Pancreatic Cancer: Overview

What is pancreatic cancer?

Cancer starts when cells change (mutate) and grow out of control. The changed (abnormal) cells often grow to form a lump or mass called a tumor. Cancer cells can also grow into (invade) nearby areas. And they can spread to other parts of the body. This is called metastasis.

Pancreatic cancer is cancer that starts in cells that make up your pancreas. The pancreas is a pear-shaped organ that lies behind your stomach and in front of your spine. It makes digestive juices that break down food and hormones, such as insulin, that help your body use food for energy.

Who is at risk for pancreatic cancer?

A risk factor is anything that may increase your chance of having a disease. The exact cause of someone’s cancer may not be known. But risk factors can make it more likely for a person to have cancer. Some risk factors may not be in your control. But others may be things you can change.

The risk factors for pancreatic cancer include:

• Older age

• Being a man

• Being African American or of Ashkenazi Jewish descent

• Tobacco use

• Heavy alcohol use

• Obesity

• Type 2 diabetes

• A high-fat diet

• Chronic pancreatitis (long-term inflammation of the pancreas)

• Cirrhosis of the liver

• Family history of pancreatic cancer

• Certain inherited genetic syndromes, such as Lynch syndrome, MEN1, hereditary breast and ovarian cancer syndrome, and hereditary pancreatitis

• H. pylori infection

• Hepatitis B infection

Talk with your healthcare provider about your risk factors for pancreatic cancer and what you can do about them.

Can pancreatic cancer be prevented?

There’s no sure way to prevent pancreatic cancer. But you can help lower your risk by making some lifestyle changes. These include:

• Eat a healthy diet.

• Be physically active.

• Stay at a healthy weight.

• Don’t smoke.

• Don’t drink alcohol or drink only in moderation.

Are there screening tests for pancreatic cancer?

There are no screening tests for pancreatic cancer in people at average risk. Screening tests are done to check for disease in people who don’t have symptoms.

Still, some people at increased risk might benefit from screening. If you have a strong family history of pancreatic cancer, you might want to talk with your healthcare provider about screening. Regular ultrasounds can be done to look for tumors in the pancreas. Or you can ask about genetic counseling and testing to help find out if you are at increased risk.

What are the symptoms of pancreatic cancer?

Pancreatic cancer often doesn't cause any symptoms until it has spread, or the tumor is large.

Symptoms may include:

• Yellowing of your eyes or skin (jaundice)

• Itchy skin

• Dark yellow or brown urine

• Pale, greasy, bulky, bad-smelling stools that float in the toilet

• Pain in your upper or middle abdomen and back

• Loss of appetite

• Weight loss without trying

• Nausea and vomiting

• Extreme tiredness

• Gallbladder or liver swelling

• Blood clots in your leg. These can cause pain, redness, or swelling in the leg.

• Blood clots in your lung. These can cause shortness of breath or chest pain.

• Uneven, lumpy fatty tissue under your skin

Many of these may be caused by other health problems. It’s important to see a healthcare provider if you have these symptoms for an accurate diagnosis. Only a healthcare provider can tell if you have cancer.

How is pancreatic cancer diagnosed?

Your healthcare provider will ask you about your health history, symptoms, risk factors, and family history of disease. They will do a physical exam. Your provider will check your belly for tumors that are big enough to be felt and for an enlarged liver.

You may also have one or more of these tests:

• Blood tests

• Ultrasound

• CT scan

• MRI scan

• PET scan

• Biopsy

A biopsy is the only way to confirm cancer. Small samples of tissue are taken out and looked at in a lab for cancer cells. 

After a diagnosis of pancreatic cancer, you’ll need more tests. These help your healthcare providers learn more about your overall health and the cancer. They can help find out the stage of the cancer. The stage is how much cancer there is and how far it has spread (metastasized) in your body. It's one of the most important things to know when deciding how to treat the cancer.

Once your cancer is staged, your healthcare provider will talk with you about what the stage means for your treatment. Ask your provider to explain the details of your cancer to you in a way you can understand.

How is pancreatic cancer treated?

Your treatment choices depend on the type of pancreatic cancer you have, test results, if the cancer can be removed with surgery, and the stage of the cancer. The goal of treatment may be to cure you, control the cancer, or to help ease problems caused by the cancer. Talk with your healthcare team about your treatment choices, the goals of treatment, and what the risks and side effects may be.

Types of treatment for cancer are either local or systemic. Local treatments remove, destroy, or control cancer cells in one area. Surgery and radiation are local treatments. Systemic treatment is used to destroy or control cancer cells that may have traveled around your body. When taken by pill or injection, chemotherapy (chemo) and targeted therapy are systemic treatments. You may have just one treatment or a combination of treatments.

Pancreatic cancer may be treated with:

• Surgery

• Radiation therapy

• Chemotherapy

• Targeted therapy

• Immunotherapy
  

Talk with your healthcare providers about your treatment choices. Make a list of questions. Think about the benefits and possible side effects of each choice. Talk about your concerns with your healthcare provider before making a decision.

What are treatment side effects? 

Cancer treatment, such as chemo and radiation, can damage normal cells. This can cause side effects, such as hair loss, mouth sores, and vomiting.

Talk with your healthcare provider about side effects linked to your treatment. There are often ways to manage them. There may be things you can do and medicines you can take to help prevent or control many treatment side effects.

Coping with pancreatic cancer 

Many people feel worried, depressed, and stressed when dealing with cancer. Getting treatment for cancer can be hard on the mind and body. Keep talking with your healthcare team about any problems or concerns you may have. Work together to ease the effect of cancer and its symptoms on your daily life.

Here are some tips:

• Talk with your family or friends.

• Ask your healthcare team or social worker for help.

• Speak with a counselor.

• Talk with a spiritual advisor, such as a minister or rabbi.

• Ask your healthcare team about medicines for depression or anxiety.

• Keep socially active.

• Join a cancer support group in person or online.

Cancer treatment is also hard on the body. To help yourself stay healthier, try to:

• Eat a healthy diet, with a focus on high-protein foods.

• Drink plenty of water, fruit juices, and other liquids.

• Keep physically active.

• Rest as much as needed.

• Talk with your healthcare team about ways to manage treatment side effects.

• Take your medicines as directed by your team.

When should I call my healthcare provider?

Your healthcare provider will talk with you about when to call. You may be told to call if you have any of the below:

• New symptoms or symptoms that get worse

• Signs of an infection, such as a fever

• Side effects of treatment that affect your daily function or don’t get better with treatment

Ask your healthcare provider what signs to watch for and when to call. Know how to get help after office hours and on weekends and holidays.

Key points about pancreatic cancer

• Pancreatic cancer is cancer that starts in cells that make up your pancreas. The pancreas is a pear-shaped organ that lies behind your stomach and in front of your spine.

• Symptoms can include yellowing of the skin and eyes, itchy skin, dark yellow or brown urine, back or stomach pain, and pale, bad-smelling stools that float in the toilet.

• There are no screening tests for people at average risk. Screening tests are done to check for disease in people who don’t have symptoms.

• There's no sure way to prevent pancreatic cancer. But you can help prevent it by eating healthy, being physically active, staying at a healthy weight, not smoking, and not drinking a lot of alcohol.

• Treatment can include surgery, chemotherapy, radiation therapy, immunotherapy, and targeted therapy.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are and when they should be reported.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions, especially after office hours or on weekends.