Pancreatic Cancer

November 27, 2018

In 2017, about 53,670 Americans will be diagnosed with pancreatic cancer. Pancreatic cancer is slightly more common in men than in women, usually occurring after age 45.

Pancreatic cancer’s tendency to spread silently before diagnosis makes it one of the most deadly cancer diagnoses, with more than 43,000 people expected to die of the disease in 2017.


Types of Pancreatic Cancer

Pancreatic cancer is classified according to which part of the pancreas is affected: the part that makes digestive substances (exocrine) or the part that makes insulin and other hormones (endocrine).


Exocrine Pancreatic Cancer

Although there are several different types of exocrine pancreatic cancer, 95% of cases are due to pancreatic adenocarcinoma.


Other less common exocrine pancreatic cancers include:

  • Adenosquamous carcinoma

  • Squamous cell carcinoma

  • Giant cell carcinoma

  • Acinar cell carcinoma

  • Small cell carcinoma

The exocrine pancreas makes up 95% of the pancreas, so it's not surprising that most pancreatic cancers arise here.


Endocrine Pancreatic Cancer

Other cells of the pancreas make hormones that are released directly into the bloodstream (endocrine system). Cancerous tumors arising from these cells are called pancreatic neuroendocrine tumors or islet cell tumors.


Endocrine pancreatic cancers are uncommon, and are named according to the type of hormone produced:

  • Insulinomas (from an insulin-producing cell)

  • Glucagonomas (from a glucagon-producing cell)

  • Somatostatinomas (from a somatostatin-making cell)

  • Gastrinomas (from a gastrin-producing cell)

  • VIPomas (from vasoactive intestinal peptide-making cell)

  • Some pancreatic islet cell tumors do not secrete hormones and are known as non-secreting islet tumors of the pancreas.


Causes of Pancreatic Cancer

Pancreatic cancer occurs when cells in the pancreas grow, divide, and spread uncontrollably, forming a malignant tumor. The exact cause of pancreatic cancer is unknown.

Cigarette smoking is the major risk factor for pancreatic cancer: Smokingroughly doubles the risk for pancreatic cancer when compared to non-smokers. While diabetes is not a risk factor for pancreatic cancer, the two have been linked. Age, race, and family history are other risk factors for pancreatic cancer.


Prevention of Pancreatic Cancer

There is no known way to prevent pancreatic cancer.


Diagnosis of Pancreatic Cancer

In addition to a history and physical exam, imaging tests will be performed to help make the diagnosis of pancreatic cancer. These tests include:

  • Ultrasound

  • CT scanning

  • MRI

  • Endoscopic ultrasonography

  • Endoscopic retrograde cholangiopancreatography (ERCP)

A definitive diagnosis of pancreatic cancer only comes from removal of tissue (biopsy) for examination in a lab. This can be done with a needle through the skin, during endoscopy, or with an operation.


Additional information available here.


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