What is pancreatic cancer?
Pancreatic cancer affects the pancreas, an organ near the gallbladder that plays a key role in digestion. The pancreas is a 6-inch long organ located behind the stomach in the back of the abdomen, near the gall bladder.
It contains glands that create pancreatic juices, hormones, and insulin. Cancer can affect either the endocrine or the exocrine glands in the pancreas. The exocrine glands produce juices, or enzymes, that enter the intestines and help digest fat, proteins, and carbohydrtes. These make up most of the pancreas.
The endocrine glands are small clusters of cells known as the islets of Langerhans. They release the hormones insulin and glucagon into the bloodstream. There, they manage blood sugar levels. When they are not working properly, the result is often diabetes.
Types of Pancreatic Cancer
There are two different types of pancreatic cancer, depending on whether it affects the exocrine or endocrine functions. They have different risk factors, causes, symptoms, diagnostic tests, treatments, and outlook.
Exocrine pancreatic cancer
Tumors that affect the exocrine functions are the most common type.
They can be malignant or benign. Benign tumors or cysts are are called cystadenomas. Most pancreatic tumors are malignant, or cancerous.
Different types of pancreatic cancers can affect the exocrine functions.
Types of tumor include:
- Adenocarcinomas, which typically start in gland cells in the ducts of the pancreas
- Acinar cell carcinoma, which starts in the pancreatic enzyme cells ampullary cancer, which starts where the bile duct and pancreatic duct meet the duodenum of the small intestine
- Adenosquamous carcinomas
- Squamous cell carcinomas
- Giant cell carcinomas
Endocrine pancreatic cancer
Tumors that affect the endocrine functions of the pancreas are called neuroendocrine or islet-cell tumors. These are fairly uncommon.
The name comes from the type of hormone-producing cell where the cancer starts.
- Insulinomas (insulin)
- Glucagonomas (glucagon)
- Gastrinomas (gastrin)
- Somatostatinomas (somatostatin)
- VIPomas (vasoactive intestinal peptide or VIP)
Functioning islet cell tumors continue to make hormones. Non-functioning ones do not. Most of these tumors are benign, but non-functioning tumors are more likely to be malignant, islet-cell carcinomas.
What Causes Pancreatic Cancer?
Changes in your DNA cause cancer. These can be inherited from your parents or can arise over time. The changes that arise over time can happen because you were exposed to something harmful. They can also happen randomly.
Pancreatic cancer’s exact causes are not well understood. About 5 to 10 percent of pancreatic cancers are considered familial or hereditary. Most pancreatic cancer happens randomly or is caused by things such as smoking, obesity and age.
You may have an increased risk of developing pancreatic cancer if you have:
- Two or more first-degree relatives who have had pancreatic cancer
- A first-degree relative who developed pancreatic cancer before the age of 50
- An inherited genetic syndrome associated with pancreatic cancer
A person may also be more likely to get pancreatic cancer because of:
- Long-standing diabetes
- Chronic and hereditary pancreatitis
- Race (ethnicity): African-American or Ashkenazi Jew
- Age: over the age of 60
- Gender: males slightly more likely
- Diets high in red and processed meats
This does not mean that everyone who has these risk factors will get pancreatic cancer or that everyone who gets pancreatic cancer has one or more of these.
Signs and Symptoms of Pancreatic Cancer
- Pancreatic cancer may cause only vague, unexplained symptoms, such as:
- Pain, usually in the abdomen or back
- Weight loss
- Jaundice (yellowing of the skin, eyes or both) with or without itching
- Loss of appetite
- Changes in stool
- Pancreatitis (swelling of the pancreas)
- Recent-onset diabetes
How Is Pancreatic Cancer Diagnosed?
- A pancreatic tumor can only be seen on an imaging study such as a computed tomography (CT) scan, magnetic resonance imaging (MRI)
- Endoscopic ultrasound (EUS). Then, the doctor gets a sample of the tumor tissue to figure out the exact diagnosis.