Pancreatic Cancer
What is Pancreatic cancer?
Pancreatic cancer occurs when cells in the pancreas grow out of control and form a tumor. The pancreas is a gland located behind your stomach that makes enzymes for digestion and hormones like insulin that control blood sugar. Most pancreatic cancers start in the cells that line the ducts carrying digestive enzymes.
This cancer is often called a silent disease because symptoms rarely appear in early stages. By the time most people notice symptoms, the cancer has often grown or spread to other organs. Early detection is difficult but critical for better outcomes.
Pancreatic cancer is the third leading cause of cancer deaths in the United States. About 64,000 Americans are diagnosed each year. The five-year survival rate improves significantly when cancer is found before it spreads, making awareness of risk factors essential.
Symptoms
- Yellowing of the skin and eyes, called jaundice
- Dark urine and pale or greasy stools
- Pain in the upper abdomen that may spread to the back
- Loss of appetite and unintended weight loss
- Fatigue and weakness
- New onset diabetes or worsening blood sugar control
- Nausea and vomiting
- Blood clots in the legs or lungs
- Enlarged gallbladder or liver that can be felt during exam
Many people have no symptoms in the early stages of pancreatic cancer. Symptoms typically appear only after the tumor grows large enough to press on nearby organs or block bile ducts. This is why regular health monitoring matters for people at higher risk.
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Causes and risk factors
The exact cause of pancreatic cancer is not fully understood, but it develops when DNA changes cause cells to multiply uncontrollably. Smoking is the most significant modifiable risk factor and accounts for about 25% of cases. Age is another major factor, with most diagnoses occurring after age 65. Family history plays a role, as 10% of cases have a genetic link.
Other risk factors include chronic pancreatitis, diabetes, obesity, and heavy alcohol use. Certain inherited genetic mutations increase risk, including BRCA2, Lynch syndrome, and familial pancreatitis genes. Workplace exposure to certain chemicals used in dry cleaning and metalworking may also elevate risk. African Americans have slightly higher rates than other groups for reasons not fully understood.
How it's diagnosed
Diagnosing pancreatic cancer typically involves imaging tests like CT scans, MRIs, or endoscopic ultrasound to visualize the pancreas. A biopsy removes a small tissue sample to confirm cancer cells under a microscope. Blood tests can help support diagnosis and monitor disease progression.
The CA 19-9 blood test measures a protein that is often elevated in people with pancreatic cancer. However, it is not used alone for diagnosis because levels can be high in people without cancer or normal in some people with cancer. Rite Aid offers CA 19-9 testing as an add-on to help monitor your health. This test is most useful for tracking treatment response in people already diagnosed or evaluating symptoms in combination with imaging.
Treatment options
- Surgery to remove the tumor when cancer has not spread, often a Whipple procedure
- Chemotherapy to kill cancer cells or slow growth, using drugs like gemcitabine or FOLFIRINOX
- Radiation therapy to target cancer cells with high-energy beams
- Targeted therapy drugs that attack specific cancer cell features
- Immunotherapy to help your immune system recognize and fight cancer cells
- Pain management with medications and nerve blocks
- Nutritional support including enzyme supplements to aid digestion
- Palliative care to improve quality of life and manage symptoms
- Clinical trials offering access to new treatment approaches
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- Simple blood draw at your nearest lab
- Results in days, not weeks
- Share results with your doctor
Frequently asked questions
Early pancreatic cancer often has no symptoms. The earliest signs that may appear include upper abdominal pain that radiates to the back, unexplained weight loss, and loss of appetite. New onset diabetes in adults over 50 without other risk factors can sometimes be an early sign. Jaundice, or yellowing of skin and eyes, may occur when a tumor blocks the bile duct.
Blood tests alone cannot definitively diagnose pancreatic cancer. The CA 19-9 test measures a protein often elevated in pancreatic cancer, but levels can be high in people without cancer. Not all people with pancreatic cancer have elevated CA 19-9. This test is most useful for monitoring treatment response in diagnosed patients or as one part of evaluating concerning symptoms alongside imaging tests.
People over age 65 face the highest risk, as most cases occur after this age. Smokers are two to three times more likely to develop pancreatic cancer than non-smokers. Those with chronic pancreatitis, family history of pancreatic cancer, or inherited genetic mutations like BRCA2 have increased risk. Obesity and diabetes also raise your chances of developing this cancer.
About 10% of pancreatic cancers have a hereditary component. Inherited mutations in genes like BRCA2, PALB2, ATM, and Lynch syndrome genes increase risk. Familial pancreatitis caused by inherited PRSS1 gene mutations significantly raises lifetime risk. If two or more close relatives had pancreatic cancer, genetic counseling and testing may be recommended to assess your risk.
Treatment depends on cancer stage and location. Surgery offers the best chance for cure when cancer has not spread beyond the pancreas. Chemotherapy is often used before or after surgery, or alone when surgery is not possible. Radiation therapy may be combined with chemotherapy. Newer approaches include targeted therapy drugs and immunotherapy for specific cancer types.
CA 19-9 is a tumor marker blood test that measures a protein often elevated in pancreatic cancer. Doctors use it primarily to monitor treatment effectiveness in people already diagnosed with pancreatic cancer. Rising levels may indicate cancer growth, while falling levels suggest treatment is working. It is not reliable as a standalone screening test because many factors can cause elevated levels.
Quitting smoking is the single most effective way to reduce your risk. Maintaining a healthy weight through balanced nutrition and regular physical activity also helps. Limiting alcohol intake reduces risk of chronic pancreatitis, which can lead to cancer. Eating a diet rich in fruits, vegetables, and whole grains while limiting red and processed meats may offer protective benefits.
The five-year survival rate for pancreatic cancer is about 12% overall. However, this varies significantly by stage at diagnosis. When found before spreading beyond the pancreas, the five-year survival rate rises to about 44%. Unfortunately, only about 12% of cases are diagnosed at this early stage. Advances in treatment continue to improve outcomes for many patients.
The pancreas sits deep in the abdomen behind other organs, making tumors hard to feel during physical exams. Early-stage pancreatic cancer rarely causes symptoms that prompt medical visits. No reliable screening test exists for average-risk people. By the time symptoms like jaundice or pain appear, cancer has often grown large or spread.
See your doctor promptly if you develop jaundice, persistent abdominal pain, unexplained weight loss, or new diabetes after age 50. These symptoms have many possible causes, but evaluation is important. If you have a family history of pancreatic cancer or known genetic mutations, discuss screening options with your doctor. Early evaluation of concerning symptoms leads to better outcomes.