• Pancreatic Cancer

    Dana-Farber/Brigham and Women's Cancer Care

    About Pancreatic Cancer

    The pancreas is a gland about six inches long that is shaped like a thin pear lying on its side. The wider end of the pancreas is the head, the middle section is the body, and the narrow end is the tail. The pancreas lies behind the stomach and in front of the spine.

    The pancreas has two main jobs in the body:

    • To produce fluids that help digest (break down) food.
    • To produce hormones, such as insulin and glucagon, to help control blood sugar levels. Both of these hormones help the body use and store the energy it gets from food.

    The digestive fluids are produced by exocrine pancreas cells and the hormones are produced by endocrine pancreas cells. About 95% of pancreatic cancers begin in exocrine cells.

    PDQ image - Anatomy of the pancreas 

    The most common type of pancreatic cancer is adenocarcinoma involving the head of the pancreas, though it can occur anywhere in the pancreas, including the body and tail.

    Cancers of the pancreas include premalignant and malignant tumors of several types. These tumors are sometimes discovered during imaging studies (MRI or a CT scan) for another condition, or for screening for familial cancers.

    Other pancreatic and biliary tumors can, in many cases, mimic tumors of the pancreas. These include tumors of the extrahepatic biliary tree, Ampulla of Vater, and duodenum.

    The final diagnosis frequently is not made until the tumors are removed surgically.

    Incidence

    According to the National Cancer Institute approximately 44,000 men and women in the United States (approximately 12.1 per 100,000) are diagnosed with pancreatic cancer every year. Most patients are diagnosed after the age of 55 with 71 as the median age at diagnosis.

    Risk Factors

    Anything that may increase your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors does not mean that you will not get cancer. 

    Risk factors for pancreatic cancer include the following:

    • Smoking
    • Long-standing diabetes
    • Chronic pancreatitis (inflammation of the pancreas, especially in people who smoke)
    • Age (55+ years)
    • Obesity
    • Race (African Americans are more likely to develop pancreatic cancer than white, Hispanic or Asian Americans)
    • Family history (one or more family members who have had the disease)
    • Genetic factors (one or more inherited genetic mutations, including the following):
      • Hereditary pancreatitis, multiple endocrine neoplasia type 1 syndrome, hereditary breast-ovarian cancer (HBOC), hereditary nonpolyposis colon cancer (HNPCC; Lynch syndrome), von Hippel-Lindau syndrome, ataxia-telangiectasia, and the familial atypical multiple mole melanoma syndrome (FAMMM)
       

    Genetic Risk Assessment for Pancreatic Cancer

    Our gastroenterologists have special expertise evaluating and managing patients whose family history increases the risk of developing pancreatic cancer.

    If you have a family history of cancers that cluster with pancreatic cancer, you may wish to meet with one of our gastroenterologists as well as a genetic counselor for an in-depth risk assessment. These cancers include:

    • Breast or ovarian cancer
    • Gastrointestinal cancer such as colon, stomach or pancreatic cancer
    • Melanoma
    • Multiple benign colon polyps

    The risk assessment includes a detailed family lineage analysis, genetic evaluation using state-of-the-art molecular tests, and tailored cancer screening and prevention recommendations for you and your family members.

    Evaluations are provided by the Cancer Genetics and Prevention Program.

    Symptoms of Pancreatic Cancer

    Pancreatic cancer often develops without any early symptoms. 

    The majority of symptoms arise because of the tumor’s location in the pancreas and its relationship to other organs. When symptoms do occur, they are often vague. One of the most common symptoms is painless jaundice. Patients or family members notice yellowing of the eyes or skin. The urine could turn dark yellow. As it gets worse, patients will get white stool and general itchiness. This is caused by a blockage in the bile duct that comes from the liver and is obstructed by the pancreatic tumor in the head of the pancreas.

    Consult your doctor if any of the following occur:

    • Jaundice (yellowing of the skin and whites of the eyes)
    • Pain in the upper or middle abdomen and back
    • Unexplained weight loss
    • Loss of appetite
    • Fatigue
    • General itchiness
    • Vomiting, diarrhea
    • New onset diabetes

    Find out more about pancreatic cancer from the National Cancer Institute

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