Pancreas cancer, also called pancreatic cancer, occurs when cancer cells form in the tissues of the pancreas. About 32,000 new cases of pancreatic cancer are diagnosed each year in the United States. Pancreatic cancer represents only 2 percent of all cancer cases, but it is the fourth leading cause of cancer death in the United States, ranking behind lung cancer, colorectal cancer, and breast cancer. For people whose cancer has not spread, the five-year survival rate is 16 percent. For all patients combined, the one-year survival rate is 24 percent and the five-year rate is about 5 percent.
The main reason for the low survival rate from pancreatic cancer is that it is difficult to detect in its earliest stages. By the time a person has symptoms, the cancer has often reached a large size and spread to other organs. Because the pancreas is deep inside the body, a doctor cannot see or feel tumors during a routine physical exam.
The pancreas has two different functions: It makes enzymes that go to the small intestine to help digest food, and it makes hormones, such as insulin, that are secreted into the bloodstream. Almost all pancreatic cancers start in the cells that line the ducts of the pancreas and are called adenocarcinomas. The ducts of the pancreas allow the flow of enzymes through the pancreas and into the small intestine. Tumors that arise from the hormone-producing cells are much less common.
Surgery, radiation treatment, and chemotherapy are treatment options for pancreatic cancer. Depending on how far the cancer has spread, two or even all of these treatments could be combined. Patients should also consider clinical trials with new treatments as they may offer improved survival. (In a clinical trial, patients voluntarily receive drugs or procedures that already have been researched in successful laboratory or animal studies to find a better way to prevent, diagnose or treat a disease.) Patients should talk to their doctors to learn more about their clinical trial options.
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The pancreas is a 6-inch-long organ located deep within the upper abdomen, surrounded by the stomach, small intestine, liver, and spleen. It is shaped something like a fish, with a head, a midsection called the body, and the tail at the narrow end.
The pancreas helps the body digest food and regulate blood sugar with the help of two kinds of cells: exocrine cells and endocrine cells.
- The exocrine cells of the pancreas make enzymes that aid in digestion. As food enters the stomach, these enzymes leave the pancreas, flowing through the pancreatic duct and into the small intestine, where they help digest fats and proteins.
- A smaller number of cells in the pancreas are endocrine cells. These cells are nestled among the exocrine cells in clusters called islets. They make hormones, such as insulin, that are secreted into the bloodstream and help balance the amount of sugar in the blood.
Both the exocrine and endocrine cells of the pancreas can grow abnormally and become cancerous, but 95 percent of pancreas cancers start in duct cells in the exocrine part of the gland. The most common type is adenocarcinoma.
Cancer begins in the body's cells, which are constantly dividing and multiplying to replace old, damaged cells. Cancer cells develop because of damage to DNA—a substance in every cell that directs all activities. Some people are prone to having damaged DNA based on inherited genetic syndromes, or a person's DNA can become damaged from an environmental exposure, like smoking. Normally when DNA becomes damaged the body is able to repair it. In cancer cells, the damaged DNA is not repaired. If an abnormal cell begins to divide, it eventually forms a malignant (cancerous) tumor. Like other cancer cells, pancreas cancer cells can travel through the bloodstream to other parts of the body. When cancer spreads from its original site, it is called metastasis.
The exact cause of pancreatic cancer is not known, but research indicates that people with certain risk factors are more likely than others to develop pancreas cancer. If you think you may be at risk for pancreas cancer, discuss this concern with your doctor.
Age—The risk of pancreatic cancer increases sharply after 50 years of age. At the time of diagnosis, most patients are between 60 and 80 years of age.
Race—African-Americans are more likely to have pancreatic cancer than other ethnic groups.
Smoking—The risk of pancreatic cancer is higher among smokers.
Obesity—People having a body mass index of 30 or greater are more likely to develop pancreatic cancer.
Chronic pancreatitis—This long-term inflammation of the pancreas is linked with a slightly higher risk of pancreas cancer. Chronic pancreatitis may be difficult to diagnose, but most people have symptoms, including abdominal pain.
Sudden onset diabetes or sudden change in blood sugar control (for people with diabetes)— Diabetes, which is being diagnosed increasingly as obesity rates rise, can be both a risk factor and an early symptom of pancreatic cancer. The exact mechanism linking diabetes with pancreatic cancer is being studied, but may be caused by high concentrations of insulin or other hormones.
Family history—Pancreatic cancer seems to run in some families. The exact genes responsible have not been fully identified, but changes in DNA that increase a person's risk for other types of cancer may also increase the risk of pancreatic cancer.
More information on pancreatic cancer is available at these websites recommended by the U.S.News & World Report library:
The National Pancreas Foundation (NPF)
The NPF provides information on symptoms and treatment of pancreatic cancer. The website also covers living with pancreatic diseases in general, including support groups, recipes, and alternative treatments.
Pancreatic Cancer Research and Education (PanCAN)
PanCAN supplies detailed information on several types of pancreatic cancer, a list of suggested questions for doctor appointments, and tips from survivors. The website provides several levels of support, including pages for caregivers and healthcare professionals.
Pancreatica is funded and maintained by the nonprofit Lorenzen Cancer Foundation. The website addresses questions about the stages of cancer, diagnosis, treatment, and how to find support and a physician and offers links to additional resources.
The Lustgarten Foundation for Pancreatic Cancer Research
The Lustgarten Foundation maintains patient resources to help identify treatment providers and support services, and it provides financial and legal assistance.
The NIH maintains ClinicalTrials.gov, a research database of federally and privately supported clinical trials. Details are available on the clinical trials resource information page.
Last reviewed on 10/13/09
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