Pancreatic cancer is one of the most serious cancer types. It affects around 10,000 people in the UK every year, making it the 10th most common cancer. It unfortunately has the highest case-fatality rate out of any major cancer. Pancreatic cancer begins in the pancreas, the organ in your body that aids digestion and blood sugar management.
What is the pancreas?
The pancreas is a banana-shaped organ in your body. It serves two main functions:
Digestion Helper: Releases enzymes that break down food.
Your pancreas is just one cog in the machine that is your digestive system. It releases enzyme-rich juice into small ducts that flow into the main pancreatic duct. The main pancreatic duct connects to your bile (a fluid that aids with digestion) from your liver to your gallbladder. From the gallbladder, the bile travels to your small intestine (duodenum), where the bile and pancreatic juice enter to break down food.
Blood Sugar Management: Produces insulin and glucagon.
Your pancreas makes hormones like insulin and glucagon, which help in controlling blood sugar levels. When blood sugar levels are too high, the pancreas produces insulin to lower them, and when blood sugar levels are too low, the pancreas makes glucagon to increase them.
What is pancreatic cancer
Cancer is an illness in which cells grow and reproduce uncontrollably due to mutations in the DNA. Uncontrollable growth can lead to invasion and destruction of healthy tissues.
Pancreatic cancer is not as common as other kinds of cancers; however, it is still serious. In the UK, there are around 10,000 people diagnosed with it annually. While it is one of the rarer cancers, it is important to understand it further, as early detection makes a huge difference.
There are several kinds of pancreatic cancers, but the vast majority (90%) develop from the cells that line the pancreatic duct. These are called adenocarcinomas.
When cancer occurs in the pancreas, it causes many problems. The key ones being:
- Blocking important ducts: Tumours in the pancreas can cause blocks, stopping digestive juices from flowing. When tumours occur in the bile duct (the duct carrying bile from the liver), this can lead to jaundice
- Spreading to nearby organs: the location of the pancreas means that as the cancer grows, it can invade nearby areas, affecting important organs like the stomach, liver and kidneys
- Metastatic cancer: this happens when cancer cells break away and travel through the lymph system or bloodstream to other organs, most commonly the liver, lungs or bones
Pancreatic cancer is often called a ‘silent disease’ because early symptoms are vague. However, these are the more common symptoms:
- Jaundice (yellow skin/eyes)
- Unexplained weight loss
- Persistent stomach or back pain
- Light coloured stools or dark urine
- New diagnosis of diabetes/diabetes that is harder to control
- Tiredness/Weakness
What causes pancreatic cancer
Cancers are caused by mutations in the DNA. These DNA mutations can occur in 3 different ways. They can be inherited, caused by behaviours, or occur by chance.
Inherited
Family history is a recognised risk factor for pancreatic cancer and an important indicator of disease risk. In approximately 5-10% of pancreatic cancer patients, they report a close relative has a history of pancreatic cancer.
Pancreatic cancer is more common in families with numerous hereditary patterns. BRCA 1 and BRCA 2 are some of the predisposing genes identified, which are also associated with breast cancer and ovarian cancer. Understanding the genetic predisposition of pancreatic cancer has been significant in the development of targeted therapy.
Proportionately, pancreatic cancer is more common in Ashkenazi Jews than in the rest of the population. Within Ashkenazi Jewish families, there is thought to be an inherited mutation within the BRCA2 gene associated with pancreatic cancer. These mutations increase the risk of pancreatic cancer.
The pancreatic cancer risk is higher in people who have:
- Peutz Jeghers syndrome
- Familial atypical multiple mole melanoma syndrome (FAMMM)
- Lynch syndrome/hereditary non-polyposis colorectal cancer (HNPCC)
Behavioural
There are a few ways in which our behaviour can damage DNA and, in turn, cause cancer.
Smoking
One of the key risks associated with pancreatic cancer is cigarette smoking. Cigarette smoke contains at least 70 cancer-causing chemicals (carcinogens), and when you smoke, the toxic chemicals enter your bloodstream, reaching the pancreas. If the carcinogens in cigarette smoking damage pancreatic cell DNA, it can lead to mutations, leading to the cell growing into cancer. The pancreas is also especially vulnerable because it filters blood constantly, exposing it to high levels of toxins. Many studies have been conducted showing the positive association of smoking with the development of pancreatic cancer. It is also associated with early age diagnosis. However, smoking is one of the most preventable causes of pancreatic cancer, with research showing that quitting smoking significantly decreases the risk of pancreatic cancer.
Obesity
More than 10 in 100 (10%) pancreatic cancer patients are the result of being overweight/obese. Being overweight is a big risk factor for cancer. Fat cells send signals to the body, and these signals can increase inflammation and make extra hormones, like growth hormones, which tell cells to divide more often. Cells divide more often, leading to cancer. The pancreas produces more insulin in overweight people; this is why being overweight is a risk factor associated with pancreatic cancer.
