Pancreatic Cancer

Overview

Pancreatic cancer is a type of cancer that occurs when abnormal cells form in the tissues of the pancreas, an organ located behind the stomach. It is a serious and often deadly disease due to its aggressive nature and the difficulty of early detection. Several risk factors include smoking, family history of pancreatic cancer, diabetes, obesity, chronic pancreatitis, heavy alcohol use and certain genetic syndromes. The most common type of pancreatic cancer is called pancreatic ductal adenocarcinoma. Unfortunately, the symptoms of pancreatic cancer often show up when the disease is advanced. Symptoms can include jaundice, weight loss, abdominal pain that spreads to the sides or back, dark urine, fatigue, itching and light colored stools.

How is it diagnosed?

Your physician may order imaging tests to help diagnose pancreatic cancer. Those tests can include a CT scan, used to visualize the pancreas and surrounding structures, assess the size and location of tumors, and detect metastasis. MRI and PET scans provide detailed images of the pancreas and nearby blood vessels, helping in tumor detection. Endoscopic Ultrasound (EUS) uses ultrasound to obtain high-resolution images of the pancreas to detect tumors. Your physician may also take tissue biopsies during a EUS, which can confirm the diagnosis of pancreatic cancer. Biopsy samples can also be obtained through fine-needle aspiration (FNA).

How is it treated?

The treatment of pancreatic cancer depends on several factors, including the tumor stage, location, size, and overall health of the patient. Treatment options may include surgery, chemotherapy, radiation, targeted therapy, and immunotherapy. Surgery options include:

  • Whipple procedure: This surgery involves removing the head of the pancreas, the duodenum and the bile duct. They may also remove a portion of the stomach and nearby lymph nodes.
  • Distal pancreatectomy: In this procedure, the tail and body of the pancreas are removed, usually along with the spleen.
  • Total pancreatectomy: In rare cases, the entire pancreas is removed.

 Chemotherapy and radiation drugs can be used to kill cancer cells or to shrink tumors before or after surgery. Targeted therapy drugs are designed to attack specific abnormalities present in cancer cells. Immunotherapy drugs work by stimulating the body’s immune system to recognize and attack cancer cells. While immunotherapy is still being studied for pancreatic cancer, some immunotherapy drugs, such as immune checkpoint inhibitors, may be used in certain cases.

Image courtesy of Mayo Clinic

References

National Institutes of Health-National Cancer Institute. (2024). Pancreatic Cancer Treatment (PDQ)–Patient Version. https://www.cancer.gov/types/pancreatic/patient/pancreatic-treatment-pdq

Mayo Clinic. 2023. Pancreatic Cancer. https://www.mayoclinic.org/diseases-conditions/pancreatic-cancer/symptoms-causes/syc-20355421