In 2019, around 56,770 Americans (26,830 women and 29,940 men) will receive a pancreatic cancer diagnosis. Pancreatic cancer represents around 3% of all cancer cases. African American people have a 25% higher incidence rate than Caucasians. Approximately 45,750 deaths (21,950 women and 23,800 men) will occur due to this cancer this year.
These are some startling statistics. Therefore, it’s crucial that you know the potential signs of pancreatic cancer and the risk factors.
Risk Factors of Pancreatic Cancer
The following risk factors could increase your risk of developing pancreatic cancer:
1. Gender: Men receive more pancreatic cancer diagnoses than women.
2. Age: As you age, your risk of developing this disease increases. Most individuals who develop this disease are older than 45 years old. The American Society of Clinical Oncology reports that 90% are older than 55 years old and 70% are older than 65 years old. However, anyone of any age can receive a pancreatic cancer diagnosis.
3. Smoking: Individuals who smoke are two to three times more likely to develop the disease than those who don’t.
4. Race/ethnicity: Black individuals are more likely than white, Hispanic or Asian individuals to develop pancreatic cancer. Individuals of Ashkenazi Jewish heritage also have a higher risk of developing pancreatic cancer.
5. Excess weight: Obesity is a pancreatic cancer risk factor. You’re around 20% more likely to develop the disease when you’re obese (30 or higher body mass index, or BMI). If you’re not significantly overweight, even carrying extra waistline weight can be a risk factor.
6. Family history: Pancreatic cancer could run in the family. It could also link with genetic disorders that raise your risk of other cancers. The term for this is familial pancreatic cancer. If you have two or more first-degree relatives or a minimum of three family members who’ve received a pancreatic cancer diagnosis, you and your family could be at risk.
7. Diabetes: Studies show diabetes, particularly when an individual has had it for years, raises the risk of pancreatic cancer development. Also, if you develop diabetes suddenly later in adulthood, it could be an early sign of pancreatic cancer.
8. Rare inherited conditions: Family members with specific uncommon inherited disorders also have a substantially increased pancreatic cancer risk, along with other cancers. These rare inherited conditions include:
- Hereditary pancreatitis (HP): A genetic, but rare condition marked by recurrent pancreatic attack episodes that may progress to chronic pancreatitis.
- Familial malignant melanoma and pancreatic cancer (FAMM-PC): Refers to families where two or more first-degree family members, like a parent, child or sibling, have melanoma skin cancer.
- Peutz-Jeghers syndrome (PJS): An inherited disorder that puts individuals at a higher risk for developing digestive tract hamartomatous polyps as well as cancers of the colon, rectum, breast, stomach, pancreas, lung, ovaries cervix, testicles and other types.
- Lynch syndrome: This condition represents a form of inherited cancer syndrome linked with a genetic predisposition to various cancer forms.
- Hereditary breast and ovarian cancer (HBOC) syndrome: Mainly linked with BRCA1 or BRCA2 gene mutations.
Individuals with the following inherited disorders might also have an increased pancreatic cancer risk:
- Familial adenomatous polyposis (FAP): FAP is an inherited condition marked by cancer of the rectum and large intestine (colon).
- Li-Fraumeni syndrome (LFS): LFS represents an inherited familial predisposition to a broad range of frequently rare cancers.
- Chemicals: Exposure to certain chemicals like benzene, pesticides, petrochemicals and dyes could raise your risk of pancreatic cancer.
- Chronic pancreatitis: Pancreatitis is a painful pancreatic condition featuring inflammation of the pancreas. If you have chronic pancreatitis, you could have a higher risk of pancreatic cancer development.
- Bacteria: Helicobacter pylori (H. pylori) causes ulcers and inflammation in your stomach. An H. pylori infection can increase your risk of pancreatic and stomach cancer. However, your risk of pancreatic cancer isn’t as high as your risk of stomach cancer.
- Cirrhosis: This develops when you have damage to your liver cells and they’re replaced by scar tissue. Alcohol abuse causes most cirrhosis in the U.S. Other causes are hemochromatosis (too much iron in your liver), viral hepatitis and some rare forms of chronic liver disease.
- Hepatitis B infection: One study demonstrated that a previous hepatitis B infection was two times as common in individuals with pancreatic cancer than in individuals without cancer.
Factors With Unclear Impact on Risk
Some other factors that could increase your risk of pancreatic cancer include:
- Diet: Some research links pancreatic cancer to a diet high in processed and red meats (like bacon and sausage) and low in vegetables and fruits. However, not all research has found these links and researchers are still conducting studies.
- Coffee: Older studies have shown drinking coffee could raise your risk of developing pancreatic cancer, but more recent research hasn’t confirmed this.
- Physical inactivity: A lack of physical activity could raise your risk of pancreatic cancer, according to some research.
