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About pancreatic cancer

Hear Dr. Diane Simeone's overview of pancreatic cancer

  

What is the pancreas?

pancreas

The pancreas is a gland about 6 inches long, shaped like a thin pear lying on its side. The wider end of the pancreas is called the head, the middle section is called the body, and the narrow end is called the tail. The pancreas is in a deep location and lies behind the stomach and in front of the spine. It has two main jobs in the body, to produce:

  • digestive enzymes that help digest (break down) food.
  • hormones, such as insulin and glucagon, that help control blood sugar levels. These hormones help the body use and store the energy it gets from food.

Exocrine pancreas cells produce the digestive juices and endocrine pancreas cells produce the hormones.

What is pancreatic cancer?

The term pancreatic cancer usually refers to the common pancreatic ductal adenocarcinoma, although there is a large variety of other exocrine tumour types with varying prognoses. About 95% of tumours begin in exocrine cells.

Pancreatic cancer usually arises in the head of the pancreas(80%) and less commonly in the body(15%) and tail(5%). Worldwide there are around 250,000 new cases each year; in Europe more than 70,000 are diagnosed, while in the States there are 32,000. In the UK, nearly 9,000 people are diagnosed with pancreatic cancer each year, split roughly equally between men and women.

Prognosis depends on the extent of the tumour at the time of diagnosis, but is generally regarded as poor. By the time of diagnosis, the disease is usually well-advanced in the majority of patients which means they are ineligible for surgery (resection). In these cases, the average survival time between diagnosis and death is 6 – 12 months. 

If the disease is not well-advanced at diagnosis, surgery is possible to remove the tumour along with part of the pancreas. About 10% of patients diagnosed are eligible for surgery. The average survival following surgery for pancreatic cancer is gradually improving, particularly using combination treatments with chemotherapy, but is still only 20-24 months. 

Pancreatic cancer has a limited response to traditional chemotherapy, which also explains the poor prognosis for patients diagnosed with the disease.

Symptoms of pancreatic cancer

Pancreatic cancer is sometimes called a 'silent cancer' because there are generally few symptoms in the early stages, and those that are present can be non-specific and vague. 

Common symptoms can include:

  • painless jaundice (yellow skin/eyes, dark urine) related to bile duct obstruction
  • significant and unexplained weight loss
  • new onset of persistent abdominal discomfort
  • persistent dyspepsia/indigestion not alleviated by modern day medication
  • loss of appetite/quickly feeling full when eating
  • unexplained back pain, often eased by sitting upright

All of these symptoms can have multiple other causes, and there is not yet a reliable diagnostic test for pancreatic cancer.

Listen to one of the leading authorities on pancreatic cancer

Margaret Tempero, Director of Clinical Sciences, University of California San Francisco's Comprehensive Cancer Center, talks about pancreatic cancer and developments in understanding the disease.