Understanding Pancreatic and Biliary Cancers

The exact cause of pancreatic or bile duct cancers isn’t known. Cancer is usually the result of damage to DNA that causes cells to grow uncontrollably. Tumors can form in the bile ducts or pancreas if glandular cells grow out of control.

Some factors are known to increase your risk of pancreatic or bile duct cancer. Risk factors common to the two cancer types include:

• smoking
• overweight or obesity
• being over 65 years of age
• drinking too much alcohol
• heavy exposure to chemicals at work
• family history

Men may be more likely to develop pancreatic cancer than women. African Americans are more likely to develop pancreatic cancer than other racial groups.

Underlying conditions that could increase your risk of pancreatic cancer include diabetes and chronic pancreatitis.

Underlying conditions that could increase your risk of bile duct cancer include:

• bile duct infections
• cysts in the bile ducts
• inflammatory bowel disease
• primary sclerosing cholangitis
• hepatitis
• biliary papillomatosis

Bile duct cancer occurs more often in Asia because of infection from a parasite called the liver fluke, which is more common in that region.

These cancers may not cause any symptoms at first. If they do occur, symptoms of pancreatic and bile duct cancers are similar. They may include:

• jaundice (yellowing of the skin and eyes)
• itchy skin
• abdominal pain
• nausea and vomiting
• dark-colored urine
• pale or chalky stools
• weight loss
• fatigue

Pancreatic cancer may also cause diabetes or make diabetes worse if you already have it.

There’s no single test for diagnosing pancreatic or bile duct cancer. A doctor or healthcare professional will use imaging tests, such as an ultrasound, CT, or MRI scan, to get detailed images of your pancreas, bile duct, and the areas around them.

If a doctor sees a mass or tumor during a scan, they’ll take a small sample of the tumor. This is called a biopsy and is needed to confirm a diagnosis.

A doctor may also order blood tests such as liver function tests, tumor marker tests, and blood counts.

Doctors don’t usually diagnose pancreatic or bile duct cancers while the tumors are small because they don’t cause any symptoms. Bile duct cancers tend to grow slowly. While researchers used to think pancreatic cancers grew slowly in the early stages, research from 2016 suggests that this may not be the case.

But these tumors can spread easily to other parts of your body via nearby blood vessels and organs. Doctors only find a small number of bile duct and pancreatic cancers before they spread.

If a doctor diagnoses cancer, they’ll run tests to determine if it has spread. This is called staging, and it helps a doctor learn the best way to treat the cancer.

The earliest stage of pancreatic and bile duct cancer is stage 0, or carcinoma in situ. The numbers then go from stage 1 up to stage 4. The lower the number, the less cancer has spread. Stage 4 cancer means that cancer has spread to distant organs such as the lungs.

Learn more about staging for pancreatic and bile duct cancers.

Surgery is the primary treatment for early stage bile duct or pancreatic cancer that hasn’t spread to other parts of the body.

Surgeons may use a technique called the Whipple procedure to remove the head of the pancreas, gallbladder, stomach, part of the small intestine, and the bile duct.

Treatment for cancer in the later stages may include:

• chemotherapy
• radiation
• targeted therapy
• immunotherapy

One emerging treatment under investigation for pancreatic and bile duct cancer is called CAR T-cell therapy. This therapy engineers cells from your own immune system, called T cells, to fight cancer. CAR T-cell therapies have been effective in treating several other cancers.

Pancreatic and bile duct cancers are aggressive cancers. People with these cancers often have a poor outlook. According to the American Cancer Society, the relative 5-year survival rates for these cancers are:

Keep in mind that these survival estimates are made based on data collected in the past. Recent medical advancements and emerging treatments are constantly improving the outlook for people with these cancers.

The pancreas and bile ducts are important parts of your digestive system. Cancers that form in these organs have similar symptoms and outcomes. They’re often aggressive and tend to go unnoticed until they’ve spread to other areas.

Because bile duct and pancreatic cancers are aggressive, you may wish to speak with a doctor about enrolling in a clinical trial.