Pancreatic Cancer

CancerGuru Types of Cancer Pancreatic

Overview

Pancreatic cancer starts in the pancreas, a gland in your belly that helps with digestion. Common symptoms are nausea, bloating, tiredness, yellowing of the skin and eyes (jaundice), and loss of appetite. Treatment options include surgery, chemotherapy, and radiation therapy. Survival rates for pancreatic cancer are low because it is hard to find the disease early.

Pancreatic cancer - A type of cancer that begins in the pancreas, often hard to detect early.

What is Pancreatic Cancer?

Pancreatic cancer happens when cells in the pancreas change and grow too fast, forming a tumor. The pancreas is a gland located in your belly, sitting between your stomach and spine. It plays two big roles: making hormones that help control your blood sugar and producing enzymes that help you digest food. Most pancreatic cancers begin in the ducts of the pancreas, especially in the main duct called the duct of Wirsung, which links the pancreas to the common bile duct.

One of the biggest challenges with pancreatic cancer is that early tumors usually do not show up on imaging tests. Because of this, many people are not diagnosed until the cancer has already spread to other parts of the body. Pancreatic cancer also tends to resist many common cancer treatments, which makes it very hard to manage. Scientists are working on ways to catch the disease earlier using genetic testing and better imaging tools, but there is still a lot to figure out.

Types of Pancreatic Cancer

Pancreatic tumors are grouped into two main types based on where they start and the kind of cells they grow from. Knowing the type of tumor is important because it helps doctors decide the best way to treat it. The two main types are exocrine tumors and neuroendocrine tumors.

Exocrine Tumors: Exocrine tumors make up more than 90% of all pancreatic tumors. The most common type is adenocarcinoma, which starts in the cells that line the organs.
Neuroendocrine Tumors (NETs): Neuroendocrine tumors are less common, making up less than 10% of cases. These tumors are also called islet cell carcinomas.

Risk Factors

Several factors can raise the chances of developing pancreatic cancer. Some are related to lifestyle choices, while others are linked to inherited traits. Understanding these risk factors can help with early detection and possibly prevention.

Smoking: Smoking is one of the strongest risk factors for pancreatic cancer. People who smoke are more likely to develop this disease compared to those who do not.
Type 2 Diabetes: Having type 2 diabetes, especially for many years, can slightly raise the risk of pancreatic cancer. It is not clear if diabetes causes cancer or if both share common risk factors.
Chronic Pancreatitis: Long-term inflammation of the pancreas, known as chronic pancreatitis, can increase the risk. This condition often causes lasting damage to the pancreas over time.
Family History of Genetic Changes: Certain inherited DNA changes can raise the risk of pancreatic cancer. These include mutations in genes like BRCA2, conditions like Lynch syndrome, and familial atypical multiple mole melanoma (FAMMM) syndrome.
Family History of Pancreatic Cancer: Having close family members, such as a parent or sibling, with pancreatic cancer can also increase a person's chances of getting the disease.
Obesity: Being very overweight is another factor linked to a higher risk of pancreatic cancer. Extra weight may cause changes in the body that encourage cancer growth.
Older Age: Age plays a big role. Most people diagnosed with pancreatic cancer are older than 65, although it can happen at younger ages in rare cases.
Heavy Alcohol Use: Drinking a lot of alcohol over time can damage the pancreas and lead to chronic pancreatitis, both of which are linked to a higher risk of pancreatic cancer.

Symptoms

Pancreatic cancer usually does not cause clear symptoms in its early stages. Many signs only appear once the tumor grows and starts to affect nearby organs in the digestive system. Because of this, pancreatic cancer is often hard to detect early. Some possible symptoms of pancreatic cancer include:

Yellowing of the skin or eyes, known as jaundice or icterus
Dark-colored urine or pale stools
Pain in the upper belly or the middle of the back
Bloating or feeling unusually full after eating small amounts
Nausea, vomiting, or frequent indigestion

Feeling very tired without a clear reason
Loss of appetite
Unexplained weight loss
Sudden development of diabetes without a clear cause

Causes

We still don’t know the exact cause of pancreatic cancer. However, we understand several risk factors that increase the chance of developing it. Some of these factors can lead to changes in cells that may eventually cause cancer.

