Pancreatic cancer at a glance
- Pancreatic cancer occurs when cells grow abnormally in the pancreas, an organ that aids digestion and sugar metabolism.
- Pancreatic cancer, which most often occurs in the ducts, accounts for only 2 percent of all cancers, although it has a poor survival rate.
- There is no known cause for the disease, although obesity, smoking, diabetes, heavy alcohol consumption and family history may all be contributing factors.
- There are few symptoms in the early stages of pancreatic cancer, making it difficult to detect.
- Treatment depends on the patient and stage of the disease. Surgery called the Whipple procedure is a common therapy. Chemotherapy, radiation and radiosurgery may also be options.
What is pancreatic cancer?
The pancreas is a pear-shaped organ about six inches long located in a horizontal position behind the stomach. Its produces hormones that help process sugars and enzymes that help digestion.
Pancreatic cancer is the abnormal growth of cells that results in a tumor in this organ. If these cells originated in the pancreas, it is considered a primary pancreatic tumor. Tumors can be either cancerous or benign.
There are two kinds of pancreatic cancer. Most tumors begin in the ducts of the pancreas and are called adenocarcinomas, referring to a category of cancer that occurs in mucus-secreting glands throughout the body.
The second kind of pancreatic cancer forms in the hormone-producing cells of the pancreas. This type – islet cell cancer, or pancreatic endocrine cancer – is much rarer, occurring in only about one in 20 cases of pancreatic cancer.
Pancreatic cancer generally brings a poor prognosis. Left untreated, median survival is about four months. Although only 2 percent of cancers in the United States are pancreatic, it is the fourth leading killer among all cancers. The low cure is due, in part, to the fact that a large proportion of pancreatic cancers are first detected in the advanced stages.
What is the cause of pancreatic cancer?
There are no clear causes for pancreatic cancer. However, there are broad risk factors. Men suffer the disease at a slightly higher rate than women. Risk also generally increases after age 55. Other risk factors include:
- Being overweight or obese
- Pancreatitis (chronic inflammation of the pancreas)
- Race – African-Americans are more likely to develop the disease than members of other races
- Family history, including genetic syndromes such as Lynch syndrome (an inherited disorder that increases the risk of cancer in general), the BRCA2 gene mutation (a so-called “cancer gene” mutation associated with breast and ovarian cancers), and a type of skin cancer called familial atypical mole-malignant melanoma (FAMMM).
Other possible factors include cirrhosis of the liver; stomach problems; heavy exposure to certain pesticides, dyes and chemicals; a diet rich in red meat and processed foods such as bacon and sausage; and heavy alcohol use.
Despite a lack of complete understanding of the causes of pancreatic cancer, doctors and scientists do know that the disease is associated with mutations of DNA (deoxyribonucleic acid) in the cells of the pancreas. Changes in the DNA are called mutations, which affect health differently depending on where they occur and whether they alter the function of essential proteins.
Mutations can be passed down from parents, or they may occur through natural development. In the case of pancreatic cancer, the mutations cause cells to grow uncontrollably and live much longer than usual.
Pancreatic cancer generally does not cause symptoms early in its development. And the symptoms are usually slight and/or vague. They may start with a pain in the back or abdomen, jaundice (yellowing of the skin), fatigue and weight loss.
The pancreas’ location behind other organs also make the disease difficult to detect. Doctors cannot see or feel tumors during routine exams but can detect them only through blood tests, imaging tests, a biopsy and a physical exam.
However, blood tests alone cannot confirm pancreatic cancer. Imaging procedures that may help in a diagnosis include magnetic resonance imaging (MRI) scans, computed tomography (CT) scans, ultrasound and positron emission tomography-CT (PET-CT) scans.
For patients who are not surgical candidates, a biopsy can determine the nature of the cancer. Doctors then determine the “stage” – or extent of the disease – by establishing how big the tumor is and how much it has spread.