Pancreatic cancer

Pancreatic cancer happens when cells in the pancreas grow abnormally and in an uncontrolled way. Most (95%) pancreatic cancers are exocrine tumours – meaning they develop in the cells that make enzymes. Other types of pancreatic cancer (endocrine tumours) are treated differently. This information is about exocrine pancreatic tumours.

Pancreatic cancer can be difficult to diagnose in the early stages because it doesn’t have many specific signs or symptoms. It’s often diagnosed when it’s more advanced which makes it difficult to treat.

Symptoms include:

• Abdominal or back pain
• Loss of appetite and unexplained weight loss
• Indigestion
• Jaundice – yellowing of the skin and eyes which requires immediate medical attention
• Changes to bowel habits or problems digesting food
• Nausea and vomiting
• Dysphagia – difficulty swallowing

Many of these symptoms are also caused by more common things or other conditions such as pancreatitis, gallstones, irritable bowel syndrome (IBS) or hepatitis.

Your GP will discuss your symptoms and medical history, and examine your abdomen. They may recommend urine and blood tests. They’ll then refer you to a specialist for further investigation. You may then have scans (such as ultrasound, CT, MRI or PET scans) and, depending on the results, further tests such as:

• Endoscopic ultrasound (EUS) – an endoscopy where a thin, flexible tube with an ultrasound probe on the end is gently inserted through your mouth into your stomach and small intestine
• Endoscopic retrograde cholangiopancreatography (ERCP) – an endoscopy where a special dye which shows up on an X-ray is injected into your bile and pancreas to highlight any tumours
• Laparoscopy – a thin, flexible tube with a camera on the end is inserted into your abdomen through a small cut in your skin
• Magnetic resonance cholangiopancreatography (MRCP) – a special type of MRI scan to create detailed images of your pancreas and surrounding organs
• Biopsy – where a small tissue sample is taken for further analysis in a laboratory

The exact cause of pancreatic cancer is unknown. However, factors that may increase your chance of getting it include:

• A family history of pancreatic cancer
• Aging
• Being overweight
• Having pancreatitis
• Smoking

Pancreatic cancer is often difficult to treat because it’s not spotted until it starts to cause symptoms, by which time it’s advanced. Your treatment will depend on the type and location of the cancer, how much it’s spread and your general health.

The main treatments for pancreatic cancer are:

• Surgery – to remove the tumour or sometimes your entire pancreas
• Surgery – to ease symptoms, such as jaundice by opening or bypassing a blocked bile duct
• Chemotherapy – to kill cancer cells or stop them from multiplying
• Radiotherapy – high energy radiation is directed at a tumour to kill cancerous cells or stop them from multiplying

For more advanced cases of liver cancer, treatment aims to relieve symptoms and slow the progression of the disease if it’s not possible to cure it.