Gene Changes That May Lead to Pancreatic Cancer: Genes are the instructions that tell cells how to grow, divide, and die. When certain genes change, they can cause normal cells to become cancerous.
Inherited Gene Mutations: Some people inherit gene changes from their parents that raise their risk of pancreatic cancer. These inherited changes are sometimes part of genetic syndromes that increase the risk of other health issues. However, inherited mutations cause only a small portion of pancreatic cancer cases.
Acquired Gene Mutations: Most gene mutations related to pancreatic cancer happen during a person’s life. Some mutations are caused by exposure to harmful substances like tobacco smoke. However, many mutations happen randomly and have no clear cause.
Common Gene Changes in Pancreatic Cancer: In both inherited and non-inherited cases, pancreatic cancer often involves changes to specific genes. Mutations in p16 and TP53 are common in both types. Other genes like KRAS, BRAF, and DPC4 (SMAD4) are more often seen in non-inherited cases.

Diagnosis

Diagnosing pancreatic cancer involves several tests. These tests help doctors see inside the body, collect tissue samples, and check for signs of cancer.

Imaging Tests

Imaging tests create pictures of the inside of your body. Common imaging tests for pancreatic cancer include ultrasound, CT scans, MRI scans, and sometimes PET scans. These tests can help doctors see tumors in the pancreas and nearby organs.

A Scope with Ultrasound

Endoscopic ultrasound (EUS) uses a thin tube with a camera to take pictures of the digestive tract and nearby organs. The tube is passed down the throat and into the stomach. An ultrasound device on the endoscope uses sound waves to create images of the pancreas and other tissues.

Removing a Tissue Sample for Testing

A biopsy is used to take a small sample of tissue for testing in a lab. The tissue is usually collected during EUS using special tools. In some cases, a needle may be inserted through the skin to take a sample from the pancreas. This method is called fine-needle aspiration.

Blood Tests

Blood tests can look for tumor markers, which are proteins that pancreatic cancer cells may produce. One common test is CA19-9, which is used to monitor the cancer's response to treatment. However, not all pancreatic cancers produce CA19-9, so this test may not be helpful for everyone.

Genetic Testing

Genetic testing can identify inherited DNA changes that increase the risk of pancreatic cancer. The test uses a sample of blood or saliva. The results can help guide treatment and show whether family members are at higher risk for the disease.

A background image of a person with pancreatic cancer

Treatments

The treatment for pancreatic cancer depends on the stage of the cancer, its location, and your overall health. The main goal of treatment is often to remove or shrink the cancer, if possible. If the cancer is too advanced, treatment may focus on improving quality of life by managing symptoms and preventing further growth. Your healthcare team will work with you to create a treatment plan that suits your needs and preferences.

Surgery

Surgery can be a potential treatment for pancreatic cancer, but it is not suitable for everyone. It may be an option if the cancer has not spread to other organs. Common procedures include the Whipple procedure, which removes part of the pancreas and nearby organs, or a distal pancreatectomy to remove the body and tail of the pancreas. In some cases, the entire pancreas may be removed. Surgery carries risks like bleeding, infection, and long recovery times. Highly experienced surgeons at specialized medical centers can reduce the risk of complications.

Chemotherapy

Chemotherapy uses medications to kill cancer cells and is often used when surgery is not an option. Chemotherapy can be given before surgery to shrink tumors or after surgery to eliminate remaining cancer cells. It may also be used in combination with radiation therapy for better results. In advanced cases, chemotherapy can help control the spread of cancer and alleviate symptoms, such as pain.

Radiation Therapy

Radiation therapy uses high-energy beams to target and kill cancer cells. It may be used before or after surgery, or in combination with chemotherapy to shrink tumors. If surgery is not an option, radiation therapy may be the first form of treatment. Additionally, when cancer spreads, radiation can help relieve symptoms like pain, improving the patient's comfort and quality of life.

Immunotherapy

Immunotherapy is a treatment that boosts the body's immune system to help it attack cancer cells. This treatment may be an option if your pancreatic cancer has specific DNA changes that make it responsive to this approach. By helping the immune system recognize and destroy cancer cells, immunotherapy can play an important role in managing certain types of pancreatic cancer.