Alcohol
There are many issues as a result of long-term drinking. Chronic pancreatitis is a condition in which there is inflammation within the pancreas. Long-term drinking leads to chronic pancreatitis. Having chronic pancreatitis is associated with developing pancreatic cancer. When we drink alcohol, our bodies turn this into a chemical called acetaldehyde. This chemical can not only damage cells but also stop cells from repairing the damage. Alcohol also increases levels of insulin, causing cells to divide more often.
While there is no complete cure for pancreatic cancer, there are steps you can take to lower the risk, such as quitting smoking, maintaining a healthy weight, eating a balanced diet, and limiting alcohol.
Age
In older people, pancreatic cancer is more frequent. Almost all new cases are diagnosed in elderly people (aged 75 and older). Naturally, with age, the cells in the body become damaged. Cancer begins when damage in the same cell builds up. As you age, there is more time for cells to become damaged.
Diagnosis of pancreatic cancer
There are many different tests to diagnose pancreatic cancer.
Imaging tests: these are used to show inside the body. They include ultrasounds, CT scans, MRI scans and PET scans. These can reveal tumours within the pancreas.
Endoscopic ultrasound: This is a test that shows pictures of the digestive tract and pancreas. A long, thin tube with a camera called an endoscope passes down the throat and into the stomach.
Biopsy: This procedure removes tissue for testing. From the pancreas, a sample is collected by fine-needle aspiration (inserting a needle through the skin and into the pancreas). It’s sent to the lab for testing and confirmation of cancer.
Blood tests: Blood tests can reveal proteins called tumour markers that pancreatic cancer makes. One tumour marker in particular is CA19-9, which doctors look out for.
Genetic testing: Genetic testing can be used to look for inherited DNA changes such as the BRCA1 or BRCA2 mutations. It can also show whether family members may have an increased risk of pancreatic cancer.
Key takeaways
✔ Pancreatic cancer is not common, but it is serious.
✔ Smoking, obesity, and alcohol are major controllable risks.
✔ Family history and genetics play a role in about 10% of cases.
✔ Early symptoms are subtle—jaundice and weight loss are key red flags.
✔ Healthy lifestyle choices can lower your risk.
Frequently asked questions
What is the main cause of pancreatic cancer?
There is no single cause, most cases develop due to DNA damage to pancreatic cells over time. The biggest controllable risk factor is smoking.
Is pancreatic cancer hereditary?
Having a first-degree relative with pancreatic cancer leads to an increased risk. This risk becomes higher if you have more than one first-degree relative with cancer.
Does smoking cause pancreatic cancer?
Smokers are more likely to develop it than non-smokers. The carcinogens in cigarettes are damaging to cells. Quitting reduces your risk, even after years of smoking.
Does alcohol cause pancreatic cancer?
Heavy drinking raises the risk of it, mainly by causing chronic pancreatitis (inflammation).
Summary
Pancreatic cancer develops when cells in the pancreas grow uncontrollably, usually due to long-term DNA damage. While the exact cause is under-researched, several key factors increase risk.
Early detection is challenging, but knowing the risks and symptoms can help. If you have a strong family history, it is advisable to consider screening options.
While some risks, like age or genetics, can’t be changed, lifestyle changes significantly lower your odds.
References
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- Ye X, Lu G, Huai J, Ding J. Impact of Smoking on the Risk of Pancreatitis: A Systematic Review and Meta-Analysis. PLoS One [Internet]. 2015 [cited 2025 Apr 4]; 10(4):e0124075. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4399880/.
- Causes of cancer and reducing your risk. Cancer Research UK [Internet]. 2015 [cited 2025 Apr 4]. Available from: https://www.cancerresearchuk.org/about-cancer/causes-of-cancer.
- Gupta S, Wang F, Holly EA, Bracci PM. Risk of pancreatic cancer by alcohol dose, duration, and pattern of consumption, including binge drinking: a population-based study. Cancer Causes Control [Internet]. 2010 [cited 2025 Apr 4]; 21(7):1047–59. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2883092/.
- The Lancet Gastroenterology & Hepatology. Cause for concern: the rising incidence of early-onset pancreatic cancer. The Lancet Gastroenterology & Hepatology [Internet]. 2023 [cited 2025 Apr 4]; 8(4):287. Available from: https://linkinghub.elsevier.com/retrieve/pii/S2468125323000390.
- Pancreatic Cancer Treatment - NCI [Internet]. 2024 [cited 2025 Apr 4]. Available from: https://www.cancer.gov/types/pancreatic/patient/pancreatic-treatment-pdq.