Pancreatic cancer

The pancreas is a small, pear-shaped gland located in the abdomen. It produces enzymes that help with the digestion of food. It also produces hormones involved in regulating blood sugar. It secretes insulin to lower blood sugar levels and glucagon to raise blood sugar levels. Pancreatic cancer occurs when abnormal cells in the pancreas grow out of control and a tumour forms.

Pancreatic cancer is the ninth most common form of cancer in New Zealand but the fifth biggest cause of our cancer deaths. This reflects the late stage that this cancer is found in people, making it harder to treat. It is unknown what causes pancreatic cancer, and mostly it happens randomly. Around 10% of cases are hereditary. It is thought that smoking, obesity, increasing age, chronic pancreatitis, exposure to certain chemicals, heavy alcohol use and a diet high in red and processed meats can increase your risk of developing the disease.

Pancreatic cancer symptoms can be very vague and similar to symptoms caused by other conditions, and they can develop slowly over time. This makes it hard to be picked up, sometimes not until it has reached a stage where it is difficult to treat. It is made more difficult to find as there is no single test to diagnose it – several are needed. The pancreas is located deep in the abdomen and doctors usually can’t see or feel a tumour on physical examination. A tumour can only be seen by CT scan, MRI or ultrasound. Your doctor may request blood tests to see if you have any markers for pancreatic cancer in your blood. If a tumour is found, a biopsy is usually performed to find out what type of pancreatic cancer it is. The tests help to find out the size of the cancer, if it has moved to the lymph nodes or if it has spread to other parts of the body.

There are two main types of pancreatic cancer. Pancreatic adenocarcinoma is the most common form (affecting 95% of pancreatic cancer patients) and occurs in the cells that help break down food. The less common pancreatic cancer is pancreatic neuroendocrine cancer (affecting 5% of patients), and this one occurs in the cells that produce the hormones that regulate blood sugar levels. The two types of cancer have different treatment regimens as well as different prognoses.

Symptoms include:

• abdominal or back pain
• weight loss
• loss of appetite
• nausea
• change in bowel habits
• itching
• jaundice (yellowing of the eyes and/or skin)
• recent onset diabetes
• fatigue.

Standard treatments for this form of cancer are surgery, chemotherapy and radiation. The treatment regime depends on the type of pancreatic cancer, the stage of the disease and the patient’s overall health. Surgery is the best option for controlling the cancer for a long period of time, but as patients are often diagnosed at a late stage in the disease, surgery may no longer be an option. Chemotherapy is used for all types of pancreatic cancer, even in those who have had surgery, as it can decrease the chance of the tumour coming back. If patients can’t have surgery, chemotherapy can slow the tumour growth and help increase life expectancy.

Radiotherapy is sometimes used in combination with chemotherapy to reduce the chance of the cancer coming back. Doctors may use it to try and decrease the size of the tumour so a patient can have surgery.

We urgently need tests that can find pancreatic cancer in its early stages so that patients have better outcomes. As technology improves and early detection methods are discovered, we will get better at treating pancreatic cancer earlier.

This blog provides general information and discussion about medicine, health and related subjects. The information contained in the blog and in any linked mate­ri­als, are not intended nor implied to be a substitute for professional medical advice.