•The pancreas is an oblong organ that lies behind the stomach and extends across the abdomen.
•The shape of the pancreas resembles a letter “J” lying on its side with the hook pointing down.
•The pancreas plays an important role in digestion with specialized cells that correspond to the pancreas’ two main functions: exocrine functions and endocrine functions. Exocrine cells are linked to a duct system and produce digestive enzymes that are secreted into the duodenum during digestion. Endocrine cells secrete hormones such as insulin and glucagon in order to help regulate metabolism and balance the amount of sugar in the blood.
•During digestion, the epithelial lining of the small intestine releases the hormones secretin and cholecystokinin (CCK). These two hormones stimulate the production of digestive enzymes by the pancreatic exocrine cells. This combination of digestive juices flows through the pancreatic duct system into the duodenum to aid in the digestion process. Most pancreatic tumors form in the exocrine epithelial cells.
•A pancreatic cancer type is based on the location of the tumor’s origin within the pancreas.
•More than 95 percent of pancreatic cancers are adenocarcinomas of the exocrine pancreas. Tumors of the endocrine pancreas are much less common and most are benign.
•Acinar Cell Cancers: Acinar cell cancers are tumors that form on the ends of the pancreatic ducts.
•Adenocarcinoma: An adenocarcinoma is a cancer that begins in the cells that line certain internal organs and have secretory properties. In the pancreas, this is a cancer of the exocrine cells that line the pancreatic ducts.
•Cystic Tumors: Cystic tumors derive their name from the presence of fluid filled sacs within the pancreas. The fluid is produced by the lining of abnormal tissues or tumors. These tumors may lead to cancer in some patients; however, most cystic tumors of the pancreas are benign.
•Sarcomas: Sarcomas are tumors that form in the connective tissue that bonds pancreatic cells together and are rare.
•Pancreatic Cancer is the number “4” cancer killer in the US and the only one of the four that does not have a known cure. The lack of early detection methods and research continues to slow progress towards a cure. There is no known cure for this deadly disease and over 42,400 people – 116 + per day are diagnosed with pancreatic cancer each year. In the last 5 years more than 210,000 people have been diagnosed with pancreatic cancer and over 92% of those individuals have passed away during the first year of their diagnosis. While only 5% of those living past the first year live to the fifth year and 3% of those will succumb to the disease sometime beyond that point. Pancreatic Cancer is one of the few cancers for which survival has not improved substantially over the last 25 years. Those that make it past the first year have been known to live significantly longer today than those diagnosed before 2006.
•There is no known specific cause of Pancreatic Cancer and it is very difficult to diagnose and detect in its early stage. While it does not necessarily attack a specific age group patients in recent years have ranged from 19 – 85 that are afflicted with pancreatic cancer. Previous research of pancreatic cancer patients put the percentages of patients at the older end but in the last couple of years that has changed dramatically while changing the age range significantly. People who are diagnosed with pancreatic cancer even at an early stage face a significant risk of recurrence and early death.
Signs and symptoms of pancreatic cancer vary and sometimes do not occur until the disease is in an advanced stage. That is why it is so difficult to diagnose and detect.
The signs and symptoms may include: •Upper abdominal pain •Lower back pain •Yellowing of skin and whites of eyes •Loss of appetite •Significant loss of weight in the first 30 -60 days •Depression •Digestive issues •Itching
Tests and Diagnosis •According to researchers studying ways to detect pancreatic cancer early detection methods are still difficult. However, it is still not clear who should undergo screening and which screening tests are most reliable to detect pancreatic cancer in its earliest stages.
***Currently there is NO SET STANDARD screening for pancreatic cancer. Every pancreatic cancer patient is unique in this area.
***•Please always contact your local cancer care center for further information regarding your specific form of pancreatic cancer.
***•To volunteer or make a donation to support patients and families with pancreatic cancer please click on the volunteer page or donate page.
Some risk factors may increase your risk of pancreatic cancer but are not necessarily a risk factor for everyone: •Second hand smoke •Smoking •Family history of pancreatic cancer
•Ethnic group – highest probability listed first: •Significant risk for African Americans – 52% •Caucasian – 37% •Hispanic – 10% •Asian/Pacific Island/American Indian/Alaskan Native -1%
•Weight (it has been shown that part of the weight problem stems from the pancreas being infected).
Risk Factor Description
Smoking - Smoking is a significant risk factor and may cause about 20-30% of all pancreatic cancer cases. People who smoke cigarettes are 2 times more likely to develop pancreatic cancer than people who do not smoke.
Age - The chance of developing pancreatic cancer increases with age. Most people diagnosed with pancreatic cancer are over the age of 60.
