You’re more likely to have pancreatic cancer if you smoke, have diabetes and are obese. But genetics and other factors play a role, too.
Your doctor might treat your cancer with a combination of therapies before surgery if it’s resectable or borderline resectable. This is called neo adjuvant therapy.
If you have a borderline resectable tumor that has involved nearby blood vessels, you might have chemotherapy before the operation.
Symptoms
Pancreatic cancer often doesn’t cause symptoms until it has grown to a large size. When symptoms do appear, they are similar to those of other illnesses and may include jaundice (yellowing of the skin and eyes), pain in the abdomen and back, and weight loss. People with pancreatic cancer often have tumors that block the flow of bile and digestive juices. This can lead to a buildup of fats and proteins in the liver, gallbladder, and spleen. It can also prevent the body from producing enough insulin, which helps control blood sugar levels.
The most common type of pancreatic cancer is adenocarcinoma, which starts in the ducts that drain the pancreas. This accounts for more than 90 percent of all cases. The other type of pancreatic cancer is neuroendocrine cancer, which starts in the hormone-producing cells of the pancreas. These cells produce insulin and other chemicals that regulate glucose, or blood sugar. Neuroendocrine cancer typically affects younger people and is less common than adenocarcinoma.
Because of the way pancreatic cancer develops, it’s hard to diagnose in its early stages. Symptoms of pancreatic cancer usually don’t show until the tumor has reached a large size and spread to other parts of the body. This is why it’s important to get checked by your doctor if you have any new or unusual symptoms, especially abdominal pain or jaundice.
Some people have risk factors that increase their chances of getting pancreatic cancer, such as smoking, having a family history of the disease, or working in certain industries that use pesticides and dyes. But most people who get pancreatic cancer do not have a known risk factor.
Your GP will arrange the first tests to check for pancreatic cancer, or refer you to a specialist, such as a gastroenterologist or surgeon. The specialist will discuss your results with you at what’s called a multidisciplinary team meeting. This includes doctors who specialise in pancreatic cancer, a nurse, and sometimes a dietician. The team will also decide which treatment option is best for you. It might be surgery, chemotherapy, radiation therapy, or targeted therapy.
Diagnosis
Pancreatic cancer is usually diagnosed at a late stage because it takes a long time for symptoms to develop, such as abdominal pain, weight loss and jaundice (yellowing of the skin or eyes). It’s also hard for health care providers to find because the pancreas is hidden behind other organs. A diagnosis of pancreatic cancer is made based on results from tests and scans, including blood work and a biopsy.
A biopsy is when a doctor removes a small sample of tissue from the area that’s suspected of being a tumor and sends it to a lab to be tested. It’s important for a biopsy to be done because cancer cells are different from healthy cells and only a biopsy can confirm a pancreatic cancer diagnosis.
The main types of tumors that affect the pancreas are exocrine cancers and neuroendocrine tumors. Most pancreatic cancers start in the cells that line the ducts of the pancreas. This type is called pancreatic adenocarcinoma. Less than 10% of pancreatic cancers start in the cells of the endocrine system, which produces and releases hormones directly into the bloodstream. This is called pancreatic neuroendocrine tumor (NET).
During an operation, doctors may put in a stent to drain bile that builds up in the ducts when a cancer is blocking them. This can help relieve symptoms such as a swollen abdomen and it can also prevent the pancreatic cancer from spreading to the liver or intestines.
Doctors might also recommend or you might request additional molecular testing of your tumor sample to look for specific mutations or genetic alterations that can affect how the cancer is treated. Some of these tests can be done at your local hospital, but others will need to be sent to a specialty laboratory.
If a diagnosis of pancreatic cancer is made, the doctors will use the results from the imaging and tissue sampling tests to determine how far the cancer has spread (called its stage). This information can help them decide on the best treatment for you. Depending on the results of these tests, you might be treated with surgery, radiation or chemotherapy.
Treatment
A health care team will create a treatment plan based on your diagnosis and how far the cancer has spread. The plan may include surgery, chemotherapy or a combination of these treatments. You’ll need to have some tests from time to time to see how your treatment is working. These are called follow-up tests. They can also show if your cancer has recurred (come back) or if other treatment might be needed.
Pancreatic cancer starts when cells develop changes that make them grow and divide without control or order. These changes are usually harmless, but sometimes they lead to the development of cancer. Cancer cells often form a mass or tumor that can destroy other healthy body tissue. Eventually, these cancer cells can break away from the pancreas and spread to other parts of the body. When they do, these cancer cells can cause symptoms such as pain in the belly or jaundice (yellowing of the skin and whites of the eyes).
If your pancreatic cancer is found at a very early stage, surgery can help prevent or treat it. But, it’s important to understand that only about 10 to 15 percent of pancreatic cancers are diagnosed at a stage when they can be surgically removed. That’s because cancer symptoms, such as belly pain and jaundice, often don’t appear until the tumor has grown to a large size.
The most common type of pancreatic cancer is called adenocarcinoma. It forms from cells that line the surface of the pancreas. These cells are called acinar cells. Acinar cells produce the digestive enzymes that help you digest food and absorb nutrients.
Another common type of pancreatic cancer is called serous or mucinous carcinoma. It forms from the cells that line the ducts that carry bile into and out of the pancreas. This type of cancer can be harder to treat than adenocarcinoma.
Some types of pancreatic cancer may be treated with a combination of therapies such as radiation and chemotherapy in addition to surgery. MD Anderson specialists are leaders in developing new and innovative treatment options for patients with pancreatic cancer, including clinical trials that test ways to combine these therapies.
Prognosis
The outlook (prognosis) for pancreatic cancer depends on many factors, including the type and stage of the tumor at diagnosis. Your doctor will also consider your general health, age and fitness, and your previous medical history. The prognosis for pancreatic cancer is worse when it spreads to nearby tissues or to other parts of the body, such as the liver and lungs.
Cancer develops when cells in your pancreas begin to grow and multiply too quickly. The changes to the DNA, or genetic instructions, of the cells allow them to keep living when healthy cells would die. The extra cells can form a mass of cancerous tissue, called a tumor. Over time, the cancer may spread to other parts of your body through the blood or lymphatic system.
Over 90 percent of pancreatic cancers are exocrine tumors, which start in the cells that line your organs. Less than 10 percent of pancreatic cancers are neuroendocrine tumors, which start in the hormone-producing cells of your pancreas.
If your cancer is resected or removed, your prognosis improves significantly. However, most pancreatic cancers aren’t resectable at the time of diagnosis. The cancer may have already spread at the time of diagnosis or it might be too advanced to be removed surgically.
Your doctor can use radiation and chemotherapy to treat your pancreatic cancer, and they may combine these treatments (chemoradiation). You might also have targeted therapy with drugs that target proteins that control how your cancer cells grow. Examples of these drugs include tyrosine kinase inhibitors, or TKIs, such as erlotinib.
Radiation therapy uses high-energy X-rays to kill cancer cells and shrink tumors. This is often used with other cancer treatments such as surgery and chemotherapy. Chemotherapy is the standard treatment for most patients with pancreatic cancer. This is because it helps decrease the size of a tumor before surgery or radiation and increases the effectiveness of these treatments.
Pancreatic cancer is difficult to treat, and it usually spreads quickly. If you have pancreatic cancer, it’s important to see your doctor as soon as possible.
