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CancerICD-10: C25About 64,000 new cases per year in the US; third leading cause of cancer death

Pancreatic Cancer

Also known as: Cancer of the Pancreas, Pancreatic Adenocarcinoma

Pancreatic cancer is one of the most aggressive and lethal cancers, arising primarily from the exocrine cells of the pancreas (ductal adenocarcinoma accounts for about 90% of cases). It is difficult to detect early because the pancreas is located deep in the abdomen and symptoms are often vague until the disease is advanced. It is the third leading cause of cancer death in the United States.

Symptoms

Painless jaundice (yellowing of skin and eyes)
Upper abdominal pain radiating to the back
Unexplained weight loss and loss of appetite
New-onset diabetes in individuals over 50
Dark urine and pale, greasy stools (steatorrhea)
Nausea and vomiting
Blood clots (sometimes the first sign)
Fatigue and depression

Causes

  • Acquired genetic mutations in pancreatic ductal cells (KRAS, TP53, CDKN2A, SMAD4)
  • Chronic inflammation of the pancreas (chronic pancreatitis)
  • Inherited genetic syndromes (BRCA2, Lynch syndrome, familial pancreatitis)

Risk Factors

  • Smoking (doubles the risk)
  • Chronic pancreatitis
  • Type 2 diabetes, especially new-onset in older adults
  • Obesity
  • Family history of pancreatic cancer
  • Age over 65

Diagnosis

  • CT scan with pancreatic protocol (contrast-enhanced, thin-cut)
  • Endoscopic ultrasound (EUS) with fine-needle aspiration biopsy
  • MRI/MRCP for detailed pancreatic duct imaging
  • CA 19-9 tumor marker (useful for monitoring, not screening)
  • Staging laparoscopy if surgical resection is planned

Treatment

  • Surgical resection (Whipple procedure for head of pancreas tumors; distal pancreatectomy for tail tumors)
  • Adjuvant chemotherapy (FOLFIRINOX or gemcitabine-based regimens)
  • Neoadjuvant chemotherapy for borderline resectable tumors
  • Palliative chemotherapy for advanced disease
  • Radiation therapy in selected cases
  • Supportive care (pain management, pancreatic enzyme replacement, nutritional support)

Prevention

  • Quit smoking or never start
  • Maintain a healthy weight
  • Limit alcohol to reduce chronic pancreatitis risk
  • Genetic counseling for families with inherited pancreatic cancer syndromes

When to See a Doctor

  • Unexplained jaundice (yellow skin or eyes)
  • Persistent upper abdominal or back pain with weight loss
  • New-onset diabetes after age 50 without typical risk factors
  • Unexplained blood clots

Frequently Asked Questions

Related Conditions

Pancreatitis

Digestive

Ovarian Cancer

Cancer

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Medical Disclaimer: This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider.

Content reviewed against peer-reviewed medical literature and clinical guidelines. Read our editorial standards.