Introduction

Pancreatic cancer develops when abnormal cells in the pancreas grow uncontrollably. Because it often advances quickly, understanding its risk factors, recognising early symptoms, and knowing how to lower your risk are crucial for timely diagnosis and better outcomes. In this article, we’ll clear up common misconceptions and answer frequently asked questions to help you stay informed and proactive about your pancreatic health.

What is pancreatic cancer?

Pancreatic cancer occurs when cells in the pancreas grow and divide uncontrollably to eventually form a tumour. The pancreas plays a major role in regulating blood sugar (also known as blood glucose) as well as digestion.¹

There are two main types of pancreatic cancer: exocrine and endocrine.

Exocrine pancreatic cancers 

Exocrine pancreatic cancers are the most common type of pancreatic cancer. Exocrine pancreatic cancers form in the exocrine cells of the pancreas. These cells are crucial for digestion as they are responsible for producing digestive enzymes.

Endocrine pancreatic cancers 

Endocrine pancreatic cancers start in the endocrine cells of the pancreas, which are associated with producing hormones. This type of cancer is more uncommon compared to exocrine pancreatic cancers.

What causes pancreatic cancer?

In the majority of pancreatic cancer cases, the exact cause is usually unclear. However, there are factors which could increase your risk of getting pancreatic cancer.²

• Age: According to the NHS, pancreatic cancer is more commonly seen in individuals over the age of 65 and is not very common in individuals below the age of 40
• Smoking: Some research shows that heavy smokers have a higher risk of having pancreatic cancer
• Weight: Obesity has been linked to an increased risk of having pancreatic cancer
• Alcohol: Heavy alcohol drinking has been associated with higher risks of pancreatic cancer
• Other medical conditions: Individuals affected by conditions such as diabetes, chronic pancreatitis (inflammation of the pancreas), gallstones and metabolic syndromes, have an increased risk of having pancreatic cancer

Is it hereditary?

Pancreatic cancer can be the result of an inherited genetic mutation or abnormality, however this is relatively uncommon and the majority of pancreatic cancer cases are not inherited. The genetic mutations involved in hereditary pancreatic cancer are associated with genes such as STK11, CDK2NA/p16, PRSS1, BRCA1 and BRCA2.³ 

What are the symptoms of pancreatic cancer?

Symptoms of pancreatic cancer can include:⁴

• Fatigue/constantly feeling tired 
• Jaundice (yellowing of the eyes and skin) 
• Weight loss 
• Loss of appetite
• Pain in the belly or the back 
• Changes in bowel habits
• Enlarged gallbladder or liver 

How is it diagnosed?

There are a variety of tests used to diagnose pancreatic cancer. These include:⁵ 

• Blood tests: This is used to look at kidney function as well as the function of the liver and are used to detect the presence of tumor markers, which are substances or proteins that indicate the presence of cancer
• Imaging tests: CT scans, MRIs and PET scans are often used to diagnose pancreatic cancer
• Ultrasound
• Biopsy

Are there any tests to screen for pancreatic cancer?

Unlike some other forms of cancer, such as breast cancer, there are currently no standard screening tests available for pancreatic cancer, particularly in low-risk individuals. This is because pancreatic cancer requires multiple forms of diagnostic tests (e.g imaging, blood tests, etc.) to be able to confirm a diagnosis. However, individuals considered high-risk may be able to get screened, usually through an ultrasound, or an MRI. The high-risk individuals typically include those with a family history of pancreatic cancer or those with certain genetic abnormalities/mutations (e.g BRCA mutations).^6,7,8 

Is it curable?

Pancreatic cancer can be cured if it is caught and treated at an earlier stage. However, due to the nature of the condition, pancreatic cancers are usually diagnosed at a later stage as symptoms occur in the latter stages of pancreatic cancer. Although most cases of pancreatic cancer are not curable, there are treatment options available that can improve prognosis and increase survival rate. 

What are the current treatment options?

• Surgery: Surgeries for pancreatic cancer typically involve the removal of some or all of the pancreas. Surgery is not used in all pancreatic cancer cases and is dependent on the stage of cancer and whether it has metastasised
• Chemotherapy: Chemotherapies are medicines used to target, slow down the growth of cancer cells and potentially kill these cancer cells. Chemotherapies are either administered orally as tablets or intravenously (into a vein)
• Radiation: Radiation therapy is a type of treatment that uses X-ray beams to target certain areas of the body to kill cancer cells⁹

It is important to note that the treatments used will be dependent on each individual’s case and it is crucial to consult with a specialist in order to determine the best treatment combination for the patient.

Is pancreatic cancer an aggressive form of cancer?

Yes, pancreatic cancer is considered one of the most aggressive forms of cancer and tends to have a lower survival rate. It tends to be more aggressive because it is usually diagnosed at advanced stages, once the cancer has already metastasised.¹⁰ 

What is the prognosis?

The prognosis of pancreatic cancer depends on how advanced it is and whether it is localised, regional, or distant. 

According to Cancer Research UK, the terms for these stage groups can be defined as follows: 

• Localised: The cancer is contained to the pancreas and has not spread
• Regional: The cancer has not spread to other organs, but has spread to the lymph nodes nearby 
• Distant: The cancer has spread to other organs or distant lymph nodes

Localised pancreatic cancers have a better prognosis with increased survival rates; however, distant pancreatic cancers tend to have a lower prognosis and a lower survival rate. According to the National Cancer Institute, the 5-year survival rate for localised pancreatic cancer, where surgical removal of the entire tumour can take place, is around 18-24%. However, exocrine pancreatic cancers, which are usually diagnosed and treated late, have an estimated survival rate of less than 6%.

Are there ways to prevent it?

There is no guaranteed way of preventing pancreatic cancer, however, there are actionable steps and lifestyle changes you could make to lower your risk of getting pancreatic cancer. These can include stopping smoking, maintaining a healthy weight, limiting alcohol consumption, and maintaining a healthy and balanced diet.¹¹

Summary 

• Pancreatic cancer occurs when there is uncontrollable growth and division of pancreatic cells 
• The two main types of pancreatic cancer are exocrine and endocrine
• There is no specific known cause of pancreatic cancer but factors such as age, smoking, weight, and alcohol consumption, may make someone more susceptible to developing pancreatic cancer and increase their risk
• Symptoms include fatigue, jaundice, stomach pain, and a loss of appetite
• To diagnose pancreatic cancer, healthcare specialists can use a variety of tests including blood tests, imaging tests (e.g., CT, MRI, PET scan), an ultrasound or a biopsy
• Unfortunately, most pancreatic cancer cases are not curable however, there are treatment options, including surgery, chemotherapy, and radiation, that can improve prognosis and increase survival rate
• Overall, pancreatic cancer is a very aggressive form of cancer, particularly when diagnosed at later stages
• Diagnosing it early and treating it as soon as possible can be extremely beneficial for improving prognosis and increasing survival rate
• If you are presenting with symptoms of pancreatic cancer, it is important you consult with a physician