Clinical Trials

Clinical trials provide opportunities to try the latest treatments and therapies that are not yet widely available. While these treatments may offer hope, they also come with the potential risk of unknown side effects. If you're interested in participating in a clinical trial, discuss the possibilities with your healthcare provider to determine if it could be a good option for your treatment plan.

Palliative Care

Palliative care focuses on improving the quality of life for those with serious illnesses, such as cancer. It includes a team of healthcare professionals who help manage pain and other symptoms. Palliative care is available alongside other treatments like chemotherapy, radiation, or surgery. It aims to relieve discomfort and provide support to both patients and their families, ensuring a better quality of life during treatment.

Side Effects of Treatment

Treatment for pancreatic cancer can have a range of side effects, depending on the type of treatment used. These side effects can vary from mild to severe and may impact a person’s daily life. It's important to discuss potential side effects with your healthcare team to better understand how to manage them.

Hair Loss: Chemotherapy often causes hair loss, which can affect not only the hair on the head but also the eyebrows, eyelashes, and body hair. This usually happens a few weeks after starting treatment and is temporary, with the hair often growing back after treatment ends.
Fatigue: A common side effect of both chemotherapy and radiation therapy, fatigue can leave patients feeling extremely tired and weak. It can affect daily activities and may persist for weeks or months after treatment.
Nausea and Vomiting: Many treatments for pancreatic cancer, including chemotherapy and radiation, can cause nausea and vomiting. This can be managed with anti-nausea medications but may still be an ongoing concern during treatment.
Loss of Appetite: Cancer treatments can impact appetite, leading to weight loss and malnutrition. This may be caused by changes in taste, nausea, or the body's altered metabolism during treatment.
Digestive Issues: Surgery and radiation therapy can cause digestive problems, including diarrhea, constipation, and difficulty swallowing. After surgery, some patients experience delayed gastric emptying, which causes bloating and discomfort.
Infections: Both chemotherapy and surgery can weaken the immune system, making patients more vulnerable to infections. These can include respiratory infections, urinary tract infections, or infections at the surgical site.
Skin Irritation: Radiation therapy and some chemotherapy drugs can cause skin irritation, such as redness, dryness, and peeling. These effects are usually temporary but can be uncomfortable.
Pain: After surgery, some patients may experience pain around the incision site or in the abdomen. Chemotherapy and radiation can also lead to nerve pain or discomfort in the treated areas.
Diabetes: If the pancreas is removed or significantly damaged during surgery, patients may develop diabetes. This can be managed with insulin and other medications but requires lifelong monitoring and care.

Support

A pancreatic cancer diagnosis can be challenging, not only for the patient but also for their family and loved ones. In addition to medical treatments, various forms of support can help patients cope with the emotional, physical, and practical challenges they face. Below are several support options available to individuals diagnosed with pancreatic cancer.

Emotional Support

A cancer diagnosis often brings emotional turmoil. Seeking emotional support from loved ones, therapists, or counselors can help patients cope with feelings of fear, anxiety, and sadness. It’s important to talk openly and seek guidance when needed.

Cancer Support Groups

Support groups create a safe space where patients and families can connect with others going through similar experiences. These groups offer valuable emotional support, information on treatment options, and advice on coping strategies from those who understand the journey firsthand.

Palliative Care

Palliative care focuses on improving the patient’s quality of life by managing symptoms and side effects such as pain, nausea, and fatigue. This care works alongside other treatments, helping the patient maintain comfort and dignity during their treatment process.

Nutrition Support

Pancreatic cancer treatments can cause changes in appetite and digestion. Nutritionists and dietitians can provide guidance on managing these issues, ensuring that patients get the right nutrients to maintain strength and improve their overall well-being.

Financial Assistance

The costs of cancer treatments can be burdensome. Financial assistance programs can help cover medical expenses, medications, travel costs, and other treatment-related expenses. Social workers and financial counselors can assist in finding resources and navigating insurance coverage.

Home Care

For patients who need help with daily activities or ongoing medical care, home care services are an essential resource. These services offer trained professionals who assist with personal care, medication management, and other activities, allowing patients to receive care in the comfort of their own homes.

