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What is Pancreatic Cancer | Understanding Your Pancreas | Types | Symptoms | Diagnosing | Risk Factors | What Causes Pancreatic Cancer | Resources
Most of the time, “pancreatic cancer” means pancreatic ductal adenocarcinoma — cancer that begins in the small tubes (ducts) inside the pancreas. A different type of cancer called a neuroendocrine tumor (NET) can also affect the pancreas.
Fred Hutchinson Cancer Center offers comprehensive treatment for pancreatic cancer and NETs from a team of experts who specialize in gastrointestinal cancers. This page is about pancreatic cancer. To learn more about NETs, visit our dedicated NET section.
When cells begin to grow abnormally they can turn into cancer. Cancer cells do not respond to regular cell growth, division and death signals like they are supposed to. They also don’t organize normally. Instead they grow into a tumor, which may break through nearby tissues or spread to other parts of the body.
Your pancreas is in your abdomen, behind your stomach. It is surrounded by your small intestine, liver and spleen.
Most of your pancreas consists of exocrine cells. These cells produce and secrete enzymes that aid in the breakdown of foods.
- Lipase breaks down fats.
- Protease breaks down proteins.
- Amylase breaks down carbohydrates.
A small portion of your pancreas consists of endocrine cells. These cells produce and secrete hormones, including:
- Gastrin, which triggers release of acid in your stomach
- Insulin, which helps lower the level of sugar in your blood
Exocrine Pancreatic Cancer
The term “pancreatic cancer” is often used to refer to cancer that started in the exocrine cells of the pancreas.
Most pancreatic cancers are exocrine cancers that begin in the ducts that carry pancreas juices and enzymes to the common bile duct, which empties into the first section of the small intestine (duodenum). The most common is pancreatic ductal adenocarcinoma.
Pancreatic cancer is often diagnosed at later stages, when the cancer has grown around major blood vessels or spread to other organs. Even then, there is a lot we can do to help control your symptoms and extend your life.
Pancreatic Neuroendocrine Tumors
Tumors that start in the endocrine cells of the pancreas are called pancreatic NETs. They are also known as neuroendocrine tumors of the pancreas or islet cell tumors, and they are different from pancreatic ductal adenocarcinoma. This page is about pancreatic cancer. To learn more about NETs, visit our dedicated NET section.
Types of Treatment for Pancreatic Cancer
Fred Hutch experts offer comprehensive care for pancreatic cancer, including advanced treatments and new options available only through clinical studies.
Many patients are seen at our Pancreatic Cancer Specialty Clinic. At this clinic, all of the specialists who will be involved in your care will meet to design treatment that's tailored to you. You will receive a multidisciplinary treatment plan in a single day — truly one-stop shopping.
Symptoms
Most cancers in the pancreas do not cause symptoms until they become large or spread to other parts of the body.
Exocrine pancreatic cancer is often advanced by the time it is found.
- One of the most pronounced symptoms is pain in the upper abdomen and back.
- At times the cancer may cause the gallbladder to swell.
- Because 80 percent of pancreatic cancers occur in the head of the pancreas, where they can block the bile duct, they may cause jaundice (yellowing of the skin or whites of the eyes and darkened urine).
- When cancer interferes with food processing, it can cause weight loss, pale and greasy stools, and vomiting and nausea after eating.
Diagnosing
If you have signs or symptoms that could be from cancer in your pancreas, your physician will start by asking about your medical history and family history and doing a physical exam.
If your physician suspects you have exocrine pancreatic cancer, you may have one or more imaging studies, such as:
Computed Tomography (CT) Scan
Computed tomography (CT) scan is used to look for any abnormal growth on your pancreas and cancer anywhere else in your body.
Upper Endoscopic Ultrasound (Upper ES)
Upper endoscopic ultrasound (upper EUS) is threading a flexible tube (endoscope) with an ultrasound probe through your mouth into your stomach to look at your tumor, determine whether it can be removed surgically and take cells for a biopsy (looking at them under a microscope to see if they are cancer).
Magnetic Resonance Imaging (MRI)
Magnetic resonance imaging (MRI) is used to get a picture of your pancreas ducts if your major blood vessels are compressed or invaded by cancer and to look at your liver for signs that cancer has spread there.
Endoscopic Retrograde Cholangiopancreatography (ERCP)
Endoscopic retrograde cholangiopancreatography (ERCP) is threading an endoscope through your mouth into your small intestine to look at your pancreas, inject dye that helps the area show up better on an X-ray or use a fine needle or brush to take cells for a biopsy. ERCP can also be used to place a stent to help relieve jaundice.
Traditionally, patients with pancreatic cancer have needed exploratory surgery to determine whether their pancreas should be removed. Now physicians often opt for the less invasive imaging procedures described above.
Tests for CA 19-9, a molecule released into the blood by some pancreatic tumor cells, can be useful in tracking the progression of the disease, but it is only 80 percent accurate in diagnosing pancreatic cancer.
