Pancreatic Cancer

What is Pancreatic Cancer?

The pancreas is a gland that is located deep in the abdomen, against the spine. Its job is to aid in food digestion and help maintain blood sugar levels.

Pancreatic cancer is diagnosed in more than 29,000 people in the United States every year. Most pancreatic cancers occur in people over the age of 55. This cancer is seldom caught early because the signs and symptoms often do not appear until the disease is advanced.

Risk Factors

Research is improving our understanding of pancreatic cancer and its causes. The following are known risk factors for the disease:

  • Age/Gender - Most people who are diagnosed with pancreatic cancer are 55 or older. It is more common in men than women.
  • Being Overweight - Overweight people are more likely to develop pancreatic cancer.
  • Chronic Pancreatitis - Long-term swelling of the pancreas is linked with a slightly higher risk of pancreatic cancer.
  • Cirrhosis of the Liver - People who have cirrhosis, the scarring of the liver, may have an increased risk of pancreatic cancer.
  • Diabetes - Pancreatic cancer is more common among people with type 2 diabetes. Diabetes can also be a symptom of pancreatic cancer.
  • Family History - Pancreatic cancer can run in families.
  • Stomach Issues - Having too much stomach acid or bacteria (H. pylori) in the stomach may increase your risk of pancreatic cancer.
  • Tobacco Products - Smoking accounts for nearly 30% of pancreatic cancer cases. People who use smokeless (spit or chew) tobacco are also more likely to get pancreatic cancer.
  • Work Exposure to Chemicals - Exposure at work to certain pesticides, dyes, and chemicals may increase your risk pancreatic cancer. 

Signs and Symptoms

Pancreatic Cancer is very difficult to diagnose in its early stages. As it develops, the following symptoms may appear:

  • Blood Clots - Blood clots may form in the veins or fatty tissue under the skin. They can travel to the lungs and cause breathing problems.
  • Diabetes - Pancreatic cancer can interfere with blood sugar levels.
  • Digestive Abnormalities - Stools might be pale, bulky, greasy and float in the toilet. Other problems may include nausea, vomiting and pain that gets worse after eating.
  • Jaundice - A yellow color in the eyes and skin is called jaundice. It is caused by a build-up of a substance (bilirubin) that is made in the liver. At least half of all people with pancreatic cancer have jaundice.
  • Pain - Pain in the abdomen or in the middle of the back is a common sign of advanced pancreatic cancer.
  • Swollen Gallbladder - During an exam, your doctor may find that the gallbladder is enlarged.
  • Weight Loss - Weight loss is a very common symptom.

Diagnosis

Pancreatic cancer is sometimes referred to as a “silent disease” because its symptoms are usually not noticed until it is advanced. If symptoms are seen, a doctor may perform one or more of the following procedures:

  • Physical Exam - A doctor examines the skin and eyes for signs of jaundice (yellow color) and feels the abdomen, looking for abnormalities near the pancreas, liver and gallbladder.
  • Lab Test - Samples of blood, urine and stool are checked for bilirubin and other substances. High bilirubin levels may suggest a blockage that could be caused by cancer or another condition.
  • CT Scan - An x-ray machine takes detailed pictures of the pancreas and surrounding organs and blood vessels.
  • Ultrasound - Sound waves and a computer are used to create a picture of the pancreas and surrounding organs.
  • ERCP (Endoscopic Retrograde Cholangiopancreatography) - An endoscope is passed through the mouth and stomach into the small intestine. A tube injects a dye through the endoscope into the bile and pancreatic ducts. The dye shows up on x-rays and can reveal blockages, which may be caused by tumors.
  • PTC (Percutaneous Transhepatic Cholangiography) - A dye injected into the liver and x-rays are used to highlight blockages caused by tumors.
  • Biopsy - A pathologist looks at a sample of tissue from the pancreas under a microscope to check for cancer cells.

Helpful Questions to Ask Your Health Care Team About Diagnostic Procedures:

  • Why is this procedure being used?
  • What can I expect to happen during this procedure?
  • What should I do to prepare for this procedure?
  • What can I expect after the procedure?
  • What complications can occur with this procedure?
  • How does this procedure compare to other ways to diagnose pancreatic cancer?
  • Where do I go for this procedure?

Stages

If pancreatic cancer is diagnosed, the doctor needs to know the stage, or extent, of the disease to determine the best treatment. Staging is used to find out whether the cancer has spread, and if so, to which parts of the body. If your cancer spreads to the bone, visit our bone metastases page.

In stage 0, cancer cells are found in the lining of the pancreas. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.

In stage I, cancer is found in the pancreas only. Stage I is divided into stage IA and stage IB, based on the size of the tumor:

  • Stage IA: The tumor is 2 centimeters or smaller.
  • Stage IB: The tumor is larger than 2 centimeters.

In stage II, the cancer may have spread to nearby tissue, organs or the lymph nodes near the pancreas. Stage II is divided into stage IIA and stage IIB, based on where the cancer has spread:

  • Stage IIA: Cancer has spread to nearby tissue and organs but not nearby lymph nodes.
  • Stage IIB: Cancer has spread to nearby lymph nodes and may have spread to nearby tissue and organs.

In stage III, the cancer has spread to the major blood vessels near the pancreas and possibly nearby lymph nodes.

In stage IV, the cancer has spread to distant organs, such as the liver, lung, and peritoneal cavity.