Pancreatic cancer | |
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Diagram showing the position of the pancreas, behind the stomach (which is transparent in this schematic). | |
Specialty | |
Symptoms |
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Usual onset | 40+ years of age[2] |
Risk factors |
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Diagnostic method |
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Prevention | Not smoking, low alcohol intake, maintaining a healthy weight, low red meat diet[5] |
Treatment | |
Prognosis | Five year survival rate 13%[6] |
Frequency | 393,800 (2015)[7] |
Deaths | 411,600 (2015)[8] |
Pancreatic cancer arises when cells in the pancreas, a glandular organ behind the stomach, begin to multiply out of control and form a mass. These cancerous cells have the ability to invade other parts of the body.[9] A number of types of pancreatic cancer are known.[10]
The most common, pancreatic adenocarcinoma, accounts for about 90% of cases,[11] and the term "pancreatic cancer" is sometimes used to refer only to that type.[10] These adenocarcinomas start within the part of the pancreas that makes digestive enzymes.[10] Several other types of cancer, which collectively represent the majority of the non-adenocarcinomas, can also arise from these cells.[10]
About 1–2% of cases of pancreatic cancer are neuroendocrine tumors, which arise from the hormone-producing cells of the pancreas.[10] These are generally less aggressive than pancreatic adenocarcinoma.[10]
Signs and symptoms of the most-common form of pancreatic cancer may include yellow skin, abdominal or back pain, unexplained weight loss, light-colored stools, dark urine, and loss of appetite.[1] Usually, no symptoms are seen in the disease's early stages, and symptoms that are specific enough to suggest pancreatic cancer typically do not develop until the disease has reached an advanced stage.[1][2] By the time of diagnosis, pancreatic cancer has often spread to other parts of the body.[10][12]
Pancreatic cancer rarely occurs before the age of 40, and more than half of cases of pancreatic adenocarcinoma occur in those over 70.[2] Risk factors for pancreatic cancer include tobacco smoking, obesity, diabetes, and certain rare genetic conditions.[2] About 25% of cases are linked to smoking,[3] and 5–10% are linked to inherited genes.[2]
Pancreatic cancer is usually diagnosed by a combination of medical imaging techniques such as ultrasound or computed tomography, blood tests, and examination of tissue samples (biopsy).[3][4] The disease is divided into stages, from early (stage I) to late (stage IV).[12] Screening the general population has not been found to be effective.[13]
The risk of developing pancreatic cancer is lower among non-smokers, and people who maintain a healthy weight and limit their consumption of red or processed meat;[5] the risk is greater for men, smokers, and those with diabetes.[14] There is some evidence that links high levels of red meat consumption to increased risk of pancreatic cancer. [15][16][17] Smokers' risk of developing the disease decreases immediately upon quitting, and almost returns to that of the rest of the population after 20 years.[10] Pancreatic cancer can be treated with surgery, radiotherapy, chemotherapy, palliative care, or a combination of these.[1] Treatment options are partly based on the cancer stage.[1] Surgery is the only treatment that can cure pancreatic adenocarcinoma,[12] and may also be done to improve quality of life without the potential for cure.[1][12] Pain management and medications to improve digestion are sometimes needed.[12] Early palliative care is recommended even for those receiving treatment that aims for a cure.[18]
Pancreatic cancer is among the most deadly forms of cancer globally, with one of the lowest survival rates. In 2015, pancreatic cancers of all types resulted in 411,600 deaths globally.[8] Pancreatic cancer is the fifth-most-common cause of death from cancer in the United Kingdom,[19] and the third most-common in the United States.[20] The disease occurs most often in the developed world, where about 70% of the new cases in 2012 originated.[10] Pancreatic adenocarcinoma typically has a very poor prognosis; after diagnosis, 25% of people survive one year and 12% live for five years.[6][10] For cancers diagnosed early, the five-year survival rate rises to about 20%.[21] Neuroendocrine cancers have better outcomes; at five years from diagnosis, 65% of those diagnosed are living, though survival considerably varies depending on the type of tumor.[10]
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