional pancreatic cancer, like weight loss or jaundice. While symptoms can vary, dehydration and vomiting are possible ones.
What causes pancreatic cancer?
There isn’t a clear answer. We don’t know exactly what causes pancreatic cancer. However, experts have identified some risk factors.
Pancreatic cancer risk factors
Something that increases your chances of getting a specific illness is called a risk factor. Typical risk factors for pancreatic cancer include:
- Smoking tobacco products, such as cigars and cigarettes.
- Excessive weight, especially if it’s concentrated around the waist.
- Diabetes, particularly the Type 2 variety. Diabetes that appears suddenly may indicate pancreatic cancer.
- Exposure to specific chemicals, such as petrochemicals and insecticides.
- A persistent inflammation of the pancreas is known as chronic pancreatitis.
- Hereditary chronic pancreatitis is caused by mutations in genes that are inherited from one’s biological parents.
- Gene-related disorders that are inherited from one’s biological parents, such as those caused by mutations in the BRCA1 or BRCA2 genes.
Pancreatic Cancer Diagnosis and Tests
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How is pancreatic cancer diagnosed?
It’s difficult to detect pancreatic cancer in the early stages. This is because healthcare providers can’t feel your pancreas during routine exams and it’s difficult to see these tumors on routine imaging tests.
If your provider suspects pancreatic cancer, they’ll recommend a combination of pancreas function tests, which may include:
Imaging tests
Your healthcare provider may need to take one or more of the following imaging tests:
- CT (computed tomography) scans.
- MRI (magnetic resonance imaging).
- PET (positron emission tomography).
- Endoscopic ultrasound (EUS).
Blood tests
A pancreas blood test can detect tumor markers. A tumor marker is a substance that may indicate the presence of cancer.
For pancreatic cancer, high levels of carbohydrate antigen (CA) 19-9 — a type of protein released by pancreatic cancer cells — might indicate a tumor.
Staging laparoscopy
A laparoscopic procedure is occasionally used by medical professionals to assess the degree of pancreatic cancer and whether excision is feasible.
Your belly will have a few tiny incisions made during this surgery, and a long tube with a camera inserted into the end will be inserted. This gives them the ability to see within your abdomen and search for any anomalies. Frequently, a biopsy will be taken as part of the same treatment.
Genetic testing
Genetic testing should be taken into consideration if you are diagnosed with pancreatic cancer. This may help determine whether your pancreatic cancer was inherited. It can also assist your healthcare professional in deciding on the best course of action for you.
Gene mutations in BRCA1 and BRCA2 have been found in certain cases of pancreatic cancer. Although BRCA1 and BRCA2 are known as the “breast cancer genes,” mutations in these genes may also be indicative of pancreatic, ovarian, and prostate cancers.
You want to think about getting tested genetically if you are a first-degree relative—a parent, child, or sibling of someone who has pancreatic cancer. You can find out from your results whether you have a BRCA1 or BRCA2 gene mutation. Remember that having the mutation does not guarantee that you will develop cancer. But it’s critical to understand your risk.
What characterizes pancreatic cancer that is treatable from that which is not?
Healthcare providers rank pancreatic tumors into four different categories:
- Resectable: The tumor is only in your pancreas and doesn’t involve nearby blood vessels or other organs. A provider can remove it with surgery.
- Borderline resectable: The tumor is in your pancreas and there’s some involvement of nearby blood vessels, but a surgeon can still remove it.
- Locally advanced: The tumor is in your pancreas and has significant involvement of nearby blood vessels. In these cases, surgical removal might be difficult or unsafe.
- Metastatic: The cancer has spread to distant areas in your body, such as your liver, lungs, or abdominal cavity. It has possibly spread to organs, tissues, or lymph nodes near your pancreas.
If you have specific questions about pancreatic cancer staging, talk to your healthcare provider. Understanding your pancreatic cancer diagnosis can help you make an informed decision about your treatment.
