Pancreatic cancer

The pancreas is a gland that sits behind the lower part of your stomach and in front of the spine. Its function is to release enzymes that help you digest food and absorb nutrients produce hormones, including insulin, that process sugar in food and drink.

What causes pancreatic cancer?

It is not yet clear what causes pancreatic cancer.  All cancers form when cells change their DNA, or the instructions that tell a cell what to do. Theses mutations cause the cells to grow in an uncontrolled manner and continue living after normal cells would die off. This process causes a tumour to form that can spread to nearby organs and other parts of the body (metastasis).  While scientists do not yet know what starts pancreatic cancer, they have identified risk factors that make people more susceptible to this deadly disease.

Factors that increase the risk of pancreatic cancer include

• Smoking
• Chronic inflammation – caused by uncontrolled activation of the immune system – in the pancreas (pancreatitis)
• Diabetes
• Family history of pancreatic cancer
• Being overweight
• Being over 65 years of age.

Types of pancreatic cancer

There are two types of pancreatic cancer, exocrine and endocrine, based on the type of cell that the cancer starts in. Each cancer type acts differently and responds to different treatments. Most pancreatic cancers are exocrine tumours (called pancreatic ductal adenocarcinoma). Endocrine tumours are rarer and slower growing.

In most cases, pancreatic cancer does not cause symptoms until it pushes on the surrounding organs or has spread. Pancreatic cancer diagnosis can be difficult because the pancreas sits behind other organs, making it difficult for doctors to see or feel the organ. There is no standard pancreatic cancer test yet. Diagnosis can be complicated, including several tests like MRIs or ultrasounds and taking a tumour sample.

What are pancreatic cancer treatments?

The best chance of successful treatment is when pancreatic cancer is found early. Treatments options are based on the extent of the cancer and include surgery, chemotherapy and radiation, or a combination. Current immunotherapy has not been successful in most patients. While surgery offers the best chance for controlling the disease, most patients are sadly diagnosed too late for surgery. A significant challenge for treating clinicians is that pancreatic tumour cells are surrounded by a dense layer of tissue, called the stroma which is difficult for treatments (eg chemotherapy) to penetrate.