Pancreatic cancer is the tenth most common cancer. (1) Unfortunately pancreatic cancer has a low survival rate as it is most often diagnosed at an advanced stage.
Incidence and mortality
There were more than 2500 new cases in Australia in 2007. The risk of being diagnosed by age 85 is 1 in 77 for women and 1 in 55 for men.
In 2007, there were 2248 deaths from pancreatic cancer.
Screening
There is no routine screening test for pancreatic cancer.
Symptoms and diagnosis
Pancreatic cancer rarely causes symptoms until the cancer is big enough to touch and affect organs nearby.
Early signs of pancreatic cancer include:
- pain in the upper abdomen
- loss of appetite
- nausea and vomiting
- weight loss
- changed bowel motions – either diarrhoea or severe constipation
- jaundice (yellowish skin and eyes, and dark urine).
Less common signs include:
- severe back pain
- onset of diabetes (10-20% of people with pancreatic cancer develop diabetes).
Tests to diagnose pancreatic cancer include:
- blood tests
- imaging tests: ultrasound, CT scan, MRI, PET scan
- tissue sampling tests including fine-needle aspiration (needle biopsy), endoscopy and laparoscopy
Staging
Imaging and tissue sampling tests (above) are used to determine the stage of the cancer.
The staging system used for pancreatic cancer is the TNM system , which describes the stage of the cancer from stage I to stage IV.
Causes
The causes of pancreatic cancer are not known, but factors that put some people at higher risk are:
- smoking
- age (it occurs mostly in people over the age of 65)
- diabetes: pancreatic cancer occurs more often in people who have diabetes
- a family history of pancreatic, ovarian or colon cancer
- chronic pancreatitis
- gastrectomy.
Prevention
Not smoking or quitting smoking. Smokers are two to three times more likely to develop pancreatic cancer.
Treatment
Treatment for pancreatic cancer may include surgery, endoscopic treatment, chemotherapy or radiotherapy, or a combination of these treatments.
For early disease, surgery is the most common treatment – usually the Whipple operation, which is removal of part of the pancreas, the first part of the small bowel (duodenum), part of the stomach and the gall bladder, and part of the bile duct.
Prognosis
An individual’s prognosis depends on the type and stage of cancer, as well as their age and general health at the time of diagnosis. Pancreatic cancer is usually not found until it is advanced. The five year survival rate is less than 5%.
For more information, contact Cancer Council Helpline on 13 11 20 (cost of a local call).
(1) Excluding non-melanoma skin cancer, which is the most commonly diagnosed cancer according to general practice and hospitals data, however there is no reporting of cases to cancer registries.