Pancreatic Cancer

Pancreatic cancer starts when cells in the pancreas grow abnormally and form a tumour. The pancreas lies behind the stomach and helps make digestive enzymes and hormones that regulate blood sugar. Tumours may arise in the part that makes digestive juices or the part that makes hormones, with ductal adenocarcinoma being the commonest type.

Jaundice is a very common presentation of pancreatic cancer, particularly when a tumour blocks the bile duct; skin and the whites of the eyes may look yellow and urine can darken. Loss of Appetite, Persistent Abdominal Pain and Unexplained Weight Loss are also very common presentations. Pain may spread to the back, and nausea, tiredness, pale stools or new changes in blood sugar can occur. These symptoms have many possible causes and need clinical assessment rather than self-diagnosis.

Most pancreatic cancers arise from acquired changes in cell DNA, but the exact reason for those changes is often unknown. Some tumours carry inherited or acquired gene changes that influence how cells repair DNA or grow. A BRCA Gene Mutation can be relevant to inherited risk and may affect treatment discussions; genetic counselling and testing are considered for some patients.

The course depends on where the tumour began, its size, whether it involves major blood vessels or nearby lymph nodes, and whether it has spread. A tumour near the bile duct may cause jaundice earlier than one elsewhere in the pancreas. The care team uses scans and pathology to determine whether surgery is possible and whether treatment should begin before or after an operation.

Risk can be higher with a strong family history, inherited gene changes, chronic pancreatitis, smoking, diabetes or certain pancreatic cyst conditions. These factors do not establish a diagnosis. If several relatives have pancreatic, breast, ovarian or prostate cancer, discuss the family pattern with a clinician or genetics service.

Assessment may include blood tests, including tests of liver function, and imaging such as ultrasound, CT or MRI. An endoscopic ultrasound can produce detailed images and allow a needle biopsy. Endoscopic retrograde cholangiopancreatography may help treat a blocked bile duct in selected situations. Pathology confirms the cancer type, while scans assess local involvement and spread.

Treatment is planned by a multidisciplinary team. Surgery may remove a tumour that has not grown into structures that make resection unsafe; a Whipple Procedure is one operation used for selected tumours in the pancreatic head. Chemotherapy may be used before or after surgery or when surgery is not suitable. Radiotherapy can target a specific area in selected plans. PARP Inhibitor Therapy may be considered for some tumours with particular DNA-repair changes. Palliative Care can support pain, nutrition, symptoms and emotional wellbeing at any stage.

Digestive enzyme replacement may help when the pancreas does not release enough enzymes. A dietitian can adapt meals for appetite, nausea or altered digestion, while a diabetes team can help with blood-sugar changes. Ask early about pain relief, sleep, emotional support and practical help; supportive care can be provided alongside cancer-directed treatment.

A tumour can obstruct bile flow or the intestine and may interfere with digestion or blood-sugar control. Cancer can also increase the tendency for Blood Clots in Cancer. Marked loss of muscle and appetite may be Cancer Cachexia. Sudden breathlessness, chest pain, a swollen painful limb, worsening jaundice or inability to keep fluids down needs urgent medical attention.

Pancreatic cancer cannot always be prevented. Avoiding tobacco, limiting alcohol, maintaining a healthy weight and managing diabetes may reduce some modifiable risks. People with a strong inherited risk may be offered genetic counselling and a personalised surveillance plan rather than routine tests chosen without specialist advice.

A specialist pancreatic or hepatobiliary team can coordinate imaging, pathology, surgery, oncology, nutrition and symptom care. Take scan reports, medication details and family cancer history to the appointment. Useful questions include whether the tumour can be removed, whether tissue testing is needed, and how symptoms such as jaundice or pain will be managed.