What is pancreatic cancer?
Pancreatic cancer occurs when malignant cells develop in part of the pancreas. This may affect how the pancreas works, including the functioning of the exocrine or endocrine glands. Pancreatic cancer can occur in any part of the pancreas, but about 70% of pancreatic cancers are located in the head of the pancreas.
It is estimated that more than 4,500 people were diagnosed with pancreatic cancer in 2023. The average age at diagnosis is 72 years old.
Pancreatic cancer is the eighth most commonly diagnosed cancer in Australia, and it is estimated that one in 70 people will be diagnosed by the time they are 85.
Pancreatic cancer signs and symptoms
Early-stage pancreatic cancer rarely causes symptoms. Symptoms often only appear once the cancer is large enough to affect nearby organs, or has spread.
Symptoms can include:
- pain in the abdomen
- loss of appetite
- nausea and vomiting
- weight loss
- change in bowel habit including diarrhoea, constipation or the feeling of incomplete emptying
- jaundice (yellowish skin and eyes, and dark urine)..
Less common signs include:
- severe back pain
- onset of diabetes (10-20% of people with pancreatic cancer develop diabetes).
Causes of pancreatic cancer
Some factors that can increase your risk of pancreatic cancer include:
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smoking tobacco
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age - most cases occur in adults over the age of 60
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diabetes, particularly newly diagnosed diabetes
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a family history of pancreatic, ovarian or colon cancer
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chronic pancreatitis
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excessive alcohol consumption
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obesity.
Diagnosis of pancreatic cancer
Tests to diagnose pancreatic cancer include:
Blood tests
Blood tests are used to check your general health and how your kidneys and liver are functioning.
Ultrasound
An ultrasound uses soundwaves to show the pancreas and surrounding area to see if a tumour is present.
CT scan
A CT (computerised tomography) scan uses x-rays to take multiple pictures of the inside of the body.
MRI
An MRI (magnetic resonance imaging) scan using magnetic waves to create a detailed image of the pancreas and surrounding organs.
PET scan
A PET(positron emission tomography) scan highlights any tumours present by injecting a small amount of radioactive substance.
Tissue sampling tests
Tissue sampling tests including fine-needle aspiration (needle biopsy), endoscopy and laparoscopy.
The tests you have will depend on the symptoms, type and stage of the cancer.
After a diagnosis of pancreatic cancer
After being diagnosed with pancreatic cancer, you may feel shocked, upset, anxious or confused. These are normal responses. A diagnosis of pancreatic cancer affects each person differently. For most it will be a difficult time, however some people manage to continue with their normal daily activities.
You may find it helpful to talk about your treatment options with your doctors, family and friends. Ask questions and seek as much information as you feel you need. It is up to you as to how involved you want to be in making decisions about your treatment.
Treatment for pancreatic cancer
Staging
Imaging and tissue sampling tests (above) are used to determine the stage of the cancer.
The staging system used for pancreatic cancer is the TNM system, which describes the stage of the cancer from stage I to stage IV.
Types of treatment
For early disease, surgery is the most common treatment - usually the Whipple operation, which is the removal of part of the pancreas, the first part of the small bowel (duodenum), part of the stomach and the gall bladder, and part of the bile duct.
For advanced pancreatic cancer, surgery may not be possible. Treatment is often to relieve symptoms such as pain and digestive problems.
Palliative care
In some cases of pancreatic cancer, your medical team may talk to you about palliative care. Palliative care aims to improve your quality of life by alleviating symptoms of cancer without aiming to cure it.
As well as slowing the spread of pancreatic cancer, palliative treatment can relieve pain and help manage other symptoms. Treatment may include radiotherapy, chemotherapy or other drug therapies.
Treatment Team
Depending on your treatment, your treatment team may consist of a number of different health professionals, such as:- GP (General Practitioner) - looks after your general health and works with your specialists to coordinate treatment.
- Gastroenterologist - specialises in diseases of the digestive system.
- Endocrinologist- specialises in diagnosing and treating disorders of the endocrine (hormonal) system.
- Pancreatic surgeon- specialises in surgery to the liver and pancreas.
- Radiation oncologist - prescribes and coordinates radiation therapy treatment.
- Medical oncologist - prescribes and coordinates the course of chemotherapy.
- Cancer nurse - assists with treatment and provides information and support throughout your treatment.
- Other allied health professionals - such as social workers, pharmacists, and counsellors.
Preventing pancreatic cancer
People with certain risk factors are more likely to develop pancreatic cancer. Not smoking or quitting smoking reduces your risk. Smokers are two to three times more likely to develop pancreatic cancer.
Other known risk factors are listed above.
Prognosis for pancreatic cancer
Prognosis means the expected outcome of a disease. You will need to discuss your prognosis and treatment options with your doctor, but it is impossible for any doctor to predict the exact course of your disease. Test results, the type, stage and location of the cancer; and other factors such as your age, fitness and medical history are all important when working out your prognosis.
Most pancreatic cancers are not found until they are advanced as symptoms can be vague or go unnoticed. If the cancer is diagnosed early and can be surgically removed, the prognosis can be better.
