Pancreatic cancer is a cancer that begins in the pancreas. The most common type of pancreatic cancer is called ductal adenocarcinoma. There are more rare types of pancreatic cancer but over 90% are adenocarcinomas. Adenocarcinomas of the pancreas most often start in the ducts of the pancreas. Adenocarcinomas can also start in the cells that make pancreatic enzymes.1,2,3
In the United States, the average lifetime risk for pancreatic cancer is 1.6%.4 Almost ninety percent of the cases are diagnosed after the age of 55, and diagnoses are slightly more common in men than women.4
General Risk Factors
- Chronic pancreatitis (long-term inflammation of the pancreas)
- Cirrhosis (condition where scar tissue has replaced damaged liver tissue)
- Type 2 diabetes
- Helicobacter pylori (a bacterium that can cause stomach inflammation and ulcers)
- Exposure to certain chemicals (pesticides, dyes, and chemicals that may be used in metal refining)
- Family history of cancer – having family members with pancreatic cancer raises the risk of pancreatic cancer, even in absence of a known hereditary cause
- Diagnosis of a genetic pancreatic cancer predisposition syndrome
As with the vast majority of cancers, there is no confirmed way to completely prevent the development of pancreatic cancer. Eating a diet high in fresh fruits and vegetables and exercising in order to maintain a healthy weight are general good health habits.
Symptoms of pancreatic cancer can include yellowing of the skin and eyes, darkening of the urine, itching, clay-colored stool, upper abdominal or upper back pain, blood clots, indigestion, floating stools with a bad odor and unusual color, weakness, loss of appetite, nausea and vomiting, chills, fever, and unexplained weight loss. Many of these symptoms can be due to the obstruction of the bile duct, which often occurs as pancreatic cancer develops. Bile (a liquid released by the liver that helps the body digest fats) moves from the liver to the gallbladder and small intestine through the bile duct.
In the United States, there is no standard or routine screening test for pancreatic cancer in the general population. If your doctor considers you to be at a higher risk than the average person for pancreatic cancer due to any of the risk factors mentioned above, including a hereditary cancer syndrome, or if you are experiencing any of the symptoms mentioned above, he or she may recommend that you undergo certain screening or diagnostic tests, which can include an endoscopic ultrasound (EUS) or a MRI/magnetic resonance cholangiopancreatography (MRCP). During an EUS a doctor can use an endoscope, a small lighted tube with a camera on the end, to view parts of the gastrointestinal tract including the stomach and beginning of the small intestine in order to take a picture of the pancreas. Biopsies (tissue samples) can be taken during this exam if needed. MRCP is used to view the bile ducts and pancreatic ducts. Biopsies can be taken during this procedure too. Other screening tests can include additional imaging exams and blood tests.
If pancreatic cancer is diagnosed following any of the tests above, treatment will depend on the stage of the cancer (how far the cancer has grown or spread). Treatment can include some combination of surgery, radiation therapy, chemotherapy, immunotherapy and targeted therapy.
AVOID THE FOLLOWING
- Being very overweight; having too much body fat
- A diet high in fatty foods, red meat, pork, and processed meat – some studies have suggested these types of foods increase the risk for pancreatic cancer, but others have not
Heavy Alcohol Intake
- Some studies have suggested an increased risk for pancreatic cancer associated with heavy alcohol intake, but this link is still uncertain. Heavy alcohol intake does increase the risk for chronic pancreatitis and cirrhosis, which are risk factors for pancreatic cancer.
Associated SyndromesHBOC SyndromeLynch SyndromeFamilial Adenomatous Plyposis (FAP)/Attenuated FAP (AFAP)Melanoma-Pancreatic Cancer SyndromeMelanoma Cancer SyndromeLi-Fraumeni SyndromePeutz-Jeghers SyndromeJuvenile Polyposis Syndrome Juvenile Polyposis Syndrome & Hereditary Hemorrhagic TelangiectasiaPALB2-associated Cancer RiskATM-associated Cancer Risk
- American Society of Clinical Oncology: Pancreatic Cancer (http://www.cancer.net/cancer-types/pancreatic-cancer)
- American Cancer Society: Pancreatic Cancer (http://www.cancer.org/cancer/pancreaticcancer/index)
- National Cancer Institute: Pancreatic Cancer treatment (http://www.cancer.gov/cancertopics/pdq/treatment/pancreatic/Patient)
- SEER Cancer Stat Facts: Pancreatic Cancer. National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/statfacts/html/pancreas.html
- van Lier MG, et al. High cancer risk in Peutz-Jeghers syndrome: a systematic review and surveillance recommendations. Am J Gastroenterol. 2010 105:1258-64.