Pancreatic cancer occurs within the tissues of the pancreas, which is a vital endocrine organ located behind the stomach. The pancreas plays an essential role in digestion by producing enzymes that the body needs to digest fats, carbohydrates, and proteins.
The pancreas also produces two important hormones: glucagon and insulin. These hormones are responsible for controlling glucose (sugar) metabolism. Insulin helps cells metabolize glucose to make energy and glucagon helps raise glucose levels when they are too low.
Due to the location of the pancreas, pancreatic cancer may be difficult to detect and is often diagnosed in more advanced stages of the disease. This type of cancer is the fourth-leading cause of cancer-related fatalities in the United States.
The cause of pancreatic cancer is unknown. This type of cancer occurs when abnormal cells begin to grow within the pancreas and form tumors. Normally, healthy cells grow and die in moderate numbers. In the case of cancer, there is an increased amount of abnormal cell production, and these cells eventually take over the healthy cells.
While the cause of this type of cancer is unknown, there are certain risk factors that may increase your chances of developing pancreatic cancer. You may be at an increased risk if you:
- smoke cigarettes — 30 percent of cancer cases are related to cigarette smoking
- are obese
- don’t exercise regularly
- eat few fruits and vegetables
- eat diets high in fat content
- drink heavy amounts of alcohol
- have diabetes
- work with pesticides and chemicals
- have chronic inflammation of the pancreas
- have liver damage
- are African-American
- have a family history of pancreatic cancer or certain genetic disorders that have been linked to this type of cancer
Pancreatic cancer often doesn’t exhibit symptoms until it reaches the advanced stages of the disease. Some of the most common symptoms can be subtle. They include:
- loss of appetite
- unintentional weight loss
- abdominal (stomach) or lower back pain
- blood clots
- jaundice (yellow skin and eyes)
Pancreatic cancer that spreads may worsen preexisting symptoms.
Diagnosis and Staging
Early diagnosis significantly increases the chances of recovery. That’s why it’s best to visit your doctor if you’re experiencing any symptoms that won’t go away or recur regularly.
To make a diagnosis, your doctor will review your symptoms and medical history. They will order one or more tests to check for pancreatic cancer, such as:
- CT or MRI scans to get a complete and detailed image of your pancreas
- an endoscopic ultrasound, in which a thin, flexible tube with a camera attached is inserted down into the stomach to obtain images of the pancreas
- biopsy, or tissue sample, of the pancreas
- blood tests to detect if tumor marker CA 19-9 is present, which can indicate pancreatic cancer
Once a diagnosis has been made, your doctor will assign a stage based on the test results:
- stage 1: tumors exist in the pancreas only
- stage 2: tumors have spread to nearby abdominal tissues or lymph nodes
- stage 3: the cancer has spread to major blood vessels and lymph nodes
- stage 4: tumors have spread to other organs, such as the liver
Treatment depends on the stage of cancer. Treatment has two goals: to kill cancerous cells and to prevent the spread of the disease. Weight loss, bowel obstruction, abdominal pain, and liver failure are among the most common complications during pancreatic cancer treatment.
If the tumor has remained confined to the pancreas, surgery may be recommended — a final call on whether surgery is an option will be based on the exact location of the cancer. If the tumor is confined to the head and neck of the pancreas, a procedure called the Whipple procedure (pancreaticoduodenectomy) can be done. In this procedure, the first part, or the “head” of the pancreas and about 20 percent of the “body,” or the second part, are removed. The bottom half of the bile duct and the first part of the intestine are also removed. In a modified version of this surgery, a part of the stomach is removed.
Other treatment options must be explored once the cancer spreads outside of the pancreas. Radiation therapy utilizes X-rays and other high-energy beams to kill the cancer cells.
In some cases, your doctor might combine other treatments with chemo, which uses cancer-killing drugs to help prevent future growth of cancer cells.
Many patients combine alternative measures with traditional medical treatments. Be sure to consult your doctor before beginning alternative therapies as these measures may interfere with certain medications.
Yoga, meditation, and light exercise might promote a sense of well-being and make you feel better during treatment.
Pancreatic cancer is one of the most deadly forms of cancer — unfortunately, many patients don’t receive a diagnosis until it has spread outside of the pancreas. Following all of your doctor’s recommendations will help improve your chances of recovery and survival. You may also consider:
- pancreatic enzyme supplements to improve digestion
- pain medications
- regular follow-up care, even if the cancer is successfully removed