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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, or adenocarcinoma, comprise more than 90 percent of pancreatic cancer cases. The prognosis and treatment of endocrine cancers of the pancreas, also called neuroendocrine tumors (NETs), vary from the more common exocrine cancers because they have different causes, risk factors, growth characteristics, symptoms, and treatment methods.

In 2022, pancreatic cancer is the fourth highest cause of cancer-related deaths in Texas. The survival rates for pancreatic cancer at any stage are lower than most forms of cancer, with only 11 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 2022, an estimated 62,210  people will be diagnosed, and 49,830 deaths are expected in the U.S.
  • In 2022, Texas is estimated to have 4,226 new cases of pancreatic cancer and 3,349 expected deaths.

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Pancreatic Cancer Stages

Risk Factors

  • Age: The risk of pancreatic cancer increases with age, with nearly all patients diagnosed after age 45, and about two-thirds of people are 65 years of age or older. The average age at diagnosis is 70.
  • Race: Ashkenazi Jews and African Americans face a higher risk of pancreatic cancer than others.
  • 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. Smoking is thought to cause about 20 to 30 percent of pancreatic cancers.
  • 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, or the bacteria Helicobacter pylori may 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. 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
  • Weakness or fatigue
  • Appetite loss
  • Stomach bloating or discomfort
  • Chills, sweats, and fever

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. Heavy alcohol consumption can lead to certain conditions that increase pancreatic cancer risk, such as chronic pancreatitis, and should also be avoided. 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 medicine. A combination of treatments may provide the best chance of disease control. In addition, clinical trials are conducted to identify new 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, American Society of Clinical Oncology, National Cancer Institute, Pancreatic Cancer Action Network, and Texas Cancer Registry


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