Pancreatic cancer occurs within the tissues of the pancreas, a vital organ that is located behind the stomach. The pancreas plays an essential role in digestion by producing enzymes that the body needs to digest fats, carbohydrates, and proteins. The pancreas also produces two important hormones that are responsible for controlling glucose (sugar) metabolism. Insulin is a hormone that helps cell metabolize glucose to make energy and glucagon, which helps raise glucose levels when they are too low.
Due to the location of the pancreas, this type of cancer may be difficult to detect and is often diagnosed in more advanced stages of the disease. According to the National Institutes of Health, this type of cancer is the fourth-leading cause of cancer-related fatalities in the United States (NIH, 2012) .
The cause of pancreatic cancer is unknown. This type of cancer occurs when abnormal cells begin to grow within the pancreas and form tumors. Normally, healthy cells grow and die in moderate numbers. In the case of cancer, there is an increased amount of abnormal cell production, and these cells eventually take over the healthy cells.
While the cause of this type of cancer is unknown, there are certain risk factors that may increase your chances of developing pancreatic cancer. According to the American Cancer Society (ACS), you may be at an increased risk if you:
- smoke cigarettes—30 percent of cancer cases are related to cigarette smoking
- are obese
- don’t exercise regularly
- eat few fruits and vegetables
- eat diets high in fat content
- drink heavy amounts of alcohol
- have diabetes
- work with pesticides and chemicals
- have chronic inflammation of pancreas
- have liver damage
- are African American
- have a family history of pancreatic cancer or certain genetic disorders that have been linked to this type of cancer (ACS, 2011)
Pancreatic cancer often doesn’t exhibit symptoms until it reaches the advanced stages of the disease. Some of the most common symptoms can be subtle, and they include:
- loss of appetite
- unintentional weight loss
- abdominal and lower back pain
- blood clots
- jaundice (yellow skin and eyes)
Early diagnosis significantly increases the chances of recovery. That’s why it is best to visit a doctor if you are experiencing any symptoms that won’t go away or recur regularly.
To make a diagnosis, the doctor will review an individual’s symptoms and medical history, and will perform one or more tests to check for pancreatic cancer such as:
- computerized tomography (CT) or magnetic resonance imaging (MRI) scans to get a complete and detailed image of the pancreas
- an endoscopic ultrasound (use of high frequency sound waves), in which a thin, flexible tube with a camera attached in inserted down into the stomach to obtain images of the pancreas
- biopsy of a tissue sample from the pancreas
- certain blood tests can also detect if the tumor marker CA 19-9 is present, which can indicate pancreatic cancer
Once a diagnosis has been made, the doctor will assign a stage based on the test results:
- Stage I: tumors exist in the pancreas only
- Stage II: tumors have spread to nearby abdominal tissues or lymph nodes
- Stage III: the cancer has spread to major blood vessels and lymph nodes
- Stage IV: tumors have spread to other organs, such as the liver
Treatment depends on the stage of cancer. Treatment has two goals: to kill cancerous cells and to prevent the spread of the disease.
If the tumor has remained confined to the pancreas, surgery may be recommended—a final call on whether surgery is an option will be based on the exact location of the cancer. If the tumor is confined to the head and neck of the pancreas, a procedure called the Whipple procedure (pancreaticoduodenectomy) can be done. In this procedure, the first part (the “head”) of the pancreas and about 20 percent of the “body” are removed, as are the bottom half of the bile duct and the first part of the intestine. In a modified version of this surgery, a part of the stomach is removed.
However, other treatment measures must be explored once the cancer spreads outside of the pancreas. Radiation therapy utilizes X-rays and other high-energy beams to kill the cancer cells.
In some cases, your doctor might combine this treatment with chemo, which uses cancer-killing drugs to help prevent future growth of cancer cells.
Cancer is frightening and many patients combine alternative measures with medical treatment. Be sure to consult your doctor before beginning alternative therapies as these measures may interfere with medications that have been prescribed.
Yoga, meditation, and light exercise might promote a sense of well-being and make you feel better during treatment
Pancreatic cancer that spreads may worsen preexisting symptoms. Some patients may begin to feel symptoms for the first time. Weight loss, bowel obstruction, abdominal pain, and jaundice are among the most common complications during pancreatic cancer treatment.
Pancreatic cancer is one of the most deadly forms of cancer—unfortunately, many patients don’t receive a diagnosis until it has spread outside of the pancreas. Follow all your doctor’s recommendations to help improve your chances of recovery and survival. You may also consider:
- pancreatic enzyme supplements to improve digestion
- pain medications
- regular follow-up care, even if the cancer is successfully removed
Written by: Kristeen Moore
Published on Aug 07, 2012
Updated on Feb 15, 2013
Medically reviewed by Brenda B. Spriggs, MD, MPH, FACP