Pancreatic Cancer Overview

Each year, about 37,000 people in the U.S. are diagnosed with pancreatic cancer. About one in 76 people in the U.S. will develop the disease. Pancreatic cancer affects about equal numbers of men and women, almost always after the age of 45.

Cancer of the pancreas barely makes the top 10 most common cancers in the U.S. However, pancreatic cancer's tendency to spread silently before diagnosis makes it the fourth deadliest cancer diagnosis.

Types of Pancreatic Cancer

Pancreatic cancer is classified according to which part of the pancreas is affected: the part that makes digestive secretions (exocrine) or the part that makes insulin and other hormones (endocrine).

Exocrine Pancreatic Cancer

Although there are several different types of pancreatic cancer, 95% of cases are due to pancreatic adenocarcinoma.

Other less common exocrine pancreatic cancers include:

• Adenosquamous carcinoma
• Squamous cell carcinoma
• Giant cell carcinoma
• Acinar cell carcinoma

The exocrine pancreas makes up 95% of the pancreas, so it's not surprising that most pancreatic cancers arise here.

Endocrine Pancreatic Cancer

Other cells of the pancreas make hormones that are released directly into the bloodstream (endocrine system). Cancer arising from one of these cells is called neuroendocrine pancreatic cancer or islet cell pancreatic cancer.

Endocrine pancreatic cancers are quite rare, and are named according to what kind of hormone-producing cell it starts from:

• Insulinomas (from an insulin-producing cell)
• Glucagonomas (from a glucagon-producing cell)
• Somatostatinomas (from a somatostatin-making cell)
• Gastrinomas (from a gastrin-producing cell)
• VIPomas (from vasoactive intestinal peptide-making cell)

Endocrine tumors usually are not cancer at all; they are nonmalignant growths. These "benign" tumors are not considered pancreatic cancer. However, they may grow to a large size or secrete unhealthy quantities of hormones, causing medical problems.

Ampullary Cancer (Carcinoma of the Ampulla of Vater)

Cancer can develop where the tube (duct) that drains the pancreas enters the small intestine (an opening called the ampulla). Although it's not technically pancreatic cancer, ampullary cancer causes symptoms similar to pancreatic cancer, and is treated similarly.

Causes of Pancreatic Cancer

Pancreatic cancer occurs when cells in the pancreas grow, divide, and spread uncontrollably, forming a malignant tumor. The exact cause of pancreatic cancer is unknown.

Smoking is the major risk factor for pancreatic cancer. Cigarette smoking roughly doubles the risk for pancreatic cancer. People with diabetes or chronic pancreatitis are also at increased risk.

Age, male gender, and family history are other risk factors for pancreatic cancer.

Prevention of Pancreatic Cancer

There is no known way to prevent pancreatic cancer. Not smoking, keeping a healthy weight, and eating a plant-based diet should reduce your risk for pancreatic cancer.

Diagnosis of Pancreatic Cancer

In addition to a history and physical exam, imaging tests may be performed to help make the diagnosis of pancreatic cancer. These tests include:

• Ultrasound
• Magnetic resonance imaging
• Endoscopic retrograde cholangiopancreatography (ERCP)

A definitive diagnosis of pancreatic cancer only comes from removal of cancer tissue (biopsy). This can be done with a needle through the skin, during endoscopy, or with an operation.