Pancreatic cancer refers to cancers that begin in the pancreas. The pancreas sits in the abdomen below the stomach. The pancreas has two important functions within the body: producing hormones that regulate both your blood sugar and your glands (endocrine) and helping with digestion (exocrine).

Adenocarcinoma is the most common form of pancreatic cancer and occurs when the pancreas’ exocrine cells begin to grow out of control. Exocrine cells form exocrine glands and ducts and comprise much of the pancreas. Exocrine glands in the body create pancreatic enzymes that are then released into the intestine to aid in the process of digestion.

Types of Benign and Precancerous Growths in the Pancreas

Occasionally, a growth in the pancreas can remain non-cancerous, or benign, while others may develop into cancer over time if not treated. When this occurs, the growth is deemed precancerous. Most benign or precancerous growths can be found with imaging tests, such as CT scans.

Mucinous Cystic Neoplasms are slow-growing tumors. These tumors contain cysts that fill with a substance called mucin. MCNs are not cancerous but have the potential to turn cancerous if they remain untreated. MCNs are most often treated with surgical removal. MCNs almost always occur in women.

Serous Cystic Neoplasms are tumors that comprise of fluid-filled cysts. These tumors are often benign and are often only treated if they begin to grow at an alarming rate or cause pain or discomfort.

Intraductal Papillary Mucinous Neoplasms (IPMNs) are tumors that grow in the ducts of the pancreas. These tumors are typically benign but can grow into cancer if not treated. Depending on the location of the IPMN, they can be left alone and monitored over time or removed surgically.

Solid Pseudopapillary Neoplasms (SPNs) are slow-growing tumors that occur in the pancreas. These tumors are rare and are almost always found in young women. These tumors are best treated by removing them surgically, as they can spread to other parts of the body if left untreated.

Types of Pancreatic Cancer

The most common form of pancreatic cancer are exocrine cancers. Roughly 95% of exocrine cancers of the pancreas are adenocarcinomas. Pancreatic Adenocarcinoma: The most common form of exocrine pancreatic cancers, adenocarcinomas begin in the ducts of the pancreas. Other Exocrine Cancers: Less common forms of exocrine cancers include squamous cell carcinomas, adeniums carcinomas, signet ring cell carcinomas, and undifferentiated carcinomas.

Ampullary Cancers: Ampullary cancers begin where the bile duct and pancreatic duct join and empty into the small intestine, called the ampulla of vater. While ampullary cancers aren’t necessarily cancers of the pancreas, they are treated similarly to pancreatic cancers.

What causes pancreatic cancer? What puts me at risk?

There is not a clear-defined cause of pancreatic cancer. However, there are factors that have the potential to increase your risk of developing pancreatic cancer, including:

• Diabetes
• Smoking
• Family history of pancreatic cancer or genetic mutations that may lead to pancreatic cancer
• Obesity
• Older age (most people are commonly diagnosed after age 65)
• Frequent or chronic pancreatitis (inflammation of the pancreas)

It is believed that the combination of long-standing diabetes, poor diet, and habitual smoking can increase your risk of developing pancreatic cancer to a higher degree than a single risk factor alone.

How do I know if I have pancreatic cancer?

Pancreatic cancer often doesn’t cause symptoms in its earliest stages. Symptoms often only occur once the cancer has spread to other organs. Common signs and symptoms of pancreatic cancer include:

• Unintended weight loss
• Loss of appetite
• Abdominal pain, typically radiating towards your back
• Jaundice (yellowing or your skin and/or the whites of your eyes)
• Dark-colored urine
• New diabetes diagnosis, or an existing diabetes diagnosis that has become difficult to control

What is the best way to treat pancreatic cancer?

Treatment for pancreatic cancer varies depending on the type and stage of ovarian cancer you are diagnosed with. Common treatments include surgery, chemotherapy, radiation, or a combination of any of these treatments. Here are some leading treatments for pancreatic cancer, all of which are available at South Texas Oncology and Hematology for Cancer Care.

Surgery
Your surgical option will depend on your type of pancreatic cancer and if it has spread to other organs. If your cancer is in the head of the pancreas and has not spread, your surgeon may elect to perform a Whipple procedure. In a Whipple, your surgeon will remove the head of the pancreas, as well as a portion of your small intestine, gallbladder, and part of the bile duct. If your pancreatic cancer is in the body of the pancreas or in its tail, your surgeon may elect to perform a distal pancreatectomy to remove the body and tail of the pancreas. If your cancer has spread throughout your pancreas, your surgeon may elect to perform a total pancreatectomy, or a complete removal of your pancreas.

Chemotherapy
Chemotherapy drugs look for cells that divide quickly (like cancer cells) and destroy them. It is particularly useful when treating cancer in later stages because it can kill cancer cells throughout the whole body. More than half of cancer treatments involve some kind of chemotherapy, sometimes to completely remove the cancer and sometimes to just slow symptoms. You might have heard of chemotherapy side effects such as hair loss, nausea, or damage to the skin and/or bones. These side effects occur because the tissues in your hair, intestines, skin, and bones are all fast-growing cells and thus might potentially be attacked by chemotherapy drugs. Chemotherapy drugs can be taken orally or injected into your veins.

Radiation
In radiation therapies, high-energy x-rays are used to kill cancerous cells or prevent their growth. Radiation therapy can take one of two forms, either internal or external radiation therapy.

External radiation therapies include the use of a machine to direct radiation towards the area of the body affected by cancer. External radiation can occur through intensity-modulated radiation therapy (also called IMRT), which aims to prevent damages to nearby health tissues. With IMRT, a computer is used to make a three-dimensional rendering of the tumor’s size and shape. Once the tumor is mapped, thin beams of differing strengths are aimed at the tumor from a variety of angles.

Internal radiation therapies used radioactive substances that may be sealed within needles, seeds, catheters, or wires that are placed near or directly into the cancer.

How can I prevent pancreatic cancer?

Most pancreatic cancers cannot be prevented. However, you can reduce your risk of developing pancreatic cancer by implementing healthy lifestyle habits, such as maintaining a healthy weight through diet and exercise, not smoking, and limiting your intake of alcohol. If you have a family history of pancreatic cancer or have experienced chronic pancreatitis, talk with your primary healthcare provider to see what you can do to mitigate these risks.

Additional Resources

National Library of Medicine - Pancreas
Mayo Clinic
John Hopkins Medicine - Pancreatic Prevention