Estimated reading time: 12 minutes
Key Takeaways
- Pancreatic cancer is a disease where malignant cells form in the pancreas, affecting digestion and blood sugar regulation.
- Most cases (90-95%) are pancreatic ductal adenocarcinoma (PDAC), which is often aggressive.
- Early symptoms are often absent, making detection challenging until advanced stages.
- Surgery offers the best chance for cure when cancer is caught early and confined to the pancreas.
- Support resources are available through the National Pancreatic Cancer Foundation.
Table of contents
Pancreatic cancer develops when abnormal cells in the pancreas grow uncontrollably, forming tumors that can spread.
A diagnosis can feel overwhelming. This guide provides clear explanations about what pancreatic cancer is, including its causes, symptoms, types, and treatment options. Our goal is to offer reliable information to help patients and families navigate this journey.
For immediate support, the National Pancreatic Cancer Foundation (NPCF) offers a free nurse hotline at 1-877-PAN-FOUND, peer support groups, and educational guides.
Quick Answer
Pancreatic cancer is a disease that begins in the pancreas, a gland located behind the stomach. It plays a vital role in digestion and blood sugar regulation.
In pancreatic cancer, abnormal cells form tumors. Benign tumors are not cancerous and do not spread. Malignant tumors are cancerous; they can invade nearby tissues and spread, or metastasize, to distant parts of the body through the bloodstream or lymphatic system.
This cancer is challenging to detect early because the pancreas is deep within the abdomen. Symptoms often appear only after the disease has progressed. Only about 10 to 20 percent of cases are discovered at a stage where surgical removal, aimed at a cure, is possible.
Pancreatic Cancer Definition
Anatomy of the Pancreas
The pancreas is divided into three sections: the head (nearest the small intestine), the body, and the tail. It performs two essential functions:
- Exocrine Function: Produces enzymes that help digest food.
- Endocrine Function: Produces hormones, including insulin, which regulates blood sugar.
How Cancer Develops
Cancer starts when pancreatic cells develop DNA mutations. These mutations instruct the cells to grow and divide rapidly, forming a mass called a tumor. Malignant pancreatic cells can invade nearby organs and tissues. They may also break away and travel through the blood or lymph systems to form new tumors in other organs, a process known as metastasis.
While factors like smoking, family history, chronic pancreatitis, and diabetes can increase risk, the exact cause in an individual is often complex and not fully understood.
Types of Pancreatic Cancer
The type of pancreatic cancer influences treatment and prognosis.
Exocrine Tumors: Pancreatic Ductal Adenocarcinoma (PDAC)
Pancreatic ductal adenocarcinoma (PDAC) is the most common type, accounting for roughly 90 to 95 percent of cases. It begins in the lining of the ducts that carry digestive enzymes out of the pancreas.
PDAC is often aggressive. Tumors in the head of the pancreas can block the bile duct, leading to jaundice, which is sometimes the first noticeable symptom.
Pancreatic Neuroendocrine Tumors (pNETs)
Pancreatic neuroendocrine tumors are far less common, representing about 5 percent of cases. They develop from the hormone-producing cells of the pancreas.
pNETs are categorized as:
- Functional: These tumors produce excess hormones, which can cause specific symptoms like severe diarrhea, skin rash, or low blood sugar.
- Nonfunctional: These do not produce hormones and are often found at a later stage.
Generally, the prognosis for pNETs can be more favorable than for PDAC, particularly when diagnosed early.
Rare Types
Other uncommon forms include acinar cell carcinoma, which starts in the enzyme-producing cells, and cystic neoplasms, which are fluid-filled sacs that may be benign or cancerous.
Comparison of Pancreatic Cancer Types
| Type | Origin | Common Symptoms | Prognosis | Treatment Approaches |
|---|---|---|---|---|
| PDAC (90–95%) | Ducts (exocrine) | Jaundice, pain, weight loss | More challenging if advanced | Surgery, chemotherapy |
| pNETs (~5%) | Hormone cells (endocrine) | Hormone-related symptoms or none | Often more favorable | Surgery, targeted therapy |
| Rare Types | Varies | Varies | Variable | Surgery, chemotherapy |
Signs and Symptoms
Pancreatic cancer is often called a “silent” disease because early symptoms are usually absent or vague.
