Understanding pancreatic cancer: symptoms, risk levels and treatment

pancreatic cancer

Learning that you have cancer is never welcome news. But pancreatic cancer is an especially difficult diagnosis. 

That’s because it’s not often found early, when treatment is most effective, and it also has fewer treatment options than many other types of cancer. 

There are no screening guidelines for the general population to detect pancreatic cancer before it causes symptoms, as there are with breast and colorectal cancers. As a result, the five-year survival rate is only 9%, according to American Cancer Society figures. 

That grim statistic is why it’s important to take new symptoms seriously; however unlikely they are to be pancreatic cancer. 

It’s hard to catch it early, but it’s not impossible. A lot of patients, when they’re having these symptoms, don’t realize it could be serious and chalk up abdominal pain or back pain or weight loss to just being something new that’s bothering them. The important thing to ask is, have you ever had it before? And if it’s a new thing you’re experiencing, it’s important to go to a doctor. 

What are the signs and symptoms of pancreatic cancer?
The pancreas is a fish-shaped organ in the abdomen that releases enzymes that help the body digest and absorb food and makes hormones that help control blood sugar. 

Pancreatic cancer often begins silently, but when symptoms do appear, they may include:

  • Pain in the belly or the back
  • Yellowing of the eyes or skin (jaundice, which can also result in brown urine and greasy stools)
  • Weight loss and reduced appetite
  • Nausea and vomiting
  • Itchy skin
  • Enlargement of the gallbladder or liver, which a doctor might be able to feel
  • Blood clots

How common is pancreatic cancer?
Of course, these symptoms are also signs of several benign conditions. Pancreatic cancer is rare and accounts for just 3% of all cancers and 7% of all cancer deaths. But don’t take a chance if you have any of these symptoms and can’t explain why. 

There’s a difference between back pain that happens after you strained yourself and back pain that keeps you up at night without a clinical cause. Tell your doctor, and follow up if the issue persists. Pancreatic cancer cannot always be found with a blood test and may require imaging. 

Patients need to advocate for themselves. Trust that you know yourself better than anybody else. 

Who is at risk for the disease?
Pancreatic cancer can happen to anyone, but it is more common in men, African Americans, people older than 65, people with diabetes, and people with chronic or hereditary pancreatitis, which is inflammation of the pancreas. Smoking is a major risk factor; the risk is about twice as high in smokers compared with people who have never smoked. People who are obese (with a body mass index of 30 or more) are also at increased risk. Eating a diet high in fat and low in fruits and vegetables is a risk factor, as is heavy alcohol use. 

Is pancreatic cancer hereditary?
Pancreatic cancer can run in families, but most people who are diagnosed with it do not have a family history of the disease. If you do have a strong family history of cancer, especially close relatives diagnosed with cancer before age 50, talk to your doctor about genetic testing. Patients who have an inherited predisposition to pancreatic cancer may qualify for screening with bloodwork and specialized imaging of their pancreas. 

What Is the most effective treatment for pancreatic cancer?
Pancreatic cancer is treated primarily with chemotherapy and surgery, and sometimes with radiation, depending on the case. In the past, surgery was often the first route taken, but more recently doctors have found success using chemotherapy to shrink the tumor before operating. Also, chemotherapy can target cancer cells that have left the pancreas and spread to other parts of the body, even those too small to show up on a CT scan. 

Pancreatic cancer surgery: what is a Whipple procedure?
Surgery, which involves removing part of the pancreas, is generally reserved for patients who have early stage tumors and are still physically healthy. The most common surgery for pancreatic cancer is called the Whipple procedure, in which the surgeon removes the head of the pancreas and nearby structures, including a portion of the intestine and the bile duct. At Northside, surgery for the pancreatic tail is usually performed using robotic-assisted minimally invasive surgery to minimize postoperative pain. 

Researchers are working on novel approaches for pancreatic cancer, including new combinations of chemotherapy, targeted treatment that attacks tumors on a molecular level, and immunotherapy, in which the patient’s immune system is activated to fight the tumor. Those treatments are still being investigated but offer some optimism. 

What do you do if you’ve been diagnosed?
My message to anyone diagnosed with pancreatic cancer is to find experts who have experience treating this disease.

At Northside’s Liver and Pancreas Program, specialists in complex cancer surgery, medical oncology, radiation oncology, body imaging, interventional radiology, and pathology meet regularly to discuss each patient’s case and next steps. That way, each patient gets the benefit of more than a dozen expert medical opinions. 

In the unlikely event you are diagnosed with pancreatic cancer, you want to know all your options, and you want to see doctors who treat pancreatic cancer frequently. The sooner you land in a major system and get to the right team, the better. 



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Dr. Malini D. Sur picture

Dr. Malini D. Sur

Specialties: Cancer Care, Liver & Pancreas Surgery

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Dr. Sur is a board-certified surgical oncologist with expertise in the surgical management of tumors of the liver, pancreas, and gastrointestinal system. She specializes in minimally invasive laparoscopic and robotic surgery and strongly values an evidence-based, multidisciplinary approach to cancer care.

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