Spiritual Support

For many, spirituality plays an important role in coping with a serious illness. Hospitals often provide spiritual support through chaplains or counselors, offering guidance and comfort based on the patient’s religious or spiritual beliefs.

Caregiver Support

Caregivers often face emotional and physical strain while supporting a loved one with cancer. Support services for caregivers, including counseling and respite care, can help alleviate stress, prevent burnout, and offer guidance on how to best care for their loved ones.

Research

Research on pancreatic cancer plays a crucial role in advancing our understanding of the disease, improving treatments, and ultimately finding a cure. With pancreatic cancer being one of the most challenging cancers to treat, ongoing research is vital in offering hope for patients and families. Below are key areas where research is making a difference in the fight against pancreatic cancer.

Early Detection

Currently, pancreatic cancer is often diagnosed at an advanced stage, which makes it harder to treat. Researchers are working on developing better methods for early detection, such as blood tests, imaging techniques, and biomarkers that can help identify pancreatic cancer at a much earlier stage, improving the chances of successful treatment.

Targeted Therapies

Targeted therapies focus on treating cancer cells by specifically targeting the changes in the DNA that allow them to grow and divide. Researchers are investigating drugs that can target these changes in pancreatic cancer cells, making treatments more effective while minimizing damage to healthy cells.

Immunotherapy

Immunotherapy uses the body’s immune system to fight cancer. Research into pancreatic cancer immunotherapy is ongoing, as scientists look for ways to boost the immune system’s ability to recognize and attack pancreatic cancer cells. Some promising treatments, like checkpoint inhibitors, are being tested in clinical trials.

Chemotherapy Advances

Chemotherapy remains one of the main treatments for pancreatic cancer, but its effectiveness can be limited. Researchers are exploring ways to make chemotherapy more effective, such as developing new drug combinations, delivering drugs directly to the tumor, or overcoming the tumor’s resistance to treatment.

Genetic Research

Genetic research aims to understand the genetic mutations that lead to pancreatic cancer. By studying these mutations, scientists hope to identify new targets for drugs and therapies. This research also includes understanding how inherited gene mutations, such as those in the BRCA genes, may increase the risk of developing pancreatic cancer.

Clinical Trials

Clinical trials are essential for testing new treatments and therapies. Researchers conduct trials to evaluate the safety and effectiveness of new drugs, techniques, and combinations of treatments for pancreatic cancer. Participation in clinical trials offers patients access to cutting-edge treatments that may not yet be available through standard care.

Prevention Studies

Prevention studies focus on understanding how lifestyle, diet, and environmental factors contribute to pancreatic cancer. Researchers are exploring ways to reduce the risk of developing pancreatic cancer through preventive measures, such as lifestyle changes, medications, or early screenings for high-risk individuals.

Personalized Medicine

Personalized medicine treatment to the individual characteristics of each patient and their cancer. Researchers are exploring how genetic, molecular, and environmental factors can guide more personalized treatment plans for pancreatic cancer, improving outcomes and minimizing side effects.

Prevention

While there is no guaranteed way to prevent pancreatic cancer, there are steps you can take to potentially reduce your risk. Leading a healthy lifestyle, such as eating a balanced diet rich in fruits, vegetables, and whole grains, can have a positive impact on your overall health. Staying active with regular exercise, avoiding smoking, and limiting alcohol consumption are also key factors in lowering your chances of developing this type of cancer.

Questions to Ask your Healthcare Provider about Pancreatic Cancer

While there's no guaranteed way to prevent pancreatic cancer, certain actions may help reduce your risk. By making healthier choices and staying informed, you can take steps that could have a positive impact on your overall health.

Q1. What can you do to lower your risk of pancreatic cancer?
Q2. Are there lifestyle changes that may help prevent pancreatic cancer?
Q3. How does diet affect the risk of pancreatic cancer?
Q4. Can regular exercise play a role in reducing pancreatic cancer risk?
Q5. Does family history influence the likelihood of developing pancreatic cancer?
Q6. Are there any screenings available to detect pancreatic cancer early?
Q7. Can smoking increase your chances of getting pancreatic cancer?
Q8. Is there a link between alcohol consumption & pancreatic cancer risk?

Illustration of a person holding a tablet with a question mark, representing questions to ask about pancreatic cancer