Family History - If a person’s mother, father, sibling, or child had pancreatic cancer, then that person’s risk for developing the disease increases by 2-3 times. The risk increases if a greater number of family members are affected. Also, the risk of pancreatic cancer increases if there is a history of familial breast or colon cancer, familial melanoma, or hereditary pancreatitis. Approximately 10% of pancreatic cancer cases are related to a family history of the disease. Individuals who smoke and have a family history of pancreatic cancer are at risk of developing pancreatic cancer up to 10 years earlier than their previously diagnosed family member(s).
Chronic Pancreatitis and Hereditary Pancreatitis People with chronic pancreatitis have an increased risk of developing pancreatic cancer. Chronic pancreatitis is common in individuals who consume large amounts of alcohol for many years. The mumps virus and various autoimmune disorders can also cause chronic pancreatitis. Hereditary pancreatitis causes recurrent episodes of inflammation of the pancreas that generally start by the time a person is 20 years old. The risk of developing pancreatic cancer is even higher in individuals who have hereditary pancreatitis.
Race (Ethnicity) African-Americans have a higher incidence of pancreatic cancer compared to individuals of Asian, Hispanic or Caucasian descent. There is also a higher incidence of pancreatic cancer among Ashkenazi Jews, possibly due to a mutation involving the breast cancer (BRCA2) gene that is found in about 1% of individuals of this background. Gender Slightly more men are diagnosed with pancreatic cancer than women. This may be linked to higher smoking rates in men. Diabetes Pancreatic cancer is more likely to occur in people who have long-standing (over 5 years) diabetes. Research studies suggest that new-onset diabetes in people over the age of 50 may be an early symptom of pancreatic cancer. A sudden change in blood sugar levels in diabetics who previously had well-controlled diabetes may also be a sign of pancreatic cancer.
Diet - The association of diet and the development of pancreatic cancer is still unclear. A diet high in red and processed meats is thought to increase the risk of developing pancreatic cancer. A diet high in fruits and vegetables may decrease the risk.
Obesity - Obese people have a 20% increased risk of developing the disease compared to people who are of normal weight. The risk is even higher in people who are obese during early adulthood. People with excessive abdominal fat may have an increased risk independent of general obesity.
The Scott Eli Jackson Foundation’s donations will go to support and encourage patients, caregivers and families affected by Pancreatic Cancer.
By the time symptoms occur, diagnosing pancreatic cancer is usually relatively straightforward. Pancreatic cancer may go undetected until it’s advanced. Unfortunately, a cure is rarely possible at that point.
Diagnosis - Diagnosing pancreatic cancer usually happens when someone comes to the doctor after experiencing weeks or months of symptoms. Pancreatic cancer symptoms frequently include abdominal pain, weight loss, itching, or jaundice (yellow skin). A doctor then embarks on a search for the cause, using the tools of the trade: •By taking a medical history, a doctor learns the story of the illness, such as the time of onset, nature and location of pain, smoking history, and other medical problems. •During a physical exam, a doctor might feel a mass in the abdomen and notice swollen lymph nodes in the neck, jaundiced skin, or weight loss. •Lab tests may show evidence that bile flow is being blocked, or other abnormalities.
Based on a person’s exam, lab tests, and description of symptoms, a doctor often orders an imaging test: •Computed tomography (CT scan): A scanner takes multiple X-ray pictures, and a computer reconstructs them into detailedimages of the inside of the abdomen. A CT scan helps doctors make a pancreatic cancer diagnosis. •Magnetic resonance imaging (MRI): Using magnetic waves, a scanner creates detailed images of the abdomen, in particular the area around the pancreas, liver, and gallbladder. •Ultrasound: Harmless sound waves reflected off organs in the belly create images, potentially helping doctors make a pancreatic cancer diagnosis. •Positron emission tomography (PET scan): Radioactive glucose injected into the veins is absorbed by cancer cells. PET scans may help determine the degree of pancreatic cancer spread.
Biopsies If imaging studies detect a mass in the pancreas, a pancreatic cancer diagnosis is likely, but not definite. Only a biopsy — taking actual tissue from the mass — can diagnose pancreatic cancer. Biopsies can be performed in several ways: •Percutaneous needle biopsy: Under imaging guidance, a radiologist inserts a needle into the mass, capturing some tissue. This procedure is also called a fine needle aspiration (FNA). •Endoscopic retrograde cholangiopancreatography (ERCP): A flexible tube with a camera and other tools on its end (endoscope) is put through the mouth to the small intestine, near the pancreas. ERCP can collect images from the area, as well as take a small biopsy with a brush. •Endoscopic ultrasound: Similar to ERCP, an endoscope is advanced near the pancreas. An ultrasound probe on the endoscope locates the mass, and a needle on the endoscope plucks some tissue from the mass. •Laparoscopy is a surgical procedure that uses several small incisions. Using laparoscopy, a surgeon can collect tissue for biopsy, as well as see inside the abdomen to determine if pancreatic cancer has spread. However, laparoscopy has higher risks than other biopsy approaches. If pancreatic cancer seems very likely, and the tumor appears removable by surgery, doctors may recommend surgery without a biopsy.