The pancreas is an organ located behind the stomach and has 3 parts: the head, body, and tail. It contains 2 types of glands. The endocrine glands produce hormones such as insulin and glucagon. The exocrine glands make enzymes used to digest food.
There are several types of pancreatic tumors. Cancers arising in the exocrine pancreas are more common than cancers arising in the endocrine pancreas. This summary focuses on pancreatic exocrine cancers.
Another type of cancer, called ampullary cancer, is a cancer that starts near the pancreas. Ampullary cancers are often considered like exocrine pancreatic cancers because the treatments are similar.
Jaundice; abdominal or back pain; weight loss; poor appetite; digestive problems; gallbladder enlargement; blood clots or fatty tissue abnormalities; diabetes.
There are no standard or routine screening tests for pancreatic cancer; the effectiveness of current screening techniques for the early diagnosis of pancreatic cancer has not been proven. For those at elevated or high risk,available screening options may include endoscopic ultrasound (EUS), MRI/magnetic resonance cholangiopancreatography (MRCP) and use of CA19-9 blood tumor marker tests at regular intervals. It is recommended that patients who are candidates for pancreatic cancer screening be managed by a multidisciplinary team with experience in pancreatic cancer screening, preferably within research protocols.
Surgical resection is considered the only potentially curative technique for managing pancreatic cancer. However, most pancreatic cancers cannot be treated with surgery. Surgically resectable and potentially resectable pancreatic cancers are those found just in the pancreas or have only spread just outside the pancreas but not into nearby major blood vessels. Surgical resection involves removing part or all of the pancreas as well as nearby organs, ducts, blood vessels, and lymph nodes depending upon the location of the tumor in the pancreas. This is often then followed by chemotherapy and in some cases radiation therapy. Unresectable cancers that have not yet spread to distant organs but still cannot be removed with surgery are often treated with chemotherapy or sometimes chemotherapy with radiation.
Metastatic pancreatic cancer is most often managed with chemotherapy, sometimes in combination with targeted therapy. Palliative interventions are often used in patients with unresectable or metastatic cancers in order to prevent/relieve symptoms or fix problems like a blocked bile duct. Pain control is often an important part of treatment for many patients as well as therapy to manage nutritional deficiencies. Many patients choose to participate in clinical trials investigating novel treatment approaches.
Demographics: Older age
Lifestyle: Diet high in fats and meats; obesity; tobacco use; alcohol use; occupational exposures
Medical History: Chronic pancreatitis; cirrhosis of the liver; type 2 diabetes; H. Pylori stomach infection
Risk reduction options: Maintain diet low in fats/meats; physical activity; avoiding tobacco use; limiting alcoholic beverages; treating H. Pylori stomach infections
Inherited: Family history of disease; inherited genetic syndromes
Associated Myriad MyRisk™ Genes: BRCA1, BRCA2, MLH1, MSH2, MSH6, PMS2, EPCAM, APC, CDKN2A (p16INK4a), CDKN2A (p14ARF), CDK4, TP53, STK11, BMPR1A, SMAD4, PALB2, ATM