Summary
The pancreas is a gland that lies behind the stomach. It secretes digestive enzymes and important hormones. Pancreatic cancer is more common among the elderly. Other risk factors for pancreatic cancer include smoking and diabetes.
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The pancreas is a gland of the digestive system. It is joined to the small bowel by a duct. Pancreatic cancer starts in the cells lining this duct. It then spreads into the body of the pancreas, before invading nearby nerves and blood vessels. If left untreated, it will spread to all the organs in the abdomen. Pancreatic cancer may also enter the lymphatic system and spread to other parts of the body.
The causes of pancreatic cancer are unknown but smokers are at greater risk. It is more common in people over 65 and relatively uncommon in people under 50 years of age. About 620 Victorians develop pancreatic cancer each year.
The role of the pancreas
The pancreas has two major roles in the digestive system:
- It produces enzymes to help break down food.
- It produces insulin, which controls the amount of sugar in the blood. Problems with insulin production can lead to diabetes.
Risks and causes of pancreatic cancer
Pancreatic cancer is caused by damage to genes, but it is not known exactly why this damage happens. The risk of pancreatic cancer is greater for smokers.
Other risk factors include:
- Age – it is more common in people over the age of 65 years
- Genes – inheriting a damaged gene
- Diabetes – between 10 and 20 per cent of people with pancreatic cancer also have diabetes
- Gastrectomy – having had surgery to remove all or part of your stomach.
Symptoms of pancreatic cancer
Pancreatic cancer symptoms are often vague and can appear similar to those caused by other, less serious conditions. This means that pancreatic cancer is often not diagnosed until it is quite advanced. Some of the common symptoms may include:
- Persistent pain in the abdomen
- Loss of appetite
- Feeling sick (nausea)
- Weight loss
- Change in your bowel habits (diarrhoea or constipation)
- Severe back pain, in some cases.
- Yellowing of the skin and eyes (jaundice) and itchy skin
- Dark urine
- Pale faeces (bowel motions or poo).
Diagnosis of pancreatic cancer
If pancreatic cancer is suspected, your doctor will refer you for tests. These may include:
- Blood tests – to check how well your liver and kidney are working and to measure for a protein known as CA19.9. Pancreatic cancer often sends CA19.9 into the blood. It is not used to diagnose pancreatic cancer, but it gives your doctor important information.
- Computed tomography (CT) scan – a special x-ray taken from many different angles to build a three-dimensional picture of your body. A dye may be injected to further highlight internal organs.
- Magnetic resonance imaging (MRI) – similar to a CT scan but uses magnetism instead of x-rays to build three-dimensional pictures of your body.
- Ultrasound – sound waves create a picture of your pancreas.
- Endoscopy (also called endoscopic retrograde cholangiopancreatography, ERCP) – a thin telescope is inserted down your throat to allow the doctor to see inside your digestive system. This device may also be used to inject dye into the pancreas and bile duct to allow images of these organs to appear on x-ray pictures.
- Laparoscopy – the internal organs are examined with an instrument inserted into the abdomen through a small cut.
- Tissue biopsy – a small sample of the pancreas is removed with a needle and examined in a laboratory.
- Positron emission tomography (PET) scan – an injection with a glucose solution containing a very small amount of radioactive material is given. The scanner can ‘see’ the radioactive substance. Cancerous cells show up as ‘hot spots’ – areas where the glucose is being taken up.
Test results can take a few days to come back. It is very natural to feel anxious waiting to get your results. It can help to talk to a close friend or relative about how you are feeling. You can also contact the Cancer Council Helpline on 13 11 20 and speak with a cancer nurse.
Treatment of pancreatic cancer
Treatment for pancreatic cancer depends on your age, general health, the size and location of the cancer and whether it has spread to other parts of the body. You may receive one type of treatment or a combination. Generally, options include:
- Surgery – is used when the cancer has not spread beyond the pancreas. The cancer and part of the pancreas and part of the small bowel are removed in an operation called ‘Whipple’s resection’. Some of the bile ducts, gall bladder and stomach may also be removed. This is major surgery and you need to be fit enough to have it.
- Chemotherapy – anti-cancer medications (either tablets or injections into the veins) may be used after surgery. The drugs work by stopping cancer cells growing and reproducing. Chemotherapy may be given with surgery or alone to help control the symptoms of an advanced cancer.
- Radiotherapy – the use of x-rays to target cancer cells may be used after surgery to destroy any cancer cells that might remain in the body. Radiotherapy can also be used as the main treatment when surgery is not possible, in combination with chemotherapy.
- Complementary and alternative therapies – it’s common for people with cancer to seek out complementary or alternative treatments. When used alongside your conventional cancer treatment, some of these therapies can make you feel better and improve quality of life. Others may not be so helpful and in some cases may be harmful.
It is important to tell all your health care professionals about any complementary medicines you are taking and never stop taking your conventional treatment without consulting your doctor first. Details of the Cancer Council Victoria’s booklet Complementary and alternative cancer therapies are in the Where to get help section.
When a cure isn’t possible
If the cancer has spread and it is not possible to cure it with surgery, your doctor may still recommend treatment that focuses on improving quality of life by relieving the symptoms (this is called palliative treatment). This can help make you feel better and may allow you to live longer.
Options may include:
- Endoscopic treatment – the cancer may cause jaundice because it is blocking the bile duct. Endoscopic surgery relieves the pressure by inserting a metal or plastic tube into the bile duct to keep it open. Similar treatment can relieve a section of the small bowel if the cancer is pressing on it.
- Surgery – a blockage in the small bowel can be bypassed by a surgical procedure that attaches a loop of bowel directly to the stomach.
- Tablets – there may be a lack of pancreatic enzymes to properly digest fats, which results in diarrhoea. Tablets containing these enzymes can control this symptom.
- Pain-relieving drugs – oral medication is usually given to control pain, but if the pain is particularly severe medications can be injected into the nerves of the back.
Caring for someone with cancer
Caring for someone with cancer can be a difficult and emotional time. If you or someone you know is caring for someone with pancreatic cancer they may find it helpful to download and read some of the Cancer Council Victoria booklets that are available.
Where to get help
- Your doctor
- Specialist
- Cancer Council Helpline 13 11 20
- Multilingual Cancer Information Line, Victoria Tel. (03) 9209 0169
- Cancer Council Victoria’s booklet Complementary and alternative cancer therapies..
Things to remember
- The pancreas is a gland that secretes digestive enzymes and insulin.
- The symptoms of pancreatic cancer are often vague and common to many other disorders.
- Pancreatic cancer is often only diagnosed in its later stages, which makes it difficult to treat.
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- Cancer.
- Cancer - exercise to help you cope.
- Cancer and food.
- Cancer and heredity.
- Cancer pain management.
- Cancer treatments - chemotherapy.
- Cancer treatments - radiotherapy.
- Digestive system.
- Hormonal (endocrine) system.
- Palliative care explained.
- Pancreatitis explained.
- Pancreas.
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The Cancer Council Victoria
Last reviewed: September 2011
Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your doctor or other registered health professional. Content has been prepared for Victorian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.
The pancreas is a gland that lies behind the stomach. It secretes digestive enzymes and important hormones. Pancreatic cancer is more common among the elderly. Other risk factors for pancreatic cancer include smoking and diabetes.
Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.
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