What Causes Pancreatic Cancer?
Very little is known about the exact cause of pancreatic cancer. Many studies have drawn links between the disease and various types of behaviors and genetic groups.
Fred Hutch’s Gastrointestinal Cancer Prevention Program offers a personalized approach to risk assessment, screening and prevention for people at high risk for pancreatic cancer and other gastrointestinal cancers.
Learn more about Gastrointestinal Cancer Prevention Program
Risk Factors
These factors may affect your risk for pancreatic cancer:
- Smoking — Adenocarcinomas are two to three times more common in heavy smokers than in nonsmokers.
- Age — Though pancreatic cancers are sometimes found in young people, most are found in people over 60.
- Sex — Men are more often diagnosed than women.
- Ethnicity —African-Americans, Ashkenazi Jews and Native Hawaiians have the highest rates of pancreatic cancer. Asians and Hispanics have the lowest rates.
- Diet — A diet high in meats and fats has been linked to increased risk.
- Environment — Pancreatic cancer is more common in people with prolonged exposure to pesticides, dyes, petrochemicals and other carcinogens.
- Family history — People with a parent or sibling who has had pancreatic cancer are three times more likely to also be diagnosed. A family history of colon cancer or ovarian cancer also increases the risk of pancreatic cancer.
How Common Is Pancreatic Cancer?
The American Cancer Society estimates that about 55,000 people in the United States will be diagnosed with pancreatic cancer (either exocrine or endocrine) each year.
Resources
There are many resources online for learning about your disease. Health educators at the Fred Hutch Patient and Family Resource Center have compiled a list of trusted sources to help you get started.
Whether you are newly diagnosed, going through treatment or know someone with cancer, our staff are available to tailor personalized resources and answer questions about support options in the community.
Cancer Research Organizations
Our list of online resources provides accurate health information from reliable and reputable sources, like the National Cancer Institute (NCI), the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN).
American Cancer Society
American Cancer Society (ACS): Overview of Pancreatic Cancer
If you have pancreatic cancer or are a caregiver for someone who does, knowing what to expect can be helpful. Here you can find out all about pancreatic cancer in adults, including risk factors, symptoms and how they are found and treated.
American Society of Clinical Oncology
American Society of Clinical Oncology (ASCO): Guide to Pancreatic Cancer
This is Cancer.Net's Guide to pancreatic cancer. Here you can learn more about pancreatic cancer, treatment, the latest research and clinical trials.
American Society of Clinical Oncology
ASCO Answers: Pancreatic Cancer
ASCO Answers is a collection of oncologist-approved patient education materials developed by ASCO for people with cancer and their caregivers. Here you can find illustrations and information on pancreatic cancer.
CancerCare
CancerCare Treatment Update: Pancreatic Cancer
The CancerCare Connect® Booklet Series offers up-to-date, easy-to-read information on the latest treatments, managing side effects and coping with cancer.
CancerCare
CancerCare: Questions to Ask Your Physician After a Pancreatic Cancer Diagnosis
From CancerCare, these are questions that you may want to ask your health care team after receiving a pancreatic cancer diagnosis.
National Cancer Institute
National Cancer Institute (NCI): Pancreatic Cancer-Patient Version
The NCI is the federal government's principal agency for cancer research and training. Here you can find more information about pancreatic cancer treatment, research and coping with cancer.
National Comprehensive Cancer Network
National Comprehensive Cancer Network (NCCN) Guidelines for Patients: Pancreatic Cancer
This step-by-step guide to the latest advances in cancer care features questions to ask your physician, patient-friendly illustrations and glossaries of terms and acronyms.
Cancer Support Organizations
Our list includes local and national organizations that are dedicated to improving the quality of life for patients and family members through providing emotional support, education and community.
CancerLifeline
Cancer Lifeline Support Group
View Cancer Lifeline's compiled list of pancreatic cancer support groups.
CancerCare
CancerCare Online Support Groups
CancerCare provides online support groups for both pancreatic cancer patients and caregivers.
Let'sWin!
Let's Win! Pancreatic Cancer
Let’s Win! Pancreatic Cancer is a platform that enables physicians, scientists and patients to share fast-breaking information on potentially life-saving pancreatic cancer treatments and clinical trials. The goal is to inform, enable and educate patients and caregivers, providing easy-to-understand, actionable information.
The National Pancreas Foundation
National Pancreas Foundation
Founded in 1997, the National Pancreas Foundation provides hope for those suffering from pancreatitis and pancreatic cancer through funding cutting-edge research, advocating for new and better therapies and providing support and education for patients, caregivers and healthcare professionals. The NPF is the only foundation dedicated to patients suffering from all forms of pancreas disease.
Pancreas Cancer Action Network
Pancreatic Cancer Action Network (PanCAN)
With PanCAN, learn about pancreatic cancer, find personal one-on-one support, find a support group for patients, caregivers and survivors or find a clinical trial.