Common Symptoms
- Abdominal or back pain: A persistent, dull ache that may worsen after eating or when lying down.
- Jaundice: Yellowing of the skin and whites of the eyes, often with dark urine and pale stools.
- Unintended weight loss: Significant loss without changes in diet or exercise.
- Loss of appetite: Feeling full quickly or having little desire to eat.
- Digestive issues: Nausea, vomiting, or bloating.
- Fatigue: Persistent tiredness not relieved by rest.
- New-onset diabetes: A sudden diagnosis of diabetes or difficulty controlling existing diabetes.
- Blood clots: Unexplained swelling, pain, or redness, often in the legs.
Symptoms Requiring Prompt Medical Attention
Consult a doctor immediately if you experience:
- Sudden onset of jaundice.
- Severe, persistent abdominal or back pain.
- Rapid, unexplained weight loss.
While these signs do not confirm cancer, prompt evaluation is crucial.
How Pancreatic Cancer is Diagnosed and Staged
Diagnostic Process
Doctors use a combination of tests: How is Pancreatic Cancer Diagnosed and Pancreatic Cancer Tests & Diagnostics
- Blood Tests: These may check for tumor markers like CA 19-9. It is important to note this marker is not definitive; levels can be normal in some with cancer and elevated in some without.
- Imaging Tests: CT scans, MRIs, and endoscopic ultrasound (EUS) create detailed pictures of the pancreas. EUS involves passing a small camera down the esophagus to get close images.
- Biopsy: A small sample of tissue is removed, usually during an EUS procedure, and examined under a microscope to confirm the diagnosis and identify the cancer type.
Staging
Staging determines how far the cancer has spread:
- Localized: Confined to the pancreas.
- Locally Advanced: Spread to nearby tissues or major blood vessels.
- Metastatic: Spread to distant organs, such as the liver or lungs.
The stage guides treatment decisions and helps provide a prognosis.
Is Pancreatic Cancer Curable?
Whether pancreatic cancer is curable depends on the type, stage at diagnosis, and the patient’s overall health.
When Cure is a Goal
For early-stage cancers that are completely confined to the pancreas, surgical removal offers the best chance for a cure, often followed by chemotherapy. For stage I pancreatic ductal adenocarcinoma, the five-year survival rate is approximately 20 to 40 percent. Unfortunately, only a minority of patients are diagnosed at this operable stage.
When the Focus is Management
Most pancreatic cancers are diagnosed at an advanced stage. While not typically curable with current treatments, the disease can often be managed. Therapies can control growth, alleviate symptoms, and extend life. Modern treatment regimens have improved survival and quality of life for many with advanced disease.
Understanding the Statistics
The overall five-year survival rate for pancreatic cancer is about 12 percent. This statistic reflects all stages combined. It has improved over the past decade due to better treatments. It is essential to discuss your specific situation with your care team, as individual outcomes vary widely. Participation in clinical trials also provides access to promising new therapies.
Treatment Options
Treatment plans are personalized based on the cancer’s characteristics and the patient’s health.
Surgery
Surgery aims to remove the entire tumor. Common procedures include:
- Whipple Procedure (Pancreaticoduodenectomy): Removes the head of the pancreas, part of the small intestine, the gallbladder, and a portion of the stomach.
- Distal Pancreatectomy: Removes the body and tail of the pancreas, often along with the spleen.
Surgery is complex and only an option for about 15 to 20 percent of patients at diagnosis. Potential risks include infection, bleeding, and the development of diabetes.
Chemotherapy and Radiation
Chemotherapy uses drugs to destroy cancer cells or stop their growth.
- It can be given before surgery (neoadjuvant) to shrink tumors.
- It is given after surgery (adjuvant) to eliminate any remaining cells.
- For advanced cancer, it helps control the disease and manage symptoms.
Chemoradiation combines chemotherapy with radiation therapy, sometimes used for locally advanced tumors. For an overview of treatment approaches, see Pancreatic Cancer Treatments
Targeted Therapy and Immunotherapy
Targeted therapies attack specific abnormalities within cancer cells. They are most effective for tumors with certain genetic mutations, including some pNETs.
