About Pancreatic Cancer
The pancreas is a gland located in the abdomen between the stomach and the spine. A majority of the pancreas is made up of exocrine cells, which form the exocrine glands and ducts. The exocrine glands and ducts are responsible for making pancreatic enzymes that are released into the duodenum (the first part of the small intestine) to help you digest foods (especially fats). Endocrine cells make up a smaller percentage of the pancreas. These cells make hormones, such as insulin and glucagon, which help control blood sugar levels and release them directly into the blood. Pancreatic cancer can begin in either of these types of cells and often goes undetected until it has spread to other organs because there are typically no symptoms in the early stages.
Pancreatic cancer accounts for approximately 3% of all cancers in the United States and about 7% of all cancer deaths and is best managed by gastrointestinal cancer specialists with a focus on these tumors.
Types of Pancreatic Cancer
Pancreatic cancer is classified according to which type of cell the cancer occurs in: exocrine(the part that makes digestive substances)and endocrine (the part that makes insulin and other hormones).
Exocrine pancreatic cancers, which originate from the exocrine cells, make up for about 95% of all pancreatic cancers and include the following:
- Adenocarcinoma, also called ductal carcinoma, occurs in the lining of the ducts in the pancreas and accounts for more than 90% of pancreatic cancer diagnoses.
- Acinar cell carcinoma occurs when adenocarcinoma develops from the cells that create the pancreatic enzymes.
- Squamous cell carcinoma is an extremely rare cancer that forms in the pancreatic ducts and is made purely of squamous cells, which are not typically seen in the pancreas.
- Adenosquamous carcinoma is another rare type of pancreatic cancer that shows characteristics of both adenocarcinomas and squamous cell carcinoma and is a more aggressive tumor.
- Colloid carcinoma is a rare cancer that tends to develop from a type of benign cyst called an intraductal papillary mucinous neoplasm. This type of cancer is not likely to spread and is easier to treat than other tumors.
Pancreatic neuroendocrine tumors, also known as endocrine or islet cell tumors, develop from cells in the endocrine gland of the pancreas, make up less than five percent of all pancreatic cancer cases, and include:
- Gastrinoma is a type of tumor that forms in gastrin-producing cells, which produce gastrin, a hormone that aids with digestion.
- Insulinoma is a type of tumor that forms in the cells that are responsible for producing insulin.
- Glucagonoma occurs when a tumor arises among a group of glucagon-producing cells, which play a role in the amount of glucose in the bloodstream.
- Other types of islet cell tumors make hormones that control the balance of water, sugar, and salt in your body. These include VIPomas, which affect vasoactive intestinal peptides, and somatostatinomas, which affect somatostatin. These types of islet cell tumors are often grouped together because they are treated in much the same way.
Symptoms of Pancreatic Cancer
Signs and symptoms of pancreatic cancer often don’t occur until the disease is advanced.
Some of the more common symptoms to look for include:
- Abdominal pain that radiates to your back
- Loss of appetite or unintended weight loss
- Jaundice (yellowing of the skin and the whites of the eyes)
- Light-colored stools
- Dark-colored urine
- Itchy skin
- New diagnosis of diabetes or existing diabetes that’s becoming more difficult to control
- Blood clots
Risk Factors for Pancreatic Cancer
Certain people are at greater risk of developing pancreatic cancer. and men are slightly more likely to develop pancreatic cancer than women.
Other common risk factors for pancreatic cancer include:
- Age: Though pancreatic cancer can occur at any age, it typically affects those over the age of 65.
- Family history: Pancreatic cancer is more common in people with a family history of the condition or of genetic syndromes that can increase cancer risk, including a BRCA1 or BRCA2 gene mutation, Lynch syndrome, and familial atypical mole-malignant melanoma (FAMMM) syndrome. Additionally, African Americans have been identified as at a slightly higher risk of developing pancreatic cancer than other groups.
- Health history: Cysts or other benign tumors that have formed in the pancreas can be precursors to pancreatic cancer. A history of diabetes and chronic inflammation of the pancreas (pancreatitis) can also lead to the condition.
- Personal history: Pancreatic cancer is linked to obesity, smoking, heavy alcohol use, lack of physical activity, a diet rich in red and processed meats as well as sugary drinks, and workplace exposure to certain chemicals typically used in the dry cleaning and metalworking industries.
Treating Pancreatic Cancer at UT Health Austin
Treatment requires accurate diagnosis and a care plan tailored to the specific type of tumor, the tumor’s location, and the overall needs of the patient. The different behavior of different tumor types helps drive decisions about treatment, which may include combinations of surgery, radiation therapy, and chemotherapy.
Care Team Approach
At UT Health Austin, we take a multidisciplinary approach to your care. This means you will benefit from the expertise of multiple specialists across a variety of disciplines. Your care team will include medical oncologists, surgical oncologists, radiation oncologists, pathologists, radiologists, oncofertility specialists, onco-psychiatrists, genetic counselors, physical therapists, dietitians, social workers, and more as well as other members of the CaLM Care Team who work together to help you get back to the things in your life that matter most to you. We also collaborate with our colleagues at the Dell Medical School and The University of Texas at Austin to utilize the latest research, diagnostic, and treatment techniques, allowing us to identify and utilize new therapies to improve cancer treatment outcomes. We are committed to communicating and coordinating your care with your other healthcare providers to ensure that we are providing you with comprehensive, whole-person care.