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Rare but deadly—pancreatic cancer

A grayscale image showing the location of the pancreas in the human abdomen

Pancreatic cancer caused the untimely deaths of Apple co-founder Steve Jobs at 56 and actor Patrick Swayze at 57. It also claimed Alan Rickman (Severus Snape in the Harry Potter series), opera singer Luciano Pavarotti, and US Supreme Court Justice Ruth Bader Ginsberg.

It’s estimated that 4,261 cases of pancreatic cancer will be diagnosed in Australia this year (2021)—approximately 2,213 males and 2,048 females—and around 3,391 people will die from it.

Pancreatic cancer has one of the lowest survival rates of all cancers. The five-year survival rate is around 12%, whereas in Australia the five-year survival rate for all types of cancers is around 69%. It is difficult to treat, and usually causes death within months of diagnosis.

The good news is that pancreatic cancer survival rates have been slowly improving.

Pancreatic cancer is also relatively rare. Rare cancers are generally regarded as occurring in fewer than 15 out of 100,000 people. In Australia in 2021 the age-standardised incidence of pancreatic cancer is expected to be 13 cases per 100,000 people.

What is the pancreas and what does it do?

The pancreas is a leaf-shaped gland about 15cm long that sits deep within the abdomen between the stomach and spine. It has two main functions: to produce enzymes for digestion and hormones that control blood-sugar levels. The pancreas can be described as having three parts, the head, body, and tail.

A drawing showing the pancreas, where it is located and what pancreatic cancer looks like

What is pancreatic cancer?

Cancer begins when abnormal cells begin to grow and multiply uncontrollably somewhere in the body. Pancreatic cancer occurs when malignant cells develop in part or parts of the pancreas. This can affect how the pancreas works.

Tumours that develop in the pancreas are most often one of two types, called exocrine and endocrine. The name depends on which type of pancreatic cell becomes cancerous.

Exocrine pancreatic cancer is the most common type at around 95% of pancreatic cancers. The pancreas is part of the digestive system and makes pancreatic enzymes for digesting food. Ducts pass these enzymes as digestive juices into the digestive system (duodenum). Most exocrine pancreatic cancers are pancreatic adenocarcinomas which usually start in the cells lining the pancreatic duct.

Neuroendocrine pancreatic cancers (NETs) make up around 5% of pancreatic cancers. The pancreas is also part of the endocrine system—a group of glands that make the body’s hormones. NETs affect the endocrine cells in the pancreas.

Who is at risk of pancreatic cancer?

Some factors that can increase your risk of pancreatic cancer include:

  • Smoking tobacco
  • age - most cases occur in adults over the age of 60
  • diabetes, particularly newly diagnosed diabetes
  • a family history of pancreatic, ovarian or colon cancer. (A high-risk individual has at least 2 first degree relatives with pancreatic cancer)
  • chronic pancreatitis
  • excessive alcohol consumption
  • obesity.

What are the signs of pancreatic cancer?

Early-stage pancreatic cancer rarely causes symptoms. Symptoms often only appear once the cancer is large enough to affect nearby organs or has spread.

Symptoms can include:

  • pain in the abdomen
  • loss of appetite
  • nausea and vomiting
  • weight loss
  • change in bowel habit with diarrhoea, constipation or the feeling of incomplete emptying
  • jaundice (yellowish skin and eyes, and dark urine)
  • severe back pain
  • onset of diabetes (10-20% of people with pancreatic cancer develop diabetes)

How is pancreatic cancer diagnosed?

Pancreatic cancer is not routinely screened for in Australia. People who have a family history of pancreatic cancer (one of the risk factors) may be offered genetic tests to try to establish their risk, and people at higher risk may be monitored using a procedure called endoscopic ultrasound.

Tests to diagnose pancreatic cancer may include:

  • Blood tests to determine general health and your kidney and liver function
  • Ultrasound scans to look for tumours. An ultrasound uses soundwaves to show the pancreas and surrounding areas to see if a tumour is present.
  • CT (computerised tomography) scans use x-rays to take multiple pictures of the inside of the body
  • MRI (magnetic resonance imaging) scans use use magnetic waves to create a detailed image of the pancreas and surrounding organs
  • PET (positron emission tomography) scans – by injecting tiny amounts of a short-lived radioactive substance first, PET scans highlight tumours that may be present.
  • Tissue sampling tests include fine-needle aspiration (needle biopsy), endoscopy and laparoscopy.

How is pancreatic cancer treated?

Imaging and tissue sampling are used to figure out what stage the cancer is at. Treatments may include surgery, chemotherapy, radiation therapy, and endoscopy. More detailed information is available here.

More information

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Last updated: 26 November 2021