Immunotherapy helps the immune system recognize and fight cancer cells. Its use in pancreatic cancer is evolving through ongoing research.
Palliative Care
Palliative care is specialized medical care focused on relieving symptoms and stress. It is appropriate at any stage and can be provided alongside curative treatments. It addresses pain, nutritional challenges, nausea, and emotional distress.
Clinical Trials
Clinical trials study new treatments. They may offer access to cutting-edge therapies, such as precision medicine approaches. Ask your doctor if a trial might be suitable for you.
Living with Pancreatic Cancer
A diagnosis affects daily life in several ways. Proactive management can help maintain quality of life.
Nutrition Management
Pancreatic cancer often impairs digestion. Pancreatic enzyme replacement therapy (PERT), taken with meals, helps the body break down and absorb nutrients. Working with a dietitian to plan small, frequent, nutrient-dense meals is highly beneficial. Understanding Nutritional Needs and Meal Planning resources are available, along with Diet & Nutrition guidance.
Managing Pain and Diabetes
Effective pain control may involve medications, nerve blocks, or complementary techniques. New or difficult-to-control diabetes is common and may require consultation with an endocrinologist for management with insulin or other medications.
Emotional and Practical Support
Counseling or therapy can help patients and families cope with the emotional weight of a diagnosis. Caregivers also need support and respite. Advance care planning, discussing and documenting healthcare wishes, is a valuable step for all adults. Finding Help & Resources and Building a Support System guides are available.
Questions to Ask Your Care Team
Prepared questions can help you get the information you need:
- What is the exact type and stage of my cancer?
- What are all my treatment options, and what is the goal of each (cure, control, comfort)?
- What are the potential benefits, risks, and side effects of each treatment?
- How will treatment affect my daily activities?
- Am I eligible for any clinical trials?
- Should I consider getting a second opinion?
- What symptoms or side effects should prompt an immediate call to your office?
- What support resources do you recommend for nutritional, financial, or emotional help?
For a printable list and more guidance on questions to ask your oncologist, see the NPCF resource.
NPCF Support & Resources
The National Pancreatic Cancer Foundation provides comprehensive support and resources at no cost.
Available Resources:
- Nurse Hotline: Speak directly with an oncology nurse at 1-877-PAN-FOUND.
- Peer Support: Connect with others through in-person or online support groups.
- Educational Materials: Access guides on treatment, nutrition, and caregiving.
- Financial Assistance: Explore programs that may help with treatment-related costs.
- Research Advocacy: NPCF funds research for better detection and treatments.
You do not have to navigate this path alone. Reach out today.
Frequently Asked Questions
What is pancreatic cancer?
Pancreatic cancer is a disease where malignant cells form in the tissues of the pancreas, an organ behind the stomach that aids in digestion and blood sugar control.
What are the main types?
The most common type is pancreatic ductal adenocarcinoma (PDAC). Pancreatic neuroendocrine tumors (pNETs) are less common. Several other rare types also exist.
Is pancreatic cancer curable?
Early-stage pancreatic cancer that can be completely surgically removed has the potential for cure, especially when followed by chemotherapy. Most cases are diagnosed at a more advanced stage, where treatment focuses on controlling the disease and relieving symptoms.
What are the key symptoms?
Important symptoms include jaundice (yellowing skin/eyes), persistent abdominal or back pain, unexplained weight loss, loss of appetite, new-onset diabetes, and digestive issues.
How is it diagnosed?
Diagnosis typically involves imaging tests (CT, MRI, endoscopic ultrasound), blood tests, and a biopsy to examine tissue under a microscope. Pancreatic Cancer Tests & Diagnostics provides more detailed information.
Next Steps
Understanding pancreatic cancer is the first step toward making informed decisions. We encourage you to use this information as a foundation for conversations with your healthcare team.
If you or a loved one is facing this diagnosis, remember that support is available. Contact the NPCF to access their free resources, from the nurse hotline to educational materials.
You are not alone. A community of support, reliable information, and dedicated professionals is ready to help. Access NPCF resources today.
