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Pancreatic cancer



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What is pancreatic cancer?

Pancreatic cancer occurs when malignant cells develop in part of the pancreas. This may affect how the pancreas works, including the functioning of the exocrine or endocrine glands. Pancreatic cancer can occur in any part of the pancreas, but about 70% of pancreatic cancers are located in the head of the pancreas. 

Pancreatic cancer is the tenth most common cancer in men and ninth most common cancer in women in Australia.1

Unfortunately pancreatic cancer has a low survival rate as it is most often diagnosed at an advanced stage. Pancreatic cancer is the fifth most common cause of cancer death over all.

In 2013, 2865 new cases of pancreatic cancer were diagnosed in Australia. The risk of being diagnosed with pancreatic cancer by age 85 is 1 in 58 for Australian men and 1 in 78 for Australian women.

In 2014, there were 2547 deaths resulting from pancreatic cancer in Australia – over 5% of all cancer deaths.


Pancreatic cancer symptoms

Pancreatic cancer rarely causes symptoms. Symptoms often only appear once the cancer is large enough to affect nearby organs, or has spread.

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).

Causes of pancreatic cancer

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

  • smoking
  • age (it occurs mostly in people over the age of 65)
  • diabetes, particularly newly diagnosed diabetes
  • a family history of pancreatic, ovarian or colon cancer
  • chronic pancreatitis
  • pancreatitis.
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Diagnosis for pancreatic cancer

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.

The tests you have will depend on the symptoms, type and stage of the cancer.


Treatment for pancreatic cancer

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.

Types of 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 the 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.

For advanced pancreatic cancer, surgery may not be possible. Treatment is often to relieve symptoms such as pain and digestive problems.

Treatment team

Generally your GP will arrange for initial tests and will continue to be part of your treatment team after a diagnosis. Your treatment team may also consist of a number of specialists such as:

  • a gastroenterologist who specialises in treating diseases of the digestive system
  • an endocrinologist to diagnose and treat hormonal disorders
  • a pancreatic surgeon who specialises in surgery to the liver and pancreas
  • a radiation oncologist to coordinate radiotherapy 
  • a medical oncologist to coordinate chemotherapy
  • cancer nurses and cancer nurse coordinators
  • a range of other health professionals including social worker, physiotherapist, counsellors and dietitian.

Palliative care

In some cases of pancreatic cancer, your medical team may talk to you about palliative care. Palliative care aims to improve your quality of life by alleviating symptoms of cancer.

As well as slowing the spread of pancreatic cancer, palliative treatment can relieve pain and help manage other symptoms. Treatment may include radiotherapy, chemotherapy or other drug therapies.

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Screening for pancreatic cancer

There is currently no screening for pancreatic cancer available in Australia.


Prognosis for pancreatic cancer

Prognosis means the expected outcome of a disease. You will need to discuss your prognosis and treatment options with your doctor, but it is impossible for any doctor to predict the exact course of your disease. Test results, the type, stage and location of the cancer; and other factors such as your age, fitness and medical history are all important when working out your prognosis.


Preventing pancreatic cancer

Not smoking or quitting smoking reduces your risk. Smokers are two to three times more likely to develop pancreatic cancer.


Sources

Understanding Pancreatic Cancer, Cancer Council Australia © 2016. Last medical review of source booklet: February 2016.

Australian Institute of Health and Welfare (AIHW) 2017. Cancer in Australia 2017. Cancer series no. 101. Cat. no. CAN 100. Canberra: AIHW.

Australian Institute of Health and Welfare (AIHW). Australian Cancer Incidence and Mortality (ACIM) books: Pancreatic cancer. Canberra: AIHW.

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.

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This page was last updated on: Thursday, April 13, 2017