Pancreatic cancer

What is it?

The pancreas is a large gland in the abdomen, which produces enzymes that aid in digestion. Pancreatic cancer is when abnormal cells develop in the pancreas and multiply out of control. As these cells do not function normally, as they multiply they hinder bodily functions, eventually leading to death if not treated.

Cancer can develop in different parts of the pancreas:

  • Ductal adenocarcinoma develops in the lining of the pancreatic ducts (which carry the enzymes produced to the digestive system). Around 95% of pancreatic cancer cases are ductal adenocarcinomas.
  • Ampullary cancer develops at the ampulla of Vater. This is where the pancreatic duct meets the bile duct before entering the intestines.
  • Cystic tumours – although the pancreas can develop benign cysts (fluid-filled sacs), occasionally it grows cancerous ones.
  • Neuroendocrine tumours start in the endocrine cells, which produce hormones like insulin.
  • Acinar cell carcinomas develop in the cells that synthesise the pancreatic juice (the mixture of digestive enzymes).
  • Lymphoma – cancer of the lymphatic tissue, which threads through the entire body, including the pancreas.


What are the symptoms?

In the early stages, pancreatic cancer may not show any symptoms, making it hard to diagnose. Symptoms such as abdominal pain, indigestion and weight loss can manifest as the cancer develops and grows. Unfortunately, these symptoms are common and can indicate a number of other conditions. Other possible symptoms include:

  • Jaundice (yellow skin and eyes, itching)
  • Change in bowel habits, e.g. constipation, diarrhoea
  • Nausea/vomiting
  • Difficulty swallowing
  • Diabetes (especially if only recently developed or diagnosed)


What causes pancreatic cancer?

The causes are not fully understood, but certain risk factors have been identified, such as age (patients are generally 50-80 years old), smoking, and a history of certain conditions (e.g. diabetes, chronic pancreatitis, stomach ulcer and H. pylori infection). There is thought to be a genetic factor in some cases, as in about 1 in 10 cases the patient’s parent or parents also had pancreatic cancer. 


What is the treatment?

Pancreatic cancer is difficult to treat, as it is rarely detected until the tumour has become quite large. Treatment depends on the type, location and size of the tumour, as well as the age and general health of the patient. If it is possible to remove the tumour completely, this is the preferred option, but in cases where this is not possible, different treatment will be recommended to contain the cancer, prevent further growth and minimise the damage it does to the body.

The three main treatments, which may be used individually or in combination are:

  • Surgery
  • Chemotherapy
  • Radiotherapy

Recovering from surgery on the pancreas can be long and painful, and the bowel will stop working for a while, meaning that the patient cannot eat or drink immediately afterwards, and may be referred to a dietician for the duration of the recovery process.