The pancreas is a body organ responsible for the production of digestive juices and insulin, as well as other hormones to do with digestion. Pancreatic cancer occurs when cancers cells form in the pancreas. Primary pancreatic cancer begins in the pancreas. When cancer begins in the pancreas and spreads to other organs, usually throughout the abdomen, liver, lungs, bones, and brain, it is defined as metastatic pancreatic cancer.
Where does Pancreatic Cancer start?
Most pancreatic cancers start in the cells lining the ducts of the pancreas, called adenocarcinoma or pancreatic exocrine cancer. Pancreatic cancer formed in the endocrine cells (the hormone-producing cells) is called pancreatic neuroendocrine tumors, islet cell tumors or pancreatic endocrine cancer. Pancreatic endocrine cancer occurs in less than 2 percent of pancreatic cancer cases and has better outcomes for patients.
Pancreatic Cancer Symptoms
Pancreatic cancer can be difficult to detect early because there are no noticeable signs or symptoms in its early stages and the signs mimic many other illnesses. As the cancer progresses, patients may notice the following symptoms:
- Abdominal pain or pain in the back
- Loss of appetite/weight loss
- Yellow tinge to your skin and the whites of your eyes
- Dark-colored urine
- Light-colored stools
- Itchy skin (caused by a tumor blocking the common bile duct)
These symptoms may be caused by other conditions and you should consult with your doctor if you have any of these symptoms.
Pancreatic Cancer Risk Factors
It is important to know the risk factors that increase your chance of developing pancreatic cancer. Some people diagnosed with the disease have few or no risk factors and it is important to understand that your behaviors and life conditions can change your risk of developing pancreatic cancer. The following are risk factors for pancreatic cancer:
- Smoking: People who smoke are 2-3 times more likely to develop pancreatic cancer.
- Age: Your risk of developing pancreatic cancer increases as you age.
- Gender: Men are more likely to be diagnosed with pancreatic cancer.
- Race: African-Americans are more likely to develop pancreatic cancer.
- Obesity: Being overweight is a risk factor for pancreatic cancer
- Diabetes: Patients with diabetes have an increased risk of developing pancreatic cancer. Developing diabetes later in life may be an early sign of pancreatic cancer. However, not all people who have diabetes develop pancreatic cancer
- Chronic pancreatitis: Chronic pancreatitis is a long-term inflammation of the pancreas seen in patients who smoke or use alcohol heavily.
Genetics and Pancreatic Cancer Risk
Some people from families with a high rate of pancreatic cancer, known as familial pancreatic cancer (FPC), may have an increased risk of this type of cancer. This includes when there are at least 2 members of the family with pancreatic cancer who are first-degree relatives, such as a parent, child, or siblings of one another, or if there are at least 3 members of the family who have pancreatic cancer. People who meet these guidelines should consider genetic testing to see if there is a specific genetic mutation that may have caused the pancreatic cancers in their family. CentraState offers high-risk pancreatic cancer screening for individuals who qualify.
Pancreatic Cancer Diagnosis & Staging
If a physical examination indicates you may have pancreatic cancer, your doctor will order tests to confirm the diagnosis and find out if the cancer has spread (metastasized). Some common tests include:
- Blood tests: Blood tests can detect pancreatic irregularities
- Imaging tests: Imaging tests include ultrasound, computerized tomography (CT), positron emission tomography (PET) scan, magnetic resonance imaging (MRI), magnetic resonance cholangiopancreatography (that sees inside the pancreatic ducts) and endoscopic retrograde cholangiopancreatography (ECRP), which allows your physician to see if the pancreatic duct is narrowed or blocked.
- Biopsy: Biopsy removes a sample of tissue to determine if it is cancerous. Doctors examine the tissue sample in the lab to determine the presence of cancer cells. A biopsy may be:
- Fine needle aspiration: A thin needle is inserted externally and guided to the tumor to acquire a tissue sample.
- Endoscopic biopsy: While the patient is sedated, a doctor inserts a thin, lighted tube through the mouth and stomach into the small intestine. A catheter passes through the endoscope and into the bile and pancreatic ducts where tissue samples can be taken.
Once pancreatic cancer is diagnosed, you will be seen by a multispecialty team who will determine the next course of action.