Pancreatic Cancer

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Questions to Ask Your Doctor About Your Cancer
(Free Handout)

The pancreas is an organ of the digestive system. It is located near the stomach and small intestine. It has two major jobs or functions. First, the exocrine pancreas makes enzymes that help in the digestion of food products. Second, the endocrine pancreas produces several hormones that have diverse functions. Cancers of the pancreas can occur in the exocrine pancreas (classic pancreatic adenocarcinomas) or can occur in the endocrine pancreas. This section will discuss exocrine pancreatic carcinoma.

Cancers of the exocrine pancreas are a very serious health issue in the United States where approximately 27,000 patients are diagnosed annually with pancreatic cancer while about the same number die annually from this disease. Due to difficulties in diagnosis, the intrinsic aggressive nature of pancreatic cancers, and the sparse systemic treatment options available, only approximately 4% of patients diagnosed with pancreatic adenocarcinoma will be alive five years after diagnosis. Pancreatic cancer is the fifth leading cause of cancer deaths following breast cancer; lung cancer, colon cancer, and prostate cancer. Because of the extremely poor prognosis for the majority of individuals with pancreatic cancer, it is very important that patients be offered the opportunity to participate in clinical trials. If you or someone you love has been diagnosed with pancreatic cancer, speak with your physician regarding any trials in which you or your loved one may be eligible to participate.

Risk Factors

The risk of developing cancer of the pancreas is usually low before the age of 40, but the risk subsequently increases sharply, with most people diagnosed between their sixties and eighties. Risk factors for the development of this disease include environmental factors, medical/surgical factors, genetic factors, and occupational exposures.

The presence of a risk factor does not necessarily mean that an individual will develop cancer, nor does the absence of risk factors mean that an individual will not develop cancer.

Age: The incidence of pancreatic cancer is relatively low in individuals up to age 50, after which it increases significantly. The age group 65 - 79 has the highest incidence of cancer of the pancreas.

Smoking: Smokers develop pancreatic cancer more than twice as often as nonsmokers.

Diet: Frequency of pancreatic cancer may be associated with high intakes of meat and fat.

Medical factors: Pancreatic cancer is more common among individuals with histories of the following conditions: cirrhosis (a chronic liver disease), chronic pancreatitis, diabetes and a history of surgery to the upper digestive tract.

Environmental factors: Long-term exposure to certain chemicals, such as gasoline and related compounds, as well as certain insecticides, may increase the risk of developing cancer of the pancreas.

Genetic predisposition: Possibly 3% of cases of pancreatic cancer are related to genetic disorders.

Signs and Symptoms

The diagnosis of pancreatic cancer is usually delayed because symptoms are nonspecific. Jaundice, which causes yellowing of the skin, is present in approximately 50% of patients at the time of diagnosis and may be associated with less-advanced disease. Other symptoms include weight loss, fatigue, discomfort in the abdomen, loss of appetite, and glucose intolerance.

In addition, the patient may experience pain in the abdomen and back. The pancreas may produce too much insulin, causing such symptoms as dizziness, weakness, diarrhea, chills, or muscle spasms.

The patient may not even notice the gradual onset of these relatively nonspecific symptoms. The doctor may interpret them as being caused by something else.

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