Pancreatic Cancer Management and Treatment
Is pancreatic cancer curable?
Considering the dire outcome of pancreatic cancer, full remission can be achieved with early detection and therapy. Complete surgical excision of the cancer is the only possible treatment for pancreatic cancer.
How is pancreatic cancer treated?
Specific treatment depends on certain factors, including:
- The exact location of the tumor.
- What stage is it?
- Your overall health.
- Whether the cancer has spread beyond your pancreas.
Pancreatic cancer treatments include:
Surgery
Surgery is the only realistic way to cure pancreatic cancer. But surgeons only recommend it when they think they can remove all of the cancer. Otherwise, there’s little to no benefit.
For surgery to be successful, the cancer must be completely confined to the pancreas. Even then, total cancer removal may not be possible.
There are a few different surgical techniques, depending on the location and size of the tumor:
Chemotherapy
Chemotherapy uses drugs that kill cancer cells. Healthcare providers give these drugs in pill form or through an IV in your arm.
Providers use chemotherapy as a stand-alone treatment — especially for people with advanced pancreatic cancer. They may also recommend chemotherapy before surgery to shrink the tumor or after surgery to kill any remaining cancer cells.
Radiation therapy
Radiation therapy uses high-energy X-rays to kill cancer cells. Healthcare providers commonly use this approach to treat pancreatic cancer.
Most often, providers combine radiation therapy with chemotherapy (chemoradiation). They may recommend it before surgery, after surgery or as part of your main cancer treatment. Radiation therapy can also help ease pancreatic cancer symptoms in people who don’t qualify for surgery (in cases of advanced cancer).
Targeted therapy
This treatment uses drugs that “target” certain proteins. These proteins control how cancer cells grow and spread. Providers may combine targeted therapy with other treatments like radiation therapy.
Common targeted therapy drugs for pancreatic cancer include:
- Erlotinib.
- Olaparib.
- Larotrectinib.
- Entrectinib.
Pain management
Pancreatic cancer could be very painful as it may involve nearby nerves. Your healthcare provider can help you manage pain with oral medications, anesthesia, or steroid injections.
If you have pancreatic cancer and start to develop severe and persistent pain, tell your healthcare provider. They can find a treatment that will ease your symptoms.
Pancreatic Cancer Prevention
Can I prevent pancreatic cancer?
You can’t prevent pancreatic cancer. But there are things you can do to lower your risk:
- Don’t smoke.
- Limit your alcohol intake.
- Eat lots of fresh fruit, vegetables, and whole grains.
- Reduce your intake of red meat, sugary drinks, and processed foods.
- Limit your exposure to harmful chemicals, such as asbestos, pesticides, and petrochemicals.
- Maintain a weight that’s healthy for you.
Pancreatic cancer screenings
Pancreatic cancer is not typically routinely screened for by medical professionals. However, physicians advise using imaging tests and endoscopy sound waves for monitoring in those who have a predisposition to genes that put them at high risk of developing pancreatic cancer.
Speak with a healthcare professional about your risk of having pancreatic cancer, appropriate screening, and genetic testing if you have parents or siblings who have the disease.
Other Frequently Asked Questions
What are some signs that pancreatic cancer has spread?
As pancreatic cancer progresses, you may develop new symptoms. Advanced pancreatic cancer symptoms may include:
- Abdominal pain.
- Extreme fatigue.
- Unexplained weight loss.
- Jaundice.
- Fluid buildup and swelling in your abdomen (ascites).
A note from Cleveland Clinic
A pancreatic cancer diagnosis has the power to drastically alter one’s life. Your medical professional is available to support you during this challenging period. You may choose to join a pancreatic cancer support group in your area or online. Socializing with like-minded individuals may be uplifting and good for your mental and emotional well-being. You can discuss your feelings with a social worker, therapist, or counselor as well. You and your family can benefit from several useful resources, and remember that knowledge is power.
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