What is Pancreatic Cancer

Pancreatic cancer is an abnormal growth of cells (tumor) in the pancreas that is cancerous (malignant). The pancreas is a gland located in the abdomen, between the stomach and the spine.

The pancreas makes hormones, including insulin and glucagon. These hormones control your blood sugar and help your body use and store energy that comes from food. The pancreas also makes pancreatic juices that help digest food.

There are two types of pancreatic cancer:

• Exocrine. This is the most common type.
• Endocrine.

The different types of cancer have their own causes, risk factors, and treatment. Pancreatic cancer can spread (metastasize) to other parts of the body.

What are the causes?

The exact cause of this condition is not known.

What increases the risk?

The following factors may make you more likely to develop this condition:

• Age. The risk of pancreatic cancer increases with age. This condition most commonly occurs in people over the age of 65.
• Tobacco use, including cigarettes, chewing tobacco, or e-cigarettes.
• Being male.
• Being African American.
• Having a family history of cancer of the pancreas, colon, or ovaries.
• Having diabetes, especially if you were diagnosed as an adult.
• Having chronic pancreatitis.
• Being exposed to certain chemicals.
• Being obese and having a decreased level of physical activity.
• Eating a diet that is high in fat and red meat.
• Having an infection in your stomach caused by a strain of bacteria (Helicobacter pylori or H. pylori). This infection can lead to ulcers.
• Having certain hereditary conditions or gene mutations.
• Cirrhosis. This is the damage and scarring of the liver, which may be caused by hepatitis or heavy alcohol use.

What are the signs or symptoms?

In the early stages, there are often no symptoms of this condition. As the cancer gets worse (progresses), symptoms may vary depending on the type of pancreatic cancer you have. Symptoms include:

• Yellowing of the skin or eyes (jaundice).
• Weakness.
• Abdominal pain.
• Diarrhea.
• Depression.
• Loss of appetite and weight loss.
• Indigestion.
• Pain in the upper abdomen or upper back.
• A lump under the rib cage on the right side.
• Nausea and vomiting.
• Fatigue.
• Stools that are light-colored and greasy-looking, or stools that are black and tarry-looking.
• Dark urine.
• High blood sugar (hyperglycemia). This may cause increased thirst and frequent urination.
• Low blood sugar (hypoglycemia). This may cause confusion, sweating, and a fast heartbeat.
• Itchy skin.
• Skin that feels uneven.

How is this diagnosed?

This condition may be diagnosed based on your medical history and a physical exam. This may include checking your skin and eyes for signs of jaundice and checking your abdomen for any changes in the areas near the pancreas. Your health care provider will also check for a collection of excess fluid in the abdomen (ascites). Tests will also be done, such as:

• Blood tests.
• Urine tests.
• Ultrasound.
• CT scan.
• MRI.
• Removal of a sample of pancreatic tissue to be examined under a microscope (biopsy).

Other tests and procedures may also be done. If pancreatic cancer is confirmed, it will be staged to determine its severity and extent. Staging is an assessment of:

• The size of the tumor.
• Whether the cancer has spread.
• Where the cancer has spread.

How is this treated?

Depending on the type and stage of your pancreatic cancer, treatment may include:

• Surgery to remove all or part of the pancreas, or to remove a tumor.
• Radiation therapy. This is the use of high-energy rays to kill cancer cells.
• Chemotherapy. This is the use of medicines to stop or slow the growth of cancer cells.
• Targeted therapy. This treatment targets specific parts of cancer cells and the area around them to block the growth and spread of the cancer.

Your health care provider may recommend a combination of surgery, radiation therapy, and chemotherapy. You may be referred to a health care provider who specializes in cancer (oncologist).

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not drive or operate heavy machinery while taking prescription pain medicine.

General instructions

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do not use tobacco products, including cigarettes, chewing tobacco, or e-cigarettes. If you need help quitting, ask your health care provider.
• Maintain a healthy diet.
• Drink enough fluid to keep your urine clear or pale yellow.
• Consider joining a support group. This may help you learn to cope with the stress of having pancreatic cancer.
• Work with your health care provider to manage any side effects of your treatment.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You feel nauseous or you vomit.
• You have unexplained weight loss.

Get help right away if:

• You have pain that suddenly gets worse.
• You have chest pain or an irregular heartbeat.
• You have trouble breathing. You cannot eat or drink without vomiting.
• You have blood in your vomit or dark, tarry stools.
• Your skin or eyes turn more yellow.
• You develop new fatigue or weakness.
• You have abdominal bloating or pain.