Doru Paul, MD, is triple board-certified in medical oncology, hematology, and internal medicine. He is an associate professor of clinical medicine at Weill Cornell Medical College and attending physician in the Department of Hematology and Oncology at the New York Presbyterian Weill Cornell Medical Center.
The pancreas consists of two types of cells that can give rise to pancreatic cancer.
Most pancreatic cancers (adenocarcinomas) begin in cells known as exocrine cells that are responsible for producing enzymes that are secreted into the intestine to help digest proteins, carbohydrates, and fats. Much less common are cancers (neuroendocrine tumors) that arise in endocrine cells that produce hormones, including insulin, that regulate processes ranging from blood sugar to the amount of acid in the stomach.
Pancreatic cancer is uncommon, but since the majority of these cancers are in the advanced stages at the time of diagnosis, it is the third leading cause of cancer-related deaths in the United States.
Treatment options include surgery, chemotherapy, targeted therapies, radiation therapy, and clinical trials.
The causes of pancreatic cancer are unclear, but risk factors may include having a family history of pancreatic cancer or genetic syndromes linked to pancreatic cancer, diabetes, advanced gum disease, pancreatitis (chronic inflammation of the pancreas), obesity, smoking, or heavy alcohol use. Risk also increases with age and almost all people are diagnosed after age 45.
Symptoms may include painless jaundice, upper abdominal pain that radiates to the back, a hard lump in the upper abdomen, and the unexpected onset of diabetes. It can also include weight loss, loss of appetite, and sometimes depression.
For early-stage cancers, surgery offers a chance to cure the disease. Unfortunately, only approximately 15% to 20% of people are candidates for surgery (for the remainder, the cancer has spread too far for surgery to improve survival).
Familial risk accounts for 5 to 10% of pancreatic cancers, and inherited genetic syndromes account for 3 to 5%. Those with a first-degree family history of pancreatic cancer or genetic diseases and mutations, such as hereditary breast and ovarian cancer syndrome caused by BRCA1 or BRCA2 genes, Peutz-Jeghers syndrome (polyps form in intestines), and hereditary pancreatitis, are considered high risk.
Explore interactive models that show how pancreatic cancer can progress in the body, and what changes each stage of the condition refers to.
A cancer that begins in glandular (secretory) cells. Glandular cells are in tissues that line certain internal organs and produce and release substances. Most pancreatic cancers and other common cancers like breast, lung, prostate, and colon are adenocarcinomas.
Chemotherapy uses medications to treat cancer. These drugs can interfere with rapid cell division and reduce the size of tumors. Chemotherapy agents may be injected or taken orally. Common side effects may include hair loss, bone marrow suppression, and nausea.
Jaundice is when there is a high level of bilirubin, a reddish-yellow pigment, in the blood that causes the skin, mucous membranes, and whites of the eyes to turn yellow. In pancreatic cancer, high bilirubin levels occur when the bile duct is blocked by the tumor.
A removal of part or all of the pancreas. If performed for pancreatic cancer, it can be done to remove all of the cancer or it may be a form of palliative care to try to reduce symptoms and prevent complications.
Radiation (also called radiotherapy) is a cancer treatment that uses high doses of radiation to destroy cancer cells or shrink cancer tissues. Radiation may be given as external beam radiation therapy in which radiation is delivered to a targeted part of the body from the outside, or via internal radiation therapy in which radioactive material is injected or implanted into the body.
The Whipple procedure (pancreaticoduodenectomy) is a common procedure for pancreatic cancer that hasn’t spread to other areas of the body. It is several procedures done in one operation and involves removal of parts of the pancreas (head of the pancreas), duodenum, common bile duct, gallbladder, adjacent lymph nodes, and sometimes part of the stomach.
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National Cancer Institute. Adenocarcinoma. NCI Dictionary of Cancer Terms.
American Cancer Society. Surgery for pancreatic cancer. Updated February 11, 2019.