Pancreatic cancer

Pancreatic cancer is caused by the abnormal and uncontrolled growth of cells in the pancreas – a large gland that's part of the digestive system.

Around half of all new cases are diagnosed in people aged 75 or over. It's uncommon in people under 40 years of age.

This information is for the most common type of pancreatic cancer, known as pancreatic ductal adenocarcinoma. Other, rarer types of pancreatic cancer may be treated differently.

Symptoms of pancreatic cancer

In the early stages, a tumour in the pancreas doesn't usually cause any symptoms, which can make it difficult to diagnose.

The first noticeable symptoms of pancreatic cancer are often:

• pain in the back or stomach area – which may come and go at first and is often worse when lying down or after eating
• unexpected weight loss
• jaundice (yellowing of the skin and whites of the eyes) – it also may cause your urine to be dark yellow or orange, your poo (faeces) to be pale-coloured, and itchy skin

Other possible symptoms of pancreatic cancer include:

• nausea and vomiting
• changes in bowel movements (diarrhoea or constipation)
• fever and shivering
• indigestion
• blood clots

It's important to remember that these symptoms can be caused by many different conditions, and aren't usually the result of cancer. But you should contact your GP if you're concerned, or if these symptoms start suddenly.

You may also develop symptoms of diabetes if you have pancreatic cancer. This is because the tumour can stop the pancreas producing insulin as it normally would.

Causes of pancreatic cancer

It's not fully understood what causes pancreatic cancer, but a number of risk factors for developing the condition have been identified.

Risk factors for pancreatic cancer include:

• age – it mainly affects people aged 50-80
• being very overweight
• smoking – around 1 in 3 cases are associated with using cigarettes, cigars or chewing tobacco
• having a history of certain health conditions – such as diabetes, chronic pancreatitis (long-term inflammation of the pancreas), stomach ulcer and Helicobacter pylori infection (a stomach infection)

In about 1 in 10 cases, pancreatic cancer is inherited. Certain genes also increase your chances of getting pancreatitis, which in turn increases your risk of developing cancer of the pancreas.

If you have 2 or more close relatives who have had pancreatic cancer, or you have an inherited disease, such as Lynch or Peutz-Jeghers syndrome, your doctor may recommend regular check-ups as you may be at increased risk of pancreatic cancer.

Want to know more?

• Cancer Research UK: risks and causes of pancreatic cancer
• Pancreatic Cancer UK: risk factors for pancreatic cancer

Diagnosing pancreatic cancer

Your GP will first ask about your general health and carry out a physical examination. They may examine your tummy (abdomen) for a lump and to see whether your liver is enlarged.

They'll also check your skin and eyes for signs of jaundice and may request a urine sample and blood test.

If your GP suspects pancreatic cancer, you'll usually be referred to a specialist at a hospital for further investigation. You may have either:

• an ultrasound scan
• a CT scan
• an MRI scan
• a PET scan or PET-CT scan

Depending on the results of the scan, further tests may include:

• an endoscopic ultrasound (EUS) – a type of endoscopy that allows close-up ultrasound pictures to be taken of your pancreas
• an endoscopic retrograde cholangiopancreatography (ERCP) – a type of endoscopy used to inject a special dye into your bile and pancreatic ducts; the dye will show up on an X-ray and highlight any tumours
• a laparoscopy – a surgical procedure that allows the surgeon to see inside your body using a laparoscope (a thin, flexible microscope)
• a magnetic resonance cholangiopancreatography (MRCP) – which uses magnetic fields to allow detailed pictures of your pancreas

You may have a biopsy, where a small sample is taken from a suspected tumour.

Treating pancreatic cancer

Cancer of the pancreas is difficult to treat. It rarely causes any symptoms in the early stages, so it's often not detected until the cancer is fairly advanced. If the tumour is large or has spread to other areas in the body, treating the cancer will be more difficult.

If you've been diagnosed with pancreatic cancer, your treatment will depend on the type and location of your cancer, and how far it's advanced, also known as its stage. Your age, general health and personal preferences will also be taken into consideration.

The 3 main treatments for pancreatic cancer are:

• surgery
• chemotherapy
• radiotherapy

You may also be offered a clinical trial.

Some stages of pancreatic cancer only require one form of treatment, whereas others may require two types of treatment or a combination of all three.

Read more about treating pancreatic cancer.

Recovering from surgery

Recovering from pancreatic cancer surgery can be a long and difficult process.

You'll probably experience some pain after your operation. The staff at your hospital will make sure you have adequate pain relief.

After any type of surgery to your digestive system, your bowel will temporarily stop working. This means you won't be able to eat or drink straight away.

You'll gradually be able to sip fluids, before eventually being able to drink and eat more regularly. You may be referred to a dietitian, who can advise you about what foods you should eat following your operation.

You may also be given pancreatic enzyme replacement therapy. These are tablets you take which contain the enzymes you need to help digest food.

After the tumour has been removed, you'll probably have a 6-month course of chemotherapy, which greatly increases your chance of being cured. However, because cancer of the pancreas is difficult to diagnose and treat, some people's cancer will come back despite this treatment.