- Infections: Studies show a stomach infection with Hepatitis B or the bacteria H. pylori could increase your risk. There needs to be more research.
- Alcohol: Research has shown an association between pancreatic cancer and heavy alcohol use, but the link isn’t certain. However, drinking excessive alcohol could lead to other conditions, like chronic pancreatitis, which researchers link with a pancreatic cancer risk increase.
Signs & Syptoms of Pancreatic Cancer
Doctors frequently call pancreatic cancer a “silent disease” because there aren’t many noticeable signs or symptoms in the early stages of the disease. There’s typically no one symptom that lets you know for certain you have pancreatic cancer. Even when you do develop symptoms, they’re not a great way of finding the disease because they could be confusing to doctors and patients. Your symptoms and signs also vary depending on the location of the tumor in your pancreas.
Also, there aren’t yet any specific tests that can find the cancer reliably in individuals who don’t have symptoms. When there are symptoms, they’re often similar to those of other health disorders, like pancreatitis or an ulcer.
Here are some symptoms of pancreatic cancer. While other medical conditions can cause them, you should speak to your doctor if you experience one or more of the symptoms below:
1. Your Stomach or Back Hurts
The primary symptom of pancreatic cancer is abdominal discomfort. It can sometimes radiate into your back, as your pancreas is in the back of your abdomen. You may experience occasional or constant pain which may worsen after you lie down or eat. However, various conditions and diseases other than pancreatic cancer could also lead to back or abdominal pain, making this a challenging symptom to link with pancreatic cancer.
A tumor could be causing mid-back or abdominal pain. Depending on where your tumor resides, it could push against your organs or the nerves near your pancreas or it could block your digestive tract.
2. You Have Difficulty Digesting Food
Indigestion, loss of appetite and nausea are common in individuals with pancreatic cancer. Symptoms like these frequently occur when the cancer impacts your ability to digest your food and absorb the nutrients. They could also occur if you have a tumor blocking or slowing your regular digestive processes.
3. You’re Bloated
Pancreatic cancer could cause digestive issues, which may cause bloating and gas. It could also cause ascites (a buildup of excess abdominal fluid), causing your belly to stretch out and swell.
4. You Have Weight Loss With No Known Reason
Pancreatic cancer could cause incomplete digestion, which in turn could cause weight loss. Weight loss induced by cancer is an issue that impacts how your body uses protein and calories. It could cause your body to burn more calories than normal, breaking down muscle and decreasing your appetite.
5. Your Eyes and Skin Appear Yellow
Yellowing of the eyes and skin is known as jaundice. It’s caused by a buildup of bilirubin (a bile component). This buildup could occur if you have a tumor blocking the bile flowing into your small intestine from your gallbladder. Individuals with jaundice might also have dark urine, itchy skin and clay-colored or light stools.
6. Your Stools Are Changing
Many individuals with pancreatic cancer have constipation, diarrhea or both. Constipation is a common issue. If your digestive system is working too slowly, it could cause your stools to become hard, dry and difficult to pass. Diarrhea consisting of watery, loose, foul-smelling or oily stools could be due to insufficient intestinal pancreatic enzyme levels.
7. You Received a Diabetes Diagnosis or You Can No Longer Control Your Diabetes
Individuals who are 50 or older, and who have a sudden onset of type 2 diabetes, could be experiencing an early pancreatic cancer symptom — particularly those with a lower body mass index, those who don’t have a family history of diabetes and those experiencing continuous weight loss. Also, if you experience a sudden blood sugar level change when you were previously controlling your diabetes well, this too could be a pancreatic cancer sign.
What Causes Pancreatic Cancer?
Pancreatic cancer causes are still unclear. It develops when a pancreas cell acquires DNA damage that causes it to multiply and behave abnormally. One cancer cell grows and then rapidly divides, turning into a tumor that doesn’t respect the body’s normal boundaries. Eventually, tumor cells travel into other areas of the body (metastasized through your lymphatic system or blood).
Nobody knows for sure how the DNA damage that leads to pancreatic cancer occurs. Analyzing surgically removed pancreatic cancers shows specific mutations that occur in just about all cases, while others vary between individuals.
Some of these mutations occur randomly. Others do so when they respond to things we do or experience in the environment. You could inherit some mutations as well. When you accumulate enough mutations, a cell turns malignant and you begin growing a tumor.
How to Detect Pancreatic Cancer Signs
Pancreatic cancer signs could go undetected until you reach the advanced stages. By the time you experience symptoms, the diagnosis is typically relatively straightforward. Sadly, curing cancer at this point is rare. A pancreatic cancer diagnosis typically occurs when an individual goes to their doctor’s office after they’ve been experiencing symptoms for weeks or months.
Your doctor may use certain tools to detect pancreatic cancer, such as:
- They’ll take your medical history and learn your story of the disease, its nature, time of onset and location of the pain. They’ll also note your smoking history and if you have other medical issues.
