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The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on March 29, 2021.

Pancreatic cancer overview

Treatment for symptoms and side effects


The pancreas is a gland that makes enzymes to help you digest food and hormones to control your blood sugar levels. Pancreatic cancer develops when cells in the pancreas grow out of control and form a tumor.


Measuring  about 6 inches long, the pancreas sits between the stomach and spine, is wide and round at one end, and comes to almost a point at the other, like the shape of a slender eggplant. Tumors may form in one of three parts of the pancreas: the head (the wide part), the body (the middle) or the tail (the narrow part). The cancer may spread to other parts of the body. 


The American Cancer Society (ACS) “Cancer Facts & Figures 2021” report estimates that 60,430 people in the United States will get a pancreatic cancer diagnosis in 2021. Adults may develop  pancreatic cancer at any age, but most pancreatic cancer patients are older than 65.


The five-year relative survival rate for pancreatic cancer is 10 percent, according to the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program. However, many factors affect survival, including age, overall health, cancer stage, cancer type and treatment.

Risk factors and causes

People who smoke cigarettes are about twice as likely to develop  pancreatic cancer as those who have never smoked, according to the ACS. Even using smokeless tobacco increases the risk. 


Other
risk factors include:

  • Obesity
  • Diabetes
  • Pancreatitis
  • Family history of pancreatic cancer or pancreatitis
  • Genetic syndromes such as:
    • Multiple endocrine neoplasia type 1 syndrome
    • Lynch syndrome
    • Von Hippel-Lindau syndrome
    • Peutz-Jeghers syndrome
    • Hereditary breast and ovarian cancer syndrome (caused by mutations in the BRCA genes)
    • Familial atypical multiple mole melanoma syndrome
    • Ataxia-telangiectasia
    • Li-Fraumeni syndrome
    • Familial adenomatous polyposis 
  • Exposure to chemicals such as pesticides, benzene and petrochemicals
  • A diet of high-fat foods
  • Excessive alcohol use

If you’re black or of Ashkenazi Jewish heritage, you’re more likely to develop pancreatic cancer than people in other racial and ethnic groups. 


That said, having one or more of these risk factors doesn’t mean you’ll get pancreatic cancer. Likewise, some people who have none of these risk factors are diagnosed with pancreatic cancer. 


Learn more about the risk factors for pancreatic cancer


Signs and symptoms of pancreatic cancer

Pancreatic cancer often doesn’t cause early symptoms, but signs of the disease include:

  • Jaundice (yellowing of the skin and eyes; accompanied by dark urine, light-colored or greasy stools, or itchy skin)
  • Abdominal or back pain
  • Weight loss and loss of appetite
  • Nausea and vomiting
  • Gallbladder or liver enlargement
  • Blood clots
  • Diabetes

Learn more about the symptoms of pancreatic cancer

Stages of pancreatic cancer

Doctors use staging to describe the size of a tumor, its spread and location. The stage number increases based on how much the cancer has grown or spread, with I being the earliest cancer and IV being the most advanced.

  • Stage I: Cancer is only in the pancreas and the tumor is smaller than 4 cm.
  • Stage II: The tumor is larger than 4 cm or the cancer has spread to three or fewer lymph nodes.
  • Stage III: The cancer has spread to nearby blood vessels or at least four lymph nodes.
  • Stage IV (metastatic): The cancer has spread to other parts of the body.

Most patients are diagnosed with this type of cancer after it has spread outside the pancreas, because early symptoms are rare and vague Researchers are working to find an early detection method for pancreatic cancer. At this time, no recommended screening method exists for the general population. Some high-risk patients may undergo procedures to detect the presence of cancer.


Learn more about the stages of pancreatic cancer

Types of pancreatic cancer

The most common kind, pancreatic adenocarcinoma starts in the exocrine cells of the pancreas. Exocrine cells help make and transport enzymes to digest food. About 95 percent of exocrine pancreatic cancers are adenocarcinoma, according to the ACS


Less common types of exocrine pancreatic cancer are:

  • Acinar cell carcinoma
  • Adenosquamous carcinoma
  • Colloid carcinoma
  • Giant cell tumor
  • Hepatoid carcinoma
  • Pancreatoblastoma
  • Serous cystadenoma
  • Signet ring cell carcinoma
  • Squamous cell carcinoma
  • Undifferentiated carcinoma

Pancreatic neuroendocrine tumors, also called islet cell tumors, start in the endocrine (or hormone-producing) cells of the pancreas. They’re very rare, making up less than 2 percent of pancreatic cancer cases, according to ACS


They can be functioning, which means they make hormones, or nonfunctioning, which means they don’t make hormones. When functioning, they’re named for the hormones they make, so they may be called: 

  • Insulinoma
  • Glucagonoma
  • Gastrinoma
  • Somatostatinoma
  • VIPoma
  • PPoma

Other growths that have the possibility of becoming pancreatic cancer are:

  • Serous cystic neoplasms
  • Mucinous cystic neoplasms or mucinous cystadenomas
  • Intraductal papillary mucinous neoplasms
  • Solid pseudopapillary neoplasms

Learn more about the types of pancreatic cancer

Diagnosis

To determine whether you have pancreatic cancer, your doctor will:

In the diagnostic process, a biopsy is used to confirm the presence of cancer. The procedure involves removing a small piece of tumor tissue for study under a microscope. A biopsy may also reveal certain factors about the cancer, such as the specific type.


Learn more about diagnosing pancreatic cancer

Pancreatic cancer treatment

After a pancreatic cancer diagnosis, patients need to discuss treatment options and goals with a care team.


Standard treatment options for pancreatic cancer include: 

  • Surgery to remove the tumor or to relieve symptoms and improve quality of life
  • Chemotherapy drugs to kill cancer cells or stop them from growing, affecting the whole body
  • Radiation therapy, via X-rays targeted at a specific place in the body, to kill cancer cells or stop them from growing
  • Targeted therapy substances to find and attack specific cancer cells 

These treatments may be used alone or together. A patient’s options depend on the stage of pancreatic cancer and factors, including age and other health conditions. 


Clinical trials are regularly testing new state-of-the-art treatments, and may be an option at any point in the cancer treatment regimen. It’s important to discuss this option with your doctors.


The American Society of Clinical Oncology recommends that all patients diagnosed with pancreatic cancer consider genetic testing, which may indicate a hereditary predisposition to cancer. . 

Knowing whether a patient has DNA mutations may help doctors better tailor treatments. It also may encourage family members to get tested.

 

Learn about treatment options for pancreatic cancer

Treatment for symptoms and side effects

No matter which treatment is prescribed, supportive care may help address symptoms and side effects—and improve a patient’s quality of life. This type of care is available at any point in the diagnosis process. 


To deal with a patient’s pain, doctors may inject medicine that stops the nerves from emanating pain in the affected area. Radiation therapy may also help shrink a tumor, so it isn’t pressing on the nerves and causing pain.


Cancer or its treatment may also produce nutritional challenges. Patients experiencing weight loss or lack of appetite may benefit from meeting with a dietitian. Additionally, if the pancreas isn’t working well, or if part or all of it was removed through surgery, doctors may prescribe enzymes to improve food digestion.


Integrative supportive care also may tackle emotional challenges, such as anxiety and depression, and help patients and their loved ones cope with the diagnosis and any issues that arise.