Pancreatic Cancer

Pancreatic cancer is cancer that started growing in the pancreas, an organ tucked behind your stomach. Your pancreas makes enzymes that aid digestion and hormones like insulin that help manage your blood sugar.

In the U.S., pancreatic cancer is the 10th most common cancer but the 3rd deadliest cancer.

Types & Stages

The most common type of pancreatic cancer is called pancreatic ductal adenocarcinoma (PDAC). It starts growing in the cells that make digestive enzymes.

Pancreatic neuroendocrine tumors (also called islet cell tumors) are another type of pancreatic cancer that are less common. These tumors start growing in the cells that make hormones like insulin.

If you are diagnosed with pancreatic cancer, your doctor will run tests to find out what stage it is. The stage means how big the tumor or tumors are and whether they have spread outside of the pancreas. When the stage is early, the tumors are smaller and haven’t spread outside of the pancreas. When the stage is later, the tumors are larger and have spread outside of the pancreas.

Knowing the stage will help your doctor figure out the best treatment for you.

Signs & Symptoms

When pancreatic cancer is in the early stages, it doesn’t usually cause any symptoms.

When pancreatic cancer gets more advanced, it can cause symptoms like:

• yellowing of the skin and eyes (jaundice)
• unexplained weight loss
• dark colored urine
• pain in the belly and back

Causes & Risk Factors

There are several factors that raise the risk of getting pancreatic cancer, namely:

• Smoking. If you smoke cigarettes or pipes, or use chewing tobacco, your risk of developing pancreatic cancer is higher than someone who doesn’t.
• Genetics. It is estimated that 5 percent to 10 percent of people with pancreatic cancer developed it because of inherited genetic changes.
• Family history. If you have a parent, sibling or child with pancreatic cancer, your risk of getting diagnosed with the disease is higher.
• Having diabetes. If you were newly diagnosed with diabetes after age 50, or have been living with diabetes for more than 5 years, your risk of developing pancreatic cancer is higher.

Not everyone with these risk factors will develop pancreatic cancer. Sometimes people with no risk factors develop pancreatic cancer.

Screening

If you don’t have any risk factors or signs of pancreatic cancer, screening tests are not recommended for you.

If you have certain risk factors for pancreatic cancer, like if someone in your family has pancreatic cancer or you have inherited a genetic change that is linked with pancreatic cancer, your doctor may recommend screening. Screening is usually done with imaging tests, blood tests and biopsy.

Diagnosis

Doctors use different tests to diagnose pancreatic cancer, including:

• Blood tests to see if there are certain tumor markers in your blood.
• Imaging tests, like ultrasound and CT, to look inside your pancreas.
• Biopsy, to look at a sample of the pancreas under the microscope. Sometimes a biopsy is done using an endoscope—a thin, flexible tube with a small video camera on the end.

Treatment

What treatment you will get depends on many factors, including the stage of your cancer.

Your treatment may include:

• Surgery to remove all or part of the pancreas, as well as all or part of nearby organs like the spleen.
• CRS-HIPEC (cytoreductive surgery and heated intraperitoneal chemotherapy), a combination of surgery and chemotherapy for abdominal tumors. First, all visible cancer cells are removed with surgery, and then remaining cancer cells are killed with heat and chemotherapy. Stony Brook University Hospital is the only hospital on Long Island to provide CRS-HIPEC.
• Radiation therapy. At Stony Brook Medicine, most of our radiation treatments are given with x-rays and electron beams generated by machines called linear accelerators.
• Chemotherapy, a type of drug that stops the growth of cancer cells.
• Targeted therapy, which is therapy that is targeted to the genetic or molecular changes in your tumors.
• Embolization therapy, a type of therapy that stops or slows blood flow to tumors. Some types of embolization therapy also deliver chemotherapy or radiation directly to tumors.
• Ablation therapy, which is therapy that uses high-energy radio waves, freezing temperatures or microwaves to destroy tumors.

At Stony Brook Medicine, our Palliative Care Service is available to everyone, no matter the stage of your cancer. This specialized team helps patients and their families cope with the physical, emotional, and spiritual distress of cancer. They can provide relief from symptoms of pancreatic cancer and/or its treatment, such as pain, nausea, fatigue and loss of appetite.

Learn more about early detection of pancreas cancer here