Stomach pain [1] of any kind can be alarming. But in some cases, abdominal pain that radiates to your back, accompanied by other symptoms like loss of appetite or weight loss, yellowing skin, itchy skin, change in stool, and fatigue, can actually be a sign of pancreatic cancer [2].
While not nearly as talked about as other forms of cancer [3], pancreatic cancer still accounts for about 3 percent of all cancers in the United States and about 7 percent of all cancer deaths, per the American Cancer Society [4].
The condition has appeared in the headlines lately as celebrities like Maria Menounos have opened up about their experience [5] with pancreatic cancer. Other well-known figures like Jerry Springer and Alex Trebek have also died from the disease over the past few years, leaving many wondering what causes pancreatic cancer, exactly? And how can you spot the symptoms? Ahead, here's everything you need to know about pancreatic cancer.
Experts Featured in This Article:
Russell C. Langan [6], MD, is the associate chief surgical officer and director of surgical oncology, Northern Region at RWJBarnabas Health and Rutgers Cancer Institute of New Jersey.
Wael Harb [7], MD, is a hematologist and medical oncologist at MemorialCare Cancer Institute at Orange Coast Medical Center in Fountain Valley, CA.
Mary Dillhoff [8], MD, a surgical oncologist at The Ohio State University Comprehensive Cancer Center.
What Is Pancreatic Cancer?
Pancreatic cancer is a form of cancer that starts in the pancreas, an organ that sits behind the stomach, according to the American Cancer Society [9] (ACS). Pancreatic cancer happens when cells in the pancreas start to grow out of control.
But there are different forms of pancreatic cancer, and the prognosis varies for each, says Russell C. Langan [10], MD, associate chief surgical officer and director of surgical oncology, Northern Region at RWJBarnabas Health and Rutgers Cancer Institute of New Jersey.
A pancreatic neuroendocrine tumor, which Menounos had, "is the second most common cancer of the pancreas," Dr. Langan says. But it is handled differently than what's traditionally thought of as pancreatic cancer, or pancreatic ductal adenocarcinoma, the most common cancer in the pancreas, he explains.
What Causes Pancreatic Cancer?
It's not known exactly what causes pancreatic cancer, but there are some known risk factors. According to the ACS [11], those include:
- Tobacco use
- Being overweight or obese
- Diabetes
- Long-term inflammation of the pancreas (known as pancreatitis)
- Heavy exposure to certain chemicals
- Older age
- Gender (men are slightly more likely to develop pancreatic cancer than women)
- Race (Black Americans are at a slightly higher risk than white Americans)
- Family history of the disease
- Certain inherited genetic syndromes
First Symptoms of Pancreatic Cancer
Symptoms of pancreatic cancer don't usually start until the disease is in more advanced stages, Dr. Langan says. However, once symptoms start, the Mayo Clinic [12] says they can include:
- Abdominal pain that radiates to your back
- Loss of appetite or unintended weight loss
- Yellowing of your skin and the whites of your eyes (jaundice)
- Light-colored stools
- Dark-colored urine
- Itchy skin
- A new diagnosis of diabetes or existing diabetes that's hard to control
- Blood clots
- Fatigue
Stages of Pancreatic Cancer
Like most forms of cancer, there are stages to pancreatic cancer that range in severity and mass size. The National Cancer Institute [13] (NCI) breaks them down:
- Stage 0: The cancer is confined to the top layers of pancreatic duct cells and has not invaded deeper tissues or spread outside of the pancreas.
- Stage 1A: The cancer is confined to the pancreas and is no bigger than two centimeters across.
- Stage 1B: The cancer is confined to the pancreas and is larger than two centimeters, but is no more than four centimeters.
- Stage 2A: The cancer is confined to the pancreas and is bigger than four centimeters across but has not spread to lymph nodes.
- Stage 2B: The cancer is bigger than four centimeters and has spread to no more than three lymph nodes.
- Stage 3: The cancer is two to four centimeters and has spread to four or more nearby lymph nodes.
- Stage 4: The cancer is any size and has spread to distant sites like the liver, lungs, or bones.
"Unfortunately, a lot of times pancreatic cancer is diagnosed at late stages because there is really no good screening program that's able to detect early pancreatic cancer," says Wael Harb [14], MD, a hematologist and medical oncologist at MemorialCare Cancer Institute at Orange Coast Medical Center in Fountain Valley, CA.
Mary Dillhoff [15], MD, a surgical oncologist at The Ohio State University Comprehensive Cancer Center, says the lack of screening is a "question we encounter frequently" with patients. "At this point, we don't have the mammogram or colonoscopy equivalent for pancreas cancer," she says.
Sometimes a patient's pancreatic cancer will be picked up on a CT scan for something else, Dr. Harb says. "But most typically what I see is a patient developing symptoms who is already in an advanced stage," he adds.
Pancreatic Cancer Survival Rate
Pancreatic cancer has a high mortality rate. The overall five-year survival rate for the disease is just 12 percent, according to the American Cancer Society [16]. However, patients with a localized form of pancreatic cancer may see survival rates up to 44 percent, the organization reports [17].
"No matter what the prognosis is, we don't know how that particular person will do with treatment," Dr. Dillhoff says. "I try to refocus on them. How they do and how their response to chemotherapy is more important than us trying to make predictions about how long they might live based on data. We still have hope on an individual level."
Dr. Langan says that overall prognoses for pancreatic cancer are improving, though. "For a very long time, the average survival for pancreatic cancer was two years," he said. "The five-year survival when I first started was 4 percent for all comers. Clearly, we have a long way to go, but it has increased."
Can Pancreatic Cancer Be Cured?
Pancreatic cancer is usually treated with one or several of five options, the NCI [18] says, including surgery, radiation therapy, chemotherapy, chemoradiation therapy, and targeted therapy.
Pancreatic cancer can be cured if it's found early, Dr. Harb says. "Once it's metastatic [19], spread outside the pancreas to other organs, it's not curable," he adds.
"Although the majority of patients will not reach cure, it is always something we strive for," Dr. Langan says. "It really has to be a multimodal therapy to offer patients the chance of long-term survival." He underscores the importance of hope with pancreatic cancer. "You have to hold onto hope," he says. "Myself and others that treat this disease really stress this."
— Additional reporting by Alexis Jones
Alexis Jones [20] (she/her) is the senior health and fitness editor at PS. In her six years of editorial experience, Alexis has developed passions and areas of expertise around mental health, women's health and fitness, racial and ethnic disparities in healthcare, and chronic conditions. Prior to joining PS, she was the senior editor at Health magazine. Her other bylines can be found at Women's Health, Prevention, Marie Claire, and more.
Korin Miller [21] is a writer specializing in general wellness, health, and lifestyle trends. Her work has appeared in Women's Health, Self, Health, Forbes, and more.