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.

According to the American Cancer Society, pancreatic cancer makes up about 3 percent of cancer diagnoses in the United States and 7 percent of cancer deaths.

There are two main types of pancreatic cancer, based on the kind of cell they start in:

  • Pancreatic adenocarcinoma. This is the most common type of pancreatic cancer. It starts in exocrine cells, which produce enzymes that aid in digestion.
  • Pancreatic neuroendocrine tumors. This rarer type of pancreatic cancer starts in the endocrine cells, which release hormones that affect everything from mood to metabolism.

Pancreatic cancer often doesn’t cause symptoms until it reaches advanced stages. As a result, there typically aren’t any early signs of pancreatic cancer.

Even at more advanced stages, some of the most common pancreatic cancer symptoms can be subtle.

As it progresses, pancreatic cancer can cause the following symptoms:

Pancreatic cancer can also affect your blood sugar. In some cases, this might lead to diabetes (or the worsening of preexisting diabetes).

Keep in mind that the above symptoms can be caused by a range of less-serious health concerns.

Learn more about the signs and symptoms of pancreatic cancer.

The cause of pancreatic cancer is unknown.

Pancreatic cancer occurs when abnormal cells begin to grow within the pancreas and form tumors, but it’s unclear why this happens.

Typically, healthy cells grow and die in moderate numbers. In the case of cancer, there’s an increase in the production of abnormal cells. These cells eventually take over healthy cells.

While the underlying cause of pancreatic cancer is unknown, certain factors may increase your risk of developing it.

These include:

  • Tobacco use. Smoking cigarettes may account for 20 to 35 percent of pancreatic cancer cases.
  • Heavy alcohol consumption. Having three or more alcoholic drinks a day may increase your risk. Drinking alcohol can also contribute to pancreatitis, another risk factor.
  • Chronic and hereditary pancreatitis. This refers to inflammation of the pancreas. Chronic pancreatitis often results from heavy drinking over a long period of time. Pancreatitis can also be hereditary.
  • Weight. Having overweight or obesity, particularly in early adulthood, may increase your risk.
  • Diet. Eating a diet high in red and processed meats, fried foods, sugar, or cholesterol may increase your risk, but experts are still figuring out the exact link between dietary factors and pancreatic cancer risk.
  • Sex. Men are slightly more likely to develop pancreatic cancer than women.
  • Workplace exposure. Working with certain chemicals, particularly those used in metalworking, and pesticides may be a factor in up to 12 percent of pancreatic cancer cases.
  • Age. People between the ages of 65 and 74 are more likely to be diagnosed with pancreatic cancer.
  • Diabetes. You may have a higher risk of developing pancreatic cancer if you have type 1 or type 2 diabetes.
  • Race. In the United States, rates of pancreatic cancer are highest among Black people. Research from 2018 suggests this is due to a mix of lifestyle, socioeconomic, and genetic factors, but experts note a need for more investigation into the underlying causes of racial disparities in rates of pancreatic cancer.
  • Family history. Up to 10 percent of people with pancreatic cancer have a family history of the condition.
  • Infections. Having a history of H. pylori infection in your digestive tract may increase your risk, though the exact link to pancreatic cancer isn’t clear. Having hepatitis B may also increase your risk by up to 24 percent.

Certain genetic variations and mutations can cause conditions that may also increase your risk of pancreatic cancer. Some of these conditions include:

  • Peutz-Jeghers syndrome
  • Lynch syndrome
  • familial atypical multiple mole melanoma syndrome
  • inherited pancreatitis
  • hereditary breast and ovarian cancer syndrome

Learn more about the hereditary factors that affect pancreatic cancer risk.

Early diagnosis significantly increases the chances of recovery. That’s why it’s best to see a healthcare professional as soon as possible if you notice any unusual symptoms, especially if you have any risk factors for pancreatic cancer.

To make a diagnosis, your care team will review your symptoms and medical history. They may 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

When pancreatic cancer is discovered, doctors will likely perform additional tests to determine whether the cancer has spread. These might include imaging tests, such as a PET scan, or blood tests.

They’ll use the results of these tests to establish the stage of the cancer. Staging helps explain how advanced the cancer is, which will help determine the best treatment option.

The stages of pancreatic cancer are:

  • Stage 0. There are abnormal cells in the pancreas that could become cancerous. This stage is sometimes called precancer.
  • Stage 1. The tumor is only in the pancreas.
  • Stage 2. The tumor has spread to nearby abdominal tissues or lymph nodes.
  • Stage 3. The tumor has spread to major blood vessels and lymph nodes.
  • Stage 4. The tumor has spread to other organs, like the liver. This is also called metastatic cancer.

Here’s a closer look at the different stages of pancreatic cancer.

Pancreatic cancer stage 4

Stage 4 pancreatic cancer has spread beyond the original site to distant sites, like other organs, the brain, or bones.

Pancreatic cancer is often diagnosed at this late stage because it rarely causes symptoms until it has spread to other sites.

Symptoms you might experience at this stage include:

Stage 4 pancreatic cancer can’t be cured, but treatments can relieve symptoms and prevent complications from the cancer.

Pancreatic cancer stage 3

Stage 3 pancreatic cancer is a tumor in the pancreas and possibly nearby sites, such as lymph nodes or blood vessels.

Symptoms of stage 3 pancreatic cancer may include:

  • pain in the back
  • pain or tenderness in the upper abdomen
  • a loss of appetite
  • weight loss
  • fatigue
  • depression

Stage 3 pancreatic cancer is difficult to cure, but treatments can help prevent the spread of the cancer and ease symptoms. These treatments may include:

The majority of people with this stage of the cancer will have a recurrence. That’s likely due to the fact that micrometastases, or small areas of undetectable cancer growth, have spread beyond the pancreas as the time of detection and aren’t removed during surgery.

