What is pancreatic cancer?
The pancreas is an organ in the digestive system, joined to the small bowel by a duct.
Pancreatic cancer starts in the cells lining this duct, spreads into the body of the pancreas, and then invades nearby nerves and blood vessels.
About 2,500 Australians are diagnosed with pancreatic cancer each year, with an average age of 71.
The pancreas is a thin, lumpy gland about 15cm long that lies between your stomach and spine. It produces enzymes which break down food so it can be absorbed and used by the body. A tube called the pancreatic duct connects the pancreas to the small bowel.
The pancreas also produces insulin.
Pancreatic cancer starts in the cells lining the pancreatic duct, and then spreads into the body of the pancreas. Cancer can also spread to nearby lymph nodes (part of the immune system), blood vessels or nerves. It may travel through the bloodstream to other parts of the body, such as the liver.
Causes of pancreatic cancer
Most people with pancreatic cancer don't have a family history of the disease. However, about one in 10 people who develop it have inherited a faulty gene that increases their risk. Smoking is a major risk factor, with smokers two to three times more likely to develop pancreatic cancer.
Other risk factors include:
- Age – it's most common in people over 65
- Diabetes – about 15% to 20% of people with pancreatic cancer have newly diagnosed diabetes
- Pancreatitis (chronic inflammation of the pancreas)
- Gastrectomy (having had all or part of the stomach removed)
Symptoms of pancreatic cancer
Early stages of pancreatic cancer rarely cause symptoms, and symptoms may go unnoticed until the cancer is large enough to affect nearby organs.
Symptoms of pancreatic cancer may include:
- Indigestion and abdominal pain
- Appetite loss
- Feeling sick (nausea)
- Vomiting
- Weight loss
- Pain in the upper abdomen, side or back
- Changed bowel motions (diarrhoea or constipation)
- Jaundice (yellowish skin and eyes, dark urine, pale stools and itchiness)
In up to 50% of people with pancreatic cancer, the cancer stops the pancreas from making insulin properly and causes diabetes (or makes existing diabetes worse).
Treatment of pancreatic cancer
A number of tests may be required to diagnose pancreatic cancer, including blood tests, CT and MRI scans, tissue biopsies, endoscopies and laparoscopies.
These tests will also help determine if the cancer has spread into blood vessels or lymph nodes near the pancreas, or into organs further away, like the liver or the lungs. This is called ‘secondary cancer’ or metastasis.
Surgery is the most effective treatment for pancreatic cancer, if the cancer hasn’t spread beyond the pancreas and the patient is in reasonably good health. The cancer, part of the pancreas and part of the small bowel are removed in a major operation called ‘Whipple’s resection’. Some of the bile ducts, gall bladder and stomach may also be removed.
Chemotherapy (either tablets or injections) may be used after surgery to stop the cancer cells growing and reproducing. Radiotherapy – x-ray treatment used to kill off any remaining cancer cells – may be used after surgery, or as the main treatment when surgery is not possible, in combination with chemotherapy.
Many people with cancer seek out complementary or alternative treatments. It’s important to discuss any treatment options you may be considering with your doctor. The Cancer Council of Victoria factsheet Complementary and alternative medicine: making informed decisions may be a useful resource.
Further information and sources
Disclaimer
This article is of a general nature only. You should always seek medical advice if you think you may have the symptoms of pancreatic cancer.