Pancreatic cancer is the 12th most common cancer in the U.S., and is relatively rare; however, it is the fourth leading cause of cancer-related death in both men and women in the U.S. It is estimated that in 2015 more than 48,000 people in the U.S. will be diagnosed with pancreatic cancer and nearly 41,000 will die of this disease. Because pancreatic cancer usually is diagnosed at an advanced stage, the survival rate is extremely low compared with that of many other cancer types.
The pancreas lies behind the stomach and in front of the spine. There are two kinds of cells in the pancreas. Exocrine pancreas cells make enzymes that are released into the small intestine to help the body digest food. Neuroendocrine pancreas cells make several hormones, including insulin and glucagon, which help control sugar levels in the blood.
Most pancreatic cancers form in exocrine cells. These tumors do not secrete hormones and do not cause signs or symptoms. This makes it hard to diagnose this type of pancreatic cancer early. For most patients with exocrine pancreatic cancer, current treatments do not cure the cancer. Some types of malignant pancreatic neuroendocrine tumors, such as islet cell tumors, have a better prognosis than pancreatic exocrine cancers.
Cigarette smoking is the most important risk factor for pancreatic cancer. Additional risk factors include personal history of diabetes or chronic inflammation of the pancreas (pancreatitis), obesity, certain hereditary conditions, and a family history of the disease or pancreatitis. Early-stage pancreatic cancer is often asymptomatic, and there is no routine screening test for pancreatic cancer. Standard treatments for pancreatic cancer include surgery, radiation therapy, chemotherapy, chemoradiation, and targeted therapy.
Signs and symptoms of pancreatic cancer
Having one or more of the signs and symptoms below does not mean you have pancreatic cancer. In fact, many of these symptoms are more likely to be caused by something else. Still, if you have any of these, it’s important to have them checked by a doctor so that the cause can be found and treated, if needed.
Early pancreatic cancers often don’t cause any signs or symptoms. By the time they do cause symptoms, they have often already grown through the pancreas or spread beyond it.
Jaundice and related symptoms: A yellowing of the eyes and skin is called jaundice. It is caused by a build-up of a substance (bilirubin) that is made in the liver. Most people with pancreatic cancer (and just about all people with ampullary cancer) have jaundice. The same problem that causes the skin to turn yellow can also cause other symptoms, such as dark-colored urine and itchy skin. While jaundice can be a sign of cancer, more often it is caused by something else.
Belly or back pain: Pain in the belly area (abdomen) or in the back is a very common sign of advanced pancreatic cancer. Again, such pain is often caused by something else.
Weight loss: Losing weight (without trying) over a number of months is very common in patients with this cancer. They may also feel very tired and not feel like eating.
Digestive problems: If the cancer blocks the release of the pancreatic juice into the intestine, a person may not be able to digest fatty foods. Stools might be pale, bulky, greasy, and float in the toilet. Other problems may include nausea, vomiting and pain that gets worse after eating.
Swollen gallbladder: The doctor may find that the gallbladder is enlarged. The doctor can sometimes feel this and see it on imaging tests.
Blood clots: Sometimes blood clots form in a vein of the leg, leading to pain, swelling, and warmth in the leg. These clots can sometimes travel to the lungs and cause breathing problems and chest pain. But having a blood clot does not usually mean that you have cancer. Most blood clots are caused by other things.
Fatty tissue changes: Another clue that there may be pancreatic cancer is an uneven texture of the fatty tissue under the skin. This is caused by the release of the pancreatic enzymes that digest fat.
Diabetes: This cancer can cause problems with blood sugar. Sometimes (but not often) it can cause diabetes. Symptoms can include feeling thirsty and hungry, and having to urinate often.
Sources: American Cancer Society and Pancreatic Cancer Action Network