Pancreatic Cancer

Pancreatic cancer is the abnormal growth of cells within the pancreas. The pancreas, located directly beneath the stomach, produces several important hormones within the body through its endocrine cells and it releases digestive enzymes that assist digestion and absorption of nutrients in the small intestine through its exocrine cells. Pancreatic cancer disrupts the hormonal function of the pancreas’ endocrine cells and the digestive function of its exocrine cells. Pancreatic cancer makes up around 3% of all cancers in the United States, and it is responsible for around 7% of cancer deaths1.


Credit: American Cancer Society

What different types of pancreatic cancers exist?

There are several types of pancreatic cancer that affect the different cells of this organ. Read more about the types of lung cancer at: http://www.cancerresearchuk.org/cancer-help/type/pancreatic-cancer/about...

What are the symptoms of pancreatic cancer?

Pancreatic cancer is referred to as a “silent” disease due to its tendency to be asymptomatic until its later stages. Depending on location, size and stage of pancreatic cancer, the symptoms may include:

  • Jaundice
  • Weight loss
  • Pain
  • Digestive difficulties
  • Changes in stools
  • Blood clots
  • Diabetes
  • Ascites
  • Pancreatitis
  • Diabetes

How is pancreatic cancer diagnosed?

Physical exams mainly focus on the abdomen to check for any masses or fluid buildup, which could indicate pancreatic cancer. Pancreatic cancer can also spread to lymph nodes; the lymph nodes will be looked at carefully for swelling during a physical examination.

Imaging tests use x-rays, magnets, sound waves, or radioactive chemicals to produce pictures of the inside of the body. For pancreatic cancer, these will include computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, somatostatin receptor scintigraphy, positron emission tomography (PET) scans, endoscopic ultrasounds, and angiography.

Blood tests for pancreatic cancer are used to make diagnoses and determine a patient’s treatment options. These tests may include a CA 19-9 test and CEA test.

Biopsies entail taking a sample of a suspected tumor so it can be examined under the microscope. Biopsies for pancreatic cancer are performed as a last resort and entail surgically removing a pancreatic tissue sample and microscopically examining it for the presence of cancer.

What are the different stages of pancreatic cancer?

The main system used to describe the stages of cancers of the pancreas is the American Joint Committee on Cancer (AJCC) TNM system.

The TNM system for staging contains 3 key pieces of information:

  • T describes the size of the primary tumor(s), measured in centimeters (cm), and whether the cancer has spread within the pancreas or to nearby organs.
  • N describes the spread to nearby (regional) lymph nodes.
  • M indicates whether the cancer has metastasized (spread) to other organs of the body. (The most common sites of pancreatic cancer spread are the liver, lungs, and the peritoneum — the space around the digestive organs.)

What are the treatments for pancreatic cancer?

This pancreatic cancer treatment information does not outline the particular treatment(s) a patient will receive. Rather, it provides general information about the typical treatments used to treat this cancer.

Primary treatment options:

  • Surgery for pancreatic cancer takes two forms. The first type of surgery aims to cure patients: these surgical procedures include pancreaticoduodenectomy (Whipple procedure), distal pancreatectomy, and total pancreatectomy. The goal of the second type of pancreatic cancer surgery is to control symptoms; this type of surgery is known as palliative surgery.
  • Radiation therapy uses high-energy x-rays (or particles) to kill cancer cells. It can be helpful in treating exocrine pancreatic cancer.
  • Chemotherapy employs drugs to treat cancer. These drugs enter the bloodstream and reach all areas of the body. Chemotherapy drugs may be used at any stage of pancreatic cancer. It is commonly used when the cancer is advanced and can’t be removed completely with surgery. Chemotherapy drugs may also be used after the cancer has been removed with surgery to kill any cancer cells that remain.

Secondary treatment options:

  • Palliative therapies aim to improve quality of life by controlling symptoms rather than curing the cancer. Palliative therapies are usually used in advanced pancreatic cancer cases where other treatments are no longer an option.

What are the risk factors of pancreatic cancer?

Some risk factors for pancreatic cancer include:

  • Age: The average age of pancreatic cancer diagnosis is 71.
  • Gender: Men are 30% more likely to be diagnosed with pancreatic cancer.
  • Race: Those with African ancestry are more likely than whites to develop pancreatic cancer.
  • Tobacco Use: About 20% to 30% of exocrine pancreatic cancer cases are thought to be caused by cigarette smoking
  • Obesity: People carrying excessive amounts of body fat are about 20% more likely to develop pancreatic cancer.
  • Diabetes: Pancreatic cancer is more likely to occur in people who have long-standing (over 5 years) diabetes than in people who do not have diabetes.
  • Chronic pancreatitis: People with an inherited (familial) form of pancreatitis have a high lifetime risk for developing pancreatic cancer.
  • Cirrhosis (scarring) of the liver: People with cirrhosis seem to have an increased risk of pancreatic cancer.
  • Chemical exposure: Prolonged exposure to different pesticides, dyes, and chemicals may increase the risk of pancreatic cancer.
  • Family history: The risk of developing pancreatic cancer increases for every family member affected.
  • Diet: Diets high in meats, cholesterol, fried foods and nitrosamines may increase risk.

How can I prevent getting pancreatic cancer?

There have been no recognized guidelines for preventing pancreatic cancer. The best approach will be to avoid the risk factors where possible.

Creators: 
Mikayla D. Williams , BS student, Nursing , The University of Arizona
Michael Principe, MA, Information Resources and Library Science , The University of Arizona
Works Cited: 
American Cancer Society (2014). Pancreatic Cancer. https://www.cancer.org/cancer/pancreatic-cancer.html
Works Consulted: 
Pancreatic Cancer Action Network (2014). Learn about Pancreatic Cancer. https://www.pancan.org