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Pancreatic Cancer

Pancreatic cancer occurs when abnormal cells within the pancreas form a tumor. The disease forms in one of two different types of glands: exocrine (glands that make enzymes to aid digestion) and endocrine (hormone-making glands). Exocrine tumors comprise about 94 percent of pancreatic cancer cases. The prognosis and treatment of endocrine cancers of the pancreas vary from the more common exocrine cancers because they may have different causes, growth characteristics, symptoms, and treatment methods.

In 2017, pancreatic cancer is one of the leading causes of cancer-related deaths in Texas. The survival rates for pancreatic cancer are lower than most forms of cancer, with only 8 percent of patients expected to survive more than five years. The low survival rates can be attributed in part to the lack of symptoms during early stages of the disease and the lack of a reliable screening test.

Statistics

  • Pancreatic cancer ranks as the third deadliest cancer in the United States after cancers of the lung and colon. 
  • In 2017, an estimated 53,670 people will be diagnosed and 43,090 deaths are expected in the U.S.
  • In 2017 Texas is estimated to have 3,410 new cases of pancreatic cancer and 2,856 expected deaths.

Risk Factors

  • Age: The risk of pancreatic cancer increases with age, with nearly all patients diagnosed after age 45, and about two out of three people are 65 years of age or older. The average age at diagnosis is 71.
  • Race: Ashkenazi Jews and African Americans face a higher risk of pancreatic cancer than Caucasians. 
  • Tobacco: People who smoke cigarettes are approximately twice as likely to have pancreatic cancer. Using smokeless tobacco products or smoking cigars or pipes also increases risk. 
    Weight: Those who are obese and those with extra weight around the waist face an increased risk of the disease.
  • Family History: Those with a family history of the disease have an increased risk. In some cases, the incidence of pancreatic cancer in a family may be associated with a genetic mutation. Genetic tests may identify a person’s risk.
  • Health Conditions: Pancreatic cancer is more common in diabetics. Chronic pancreatitis due to a gene mutation; cirrhosis of the liver; and excess stomach acid or the bacteria H. pylori also increase risk.
  • Industrial Exposure: Working with chemicals used in dry cleaning and metal working increases risk.

Symptoms and Signs

Because the pancreas is located deep in the body, physicians often are unable to detect tumors during a regular checkup visit. When symptoms begin to appear, pancreatic cancer has often grown to an advanced stage and metastasized to surrounding organs, leading to a lower survival rate. If any of these symptoms are experienced, consult a physician:

  • Yellowing of the skin or eyes
  • Mid-back or abdomen pain
  • Diabetes
  • Unexplained weight loss
  • Difficulty digesting foods
  • Swelling of the gallbladder or liver
  • Pale stools or dark urine
  • Itching
  • Nausea or vomiting
  • Blood clots
  • Fatigue
  • Appetite loss
  • Uneven appearance or feel of fatty tissue under the skin

Tips for Prevention

While there is no definite way to prevent pancreatic cancer, men and women can actively take steps to decrease their risk. Because smokers face a significantly increased risk, everyone should avoid smoking, as the use of tobacco also increases risk for a number of cancer types. In addition, obesity can further complicate pancreatic cancer, so maintaining a healthy body weight through proper nutrition and consistent physical activity is recommended.

Treatment

Treatment options for pancreatic cancer patients often include surgery, radiation therapy, proton therapy, chemotherapy, targeted therapy, immunotherapy, ablation or embolization treatment, or palliative therapy. A combination of treatments may provide the best chance of disease control. In addition, clinical trials are conducted to identify new or expanded cancer therapies to improve treatment outcomes. Through participation in clinical trials, patients can help physicians identify new and promising drugs while expanding treatment options.

Sources: American Cancer Society, National Cancer Institute, Pancreatic Cancer Action Network, and Texas Cancer Registry