Pancreatic cancer’s tendency to spread silently before diagnosis makes it one of the most deadly cancer diagnoses, with more than 45,000 people expected to die of the disease in 2019.
Types of Pancreatic Cancer
Exocrine Pancreatic Cancer
Although there are several different types of exocrine 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
- Small 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). Cancerous tumors arising from these cells are called pancreatic neuroendocrine tumors or islet cell tumors.
Endocrine pancreatic cancers are uncommon, and are named according to the type of hormone produced:
- 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)
- Some pancreatic islet cell tumors do not secrete hormones and are known as non-secreting islet tumors of the pancreas.
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.
Cigarette smoking is the major risk factor for pancreatic cancer: Smoking roughly doubles the risk for pancreatic cancer when compared to non-smokers. Pancreatic cancer is also more commonly diagnosed in people with diabetes. Other risk factors include age, race, obesity, family history, some inherited genetic syndromes, chronic pancreatitis, and exposure to certain workplace chemicals used in dry cleaning and metalworking.
Prevention of Pancreatic Cancer
There is no known way to prevent pancreatic cancer.
Diagnosis of Pancreatic Cancer
In addition to a history and physical exam, imaging tests will be performed to help make the diagnosis of pancreatic cancer. These tests include:
- CT scanning
- Endoscopic ultrasonography
- Endoscopic retrograde cholangiopancreatography (ERCP)
A definitive diagnosis of pancreatic cancer only comes from removal of tissue (biopsy) for examination in a lab. This can be done with a needle through the skin, during endoscopy, or with an operation.
Treatment for Pancreatic Cancer
Pancreatic cancer is treated in several ways, alone or in combination:
Surgery is generally done to attempt to cure pancreatic cancer, but it may also be done to lessen or prevent symptoms. Chemotherapy and radiation are often given together, prior to, after, or even without surgery, to slow pancreatic cancer's growth. Targeted therapy is sometimes given to treat advanced pancreatic cancer. Immunotherapy can be given to people whose cancer cells have certain gene changes.Palliative care aims to reduce discomfort for people whose pancreatic cancer cannot be cured.
What to Expect From Pancreatic Cancer
Pancreatic cancer is a serious condition. Most cases of pancreatic cancer have already spread at the time of diagnosis, making a full cure unlikely. Treatments can allow people to live longer with pancreatic cancer and improve their quality of life. Clinical trials are ongoing to discover more effective ways of treating pancreatic cancer.