- They’ll perform a physical exam where they’ll feel the abdominal mass and notice any jaundiced skin, swollen lymph nodes in your neck or weight loss.
- They’ll perform lab tests, which could show you have blocked bile flow or other abnormalities.
Based on your exam, description of symptoms and lab tests, your doctor may order an imaging test such as:
- Magnetic resonance imaging (MRI): This uses magnetic waves and a scanner that generates detailed abdomen images, and particularly the area around your liver, pancreas and gallbladder.
- Computed tomography (CT scan): A scanner that takes various X-ray images and a computer, then reconstructs these images into detailed images of your abdomen.
- Ultrasound: Uses sound waves that reflect off your belly’s organs and create images that will possibly help your doctor make a diagnosis.
- Positron emission tomography (PET scan): Uses radioactive glucose the doctor injects into your veins, which cancer cells absorb. PET scans could help the doctor figure out how far your cancer has spread.
If the doctor detects a pancreas mass from the imaging studies, they’ll likely make a pancreatic cancer diagnosis — but this is not definite. The only true way of coming up with a pancreatic cancer diagnosis is for the doctor to take a biopsy of the tissue. The doctor can perform the biopsy in various ways:
- Percutaneous needle biopsy. The radiologist uses imaging guidance to insert a needle into the mass and capture some tissue. Another name for this procedure is fine needle aspiration (FNA).
- Endoscopic ultrasound. This places an endoscope near your pancreas. The ultrasound probe attached to the endoscope locates the mass. The doctor then uses a needle on the endoscope to pluck out some mass tissue.
- Endoscopic retrograde cholangiopancreatography (ERCP): The doctor uses this tool with a camera attached to a flexible tube and endoscope, and puts it through your mouth straight down near your pancreas to your small intestine. ERCP can gather images from the location and use a brush to take a small biopsy.
- Laparoscopy: This is a surgical procedure where the surgeon uses a few small incisions. They use laparoscopy to collect tissue for a biopsy and also to see the inside of your abdomen to figure out if your cancer has spread. Laparoscopy comes with more risks than other biopsy techniques.
If it seems likely you have pancreatic cancer and the doctor is confident surgery can remove the tumor, they might recommend surgery without a biopsy.
Knowledge of pancreatic cancer is key. You should learn about the risk factors linked with cancer — including obesity, smoking and a history of chronic pancreatitis. There could also be hereditary factors involved which can increase your risk. Being aware of your own possible risk factors, and maintaining a healthy lifestyle, are vital.
If you’re experiencing any symptoms that concern you or are persistent, see your doctor. They can run some tests and perform procedures that will help them figure out what the cause could be. If you do have risk factors, you’ll also want to visit a pancreatic professional early. Remember that you’re your own best advocate.
Contact Dr. Fraiman for an Appointment
If you suspect you have pancreatic cancer and/or are experiencing symptoms, contact Dr. Mark Fraiman, the liver and pancreas surgeon at The University of Maryland St. Joseph Medical Center. We’re located in Towson, Maryland, and are here to address your specific needs.
Dr. Fraiman is a leading expert in the diagnosis and treatment of various diseases, including pancreatic cancer. Our team of friendly and caring specialists will provide you with the support you need throughout each stage of your healing process. Contact Dr. Fraiman today to set up your appointment.
This article was medically reviewed by Dr. Mark Fraiman on June 12, 2019.
Sources:
https://www.cancer.net/cancer-types/pancreatic-cancer/risk-factors
https://www.cancer.org/cancer/pancreatic-cancer/causes-risks-prevention/risk-factors.html
https://www.webmd.com/cancer/pancreatic-cancer/causes-pancreatic-cancer
https://www.cancer.net/cancer-types/pancreatic-cancer/statistics
https://www.cancer.org/cancer/pancreatic-cancer/about/key-statistics.html
https://seer.cancer.gov/statfacts/html/pancreas.html
https://www.cancer.net/cancer-types/pancreatic-cancer/symptoms-and-signs
https://www.webmd.com/cancer/pancreatic-cancer/pancreatic-cancer-symptoms#1
https://www.cancer.org/cancer/pancreatic-cancer/detection-diagnosis-staging/signs-and-symptoms.html
https://www.pancan.org/news/7-pancreatic-cancer-symptoms-and-signs-you-should-know/
https://health.usnews.com/conditions/pancreatic-cancer/signs-of-pancreatic-cancer
https://www.bbc.com/news/health-41817061
https://www.mayoclinic.org/diseases-conditions/pancreatic-cancer/symptoms-causes/syc-20355421
https://www.pancan.org/facing-pancreatic-cancer/symptoms/
https://www.aarp.org/health/conditions-treatments/info-2018/pancreatic-cancer-symptoms.html
