Pancreatic cancer is the twelfth most diagnosed type of cancer, and the fourth leading cause of cancer death overall. In 2014, the American Cancer Society estimated that 46,420 people would be diagnosed with pancreatic cancer and 39,590 people would die of the disease.
The lifetime risk of having pancreatic cancer is approximately 1 in 67. Most patients with pancreatic cancer don’t have any predisposing risk factors. Perhaps the biggest risk factor for this cancer is increasing age; being older than age 60 puts an individual at greater risk.
Rarely, there are genetic syndromes that run in families, such as mutations (alterations) in the BRCA2 and, to a lesser extent, BRCA1 genes, which put individuals at increased risk for pancreatic cancer. Familial syndromes are unusual, but it is important to let your physician know if anyone else in your family has been diagnosed with cancer. Certain lifestyle behaviors and medical conditions are thought to slightly increase the risk for pancreatic cancer, including tobacco use, obesity, sedentary lifestyle, a history of diabetes, chronic pancreatic inflammation (pancreatitis), a fatty or Western diet, previous stomach surgery, chronic infections (such as hepatitis B or H pylori), and a history of pancreatic cysts.
Cancers that develop within the pancreas fall into 2 major categories: (1) cancers of the endocrine pancreas islet cell, which makes insulin and other hormones, and (2) cancers of the exocrine pancreas adenocarcinoma, which makes digestive enzymes. Adenocarcinoma of the pancreas comprises 95% of all pancreatic ductal cancers.
Because the pancreas lies deep in the abdomen, pancreatic cancer often grows silently for months before it is discovered. Early symptoms can be subtle or even absent. Identifiable symptoms, such as nausea, weight loss, jaundice, and itching of the skin develop once the tumor becomes larger. Most pancreatic cancers are found after the cancer has grown beyond the pancreas, or has spread (metastasized) to other places, such as the liver, lymph nodes, and the lining of the abdomen.
The Three Types of Pancreatic Cancer
Patients with pancreatic cancer are grouped into 3 categories—local disease, locally advanced disease, and metastatic disease. Patients with stage I or stage II cancers are thought to have local or surgically resectable (can be removed surgically) cancer. The most common potentially curative surgery is called pancreatoduodenectomy (also known as the Whipple procedure), in which the head or body of the pancreas, parts of the small intestine, bile duct, gallbladder, lymph nodes, and stomach are removed. Only approximately 20 in 100 people diagnosed with pancreatic cancer are found to have a tumor amenable to surgical resection.
Patients with stage III cancers have locally advanced, unresectable disease, in which the opportunity for cure has been lost but local control with radiation therapy remains a goal option. In patients with stage IV pancreatic cancer, chemotherapy is the most frequently recommended treatment for controlling the symptoms related to the cancer and for extending life.
At this time, there is no screening strategy to reduce the risk for pancreatic cancer for the general population. In addition, physicians do not routinely screen individuals with family members who have been diagnosed with the disease, except in the rare case where a known genetic risk factor is present.
As researchers have learned more about what makes pancreatic cancer cells different from normal cells, newer drugs have been developed that should be able to attack only the cancer cells. These newer drugs include “targeted” therapies, growth factor inhibitors, and angiogenesis inhibitors. Clinical research trials have shown promise for treating pancreatic cancer through immune therapies (that use the patient’s immune system to fight cancer cells), such as monoclonal antibodies and cancer vaccines to boost the body’s immune response to attack pancreatic cancer cells.
- The cancer centers of Valley View Medical Center and Dixie Regional Medical Center. Educational resources and support networks utilizing the expertise of trained oncology nurse navigators and social workers with experience in caring for people with cancer Pancreatic Cancer Action Network (www.pancan.org).
- Patient/liaison services program offering information on available treatments, diet and nutrition, specialists, and clinical trials, specific to pancreatic cancer, as well as a survivor/caregiver network that matches newly diagnosed patients and their families with volunteer survivors and caregivers Confronting Pancreatic Cancer (www.pancreatica.org).
- Real-world, unbiased, clear information about pancreatic cancer; for free information and counseling, call 800-525-3777, or to be put in contact with a fellow survivor, call 800-433-0464
- Hirshberg Foundation for Pancreatic Cancer Research (www.pancreatic.org). Information, resources, support, physician referrals, treatment facilities, and second opinions for patients with pancreatic cancer and their families (call 310-473-5121)
- The Lustgarten Foundation for Pancreatic Cancer Research (www.lustgarten.org). Free patient guide entitled “Understanding Pancreatic Cancer,” newsletters, and a quarterly “Ask an Expert” patient information series for new information on pancreatic cancer (call 866-789-1000)