Pancreatic cancer stage 2

Stage 2 pancreatic cancer is cancer that remains in the pancreas but may have spread to a few nearby lymph nodes or blood vessels.

This stage is divided into two subcategories, depending on where the cancer is and the size of the tumor:

  • Stage 2A. The tumor is larger than 4 centimeters (cm) but hasn’t spread to any lymph nodes or nearby tissue.
  • Stage 2B. The tumor has spread to nearby lymph nodes, but not to more than three of them.

Symptoms of stage 2 pancreatic cancer tend to be very subtle and may include:

Treatment may include:

  • surgery
  • radiation
  • chemotherapy
  • targeted drug therapies

Your doctor may use a combination of these approaches to help shrink the tumor and prevent possible metastases.

Pancreatic cancer stage 1

Stage 1 pancreatic cancer involves a tumor that’s only in the pancreas. This stage is divided into two subcategories, depending on the size of the tumor:

  • Stage 1A. The tumor measures 2 cm or less.
  • Stage 1B. The tumor measures more than 2 cm but less than 4 cm.

Stage 1 pancreatic cancer typically doesn’t cause any noticeable symptoms.

If detected at this stage, pancreatic cancer may be curable with surgery.

Pancreatic cancer stage 0

This is the earliest stage of pancreatic cancer, though it may not necessarily involve cancer. It just means that abnormal cells have been detected, and they could potentially become cancerous in the future. This stage doesn’t involve any symptoms.

Read more about pancreatic cancer staging.

Treating pancreatic cancer involves two main goals: to kill cancerous cells and prevent the cancer from spreading. The most appropriate treatment option will depend on the stage of the cancer.

The main treatment options include:

  • Surgery. Surgical treatment of pancreatic cancer involves removing portions of the pancreas (more on this below). While this can eliminate the original tumor, it won’t remove cancer that’s spread to other areas. As a result, surgery usually isn’t recommended for advanced-stage pancreatic cancer.
  • Radiation therapy. X-rays and other high-energy beams are used to kill cancer cells.
  • Chemotherapy. Anticancer drugs are used to kill cancer cells and help prevent their future growth.
  • Targeted therapy. Medications and antibodies are used to individually target cancer cells without harming other cells, which can happen with chemotherapy and radiation therapy.
  • Immunotherapy. Various methods are used to trigger your immune system to target the cancer.

In some cases, a doctor might recommend combining multiple treatment options. For example, chemotherapy might be done before surgery.

For advanced-stage pancreatic cancer, treatment options might focus more on pain relief and keeping symptoms as manageable as possible.

Pancreatic cancer surgery

Tumors confined to the “head and neck” of the pancreas can be removed with a procedure called the Whipple procedure (pancreaticoduodenectomy).

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 also removed.

A survival rate is a percentage of how many people with the same type and stage of a cancer are still alive after a specific amount of time. This number doesn’t indicate how long people may live. Instead, it helps gauge how successful treatment for a cancer might be.

Many survival rates are given as a 5-year percentage, which refers to the percentage of people alive 5 years after being diagnosed or starting treatment.

It’s important to keep in mind that survival rates aren’t definitive and can vary greatly from person to person depending on age, overall health, and how the cancer progresses. As a result, they also can’t determine an individual’s life expectancy.

Survival rates for pancreatic cancer are typically provided for localized, regional, and distant stages:

  • Localized. Cancer hasn’t spread from the pancreas, which corresponds with stages 0, 1, or 2A.
  • Regional. Cancer has spread to nearby tissues or lymph nodes, which corresponds with stages 2B and 3.
  • Distant. Cancer has spread to distant sites, like the lungs or bones, which corresponds with stage 4.

Here’s a look at the 1-, 5-, and 10-year relative survival rates from diagnosis for each stage.

Stage1-year survival rate5-year survival rate10-year survival rate
Localized55%35.4%29.8%
Regional50.6%12.3%8.1%
Distant17.4%2.8%1.6%

If you or a loved one was recently diagnosed with pancreatic cancer, it’s understandable to immediately wonder about life expectancy, but this depends on a range of factors that vary greatly from person to person. Your healthcare team can provide the most accurate estimate based on these factors.

Read more about life expectancy and pancreatic cancer.

Pancreatic cancer prognosis

It’s worth noting that survival rates are based on people who were first treated at least 5 years ago. Someone being diagnosed today may have a better survival rate thanks to advances in cancer treatments.

That said, pancreatic cancer is still considered difficult to treat, largely because it often isn’t found until it’s spread to other parts of the body.

It’s still not clear what causes pancreatic cancer, so there’s no reliable way to prevent it.

While certain things might increase your risk of developing pancreatic cancer, some of these — like your family history and age — can’t be changed.

But a few lifestyle changes may help reduce your risk:

  • Quit smoking. If you currently smoke, explore different approaches to help you quit.
  • Limit alcohol. Heavy drinking may increase your risk of chronic pancreatitis and, possibly, pancreatic cancer.
  • Maintain a moderate weight. A range of factors can contribute to overweight and obesity, some of which you can’t control. If you have overweight or obesity, consider talking with a healthcare professional about strategies for maintaining a moderate weight.
  • Incorporate whole foods. Certain foods, including red meat, processed meat, sugar, and fried foods, may increase your risk of pancreatic cancer. You don’t need to cut these out of your diet entirely, but aim to balance them with fresh or frozen fruits and vegetables, whole grains, and lean proteins.

If you’re experiencing symptoms you think might indicate pancreatic cancer, talk with a healthcare professional as soon as possible, especially if you have an increased risk of pancreatic cancer. While many conditions can have similar symptoms, pancreatic cancer responds best to treatment when caught in its earlier stages.