What You Need to Know About Cancer of the Pancreas
November is Pancreatic Cancer Awareness Month and World Pancreatic Cancer Day is Thursday 17 November. Most people are not always as knowledgeable about pancreatic cancer as breast, lung or prostate cancer, but the disease is just as debilitating.
The pancreas is a fish shaped organ that lies behind the stomach, deep in the body. It measures about 6 inches long and less than 2 inches wide. The pancreas is made up of exocrine glands (which make pancreatic enzymes that break down food in the intestines) and clusters of cells (which make hormones like insulin that help balance the amount of sugar in the blood).
Pancreatic cancer starts when the exocrine glands or the endocrine cells form tumours, which can spread throughout the body. Cancers formed by the exocrine cells are much more common.
When pancreatic cancer spreads, the cancer cells may also be found in nearby lymph nodes, the liver, the lungs or in fluid collected from the abdomen.
What is the pancreas?
The pancreas is a large gland that lies behind the stomach, at the back of the tummy area (abdomen) – at about the same height as the bottom of the breastbone. It is about 15cm (6 inches) long and shaped a bit like a tadpole. It is often described as having a head, body and tail. It is surrounded by several large and important organs and blood vessels. The head of the pancreas is next to the duodenum (first part of the small intestines). The body of the pancreas is the middle section, and the tail is next to the spleen. The liver, stomach, intestines, left kidney and gallbladder are also all close to the pancreas. The blood vessels that carry blood to the liver, intestines, kidneys and lower part of the body are very close to the pancreas, and may touch it. The pancreatic duct runs the length of the pancreas. It carries pancreatic juices, which contain enzymes made by the pancreas to the intestines. The pancreatic duct and bile duct (which carries a fluid called bile from the liver) both open into the duodenum (small intestines).
Facts About Pancreatic Cancer
Pancreatic cancer is the 10th most common cancer in the UK.
Pancreatic cancer is the fifth biggest cancer killer in the UK – 26 a day.
8,500 people die from pancreatic cancer in the UK every year.
Just 5% of patients survive – it has the worst survival rate of all 22 common cancers.
The average life expectancy on diagnosis is four to six months.
There are around 9,500 new cases of pancreatic cancer in the UK every year.
About 1 in 75 people will get pancreatic cancer at some point in their life.
Pancreatic cancer affects men and women equally.
Nearly half of people are diagnosed as an emergency in our A&E system.
The earlier pancreatic cancer is caught, the better chance a person has of surviving 5 years after being diagnosed.
Pancreatic cancer – what is it?
Pancreatic cancer occurs when a malignant tumour forms in the pancreas. There are two main types of pancreatic cancer: Exocrine tumours which make up the vast majority of all pancreatic cancers and come from the cells that line the ducts in the pancreas which carry digestive juices into the intestine, and rarer, Endocrine tumours which are much less common.
What causes pancreatic cancer?
The causes of pancreatic cancer are not fully understood. However, there are some risk factors that make developing pancreatic cancer more likely:
Smoking – There is a direct relationship between the amount you smoke and the risk of pancreatic cancer. Around a third of all cases are associated with smoking.
Age – The risk of developing pancreatic cancer increases with age. It mainly affects people who are 50-80.
Chronic Pancreatitis – Long-term inflammation of the pancreas (pancreatitis) has been linked to pancreatic cancer.
Diabetes – There have been a number of reports which suggest that diabetics have an increased risk of developing pancreatic cancer.
Obesity – Recent studies have shown that risk is higher in people who are obese (have a Body Mass Index more than 30). Some studies show that obese women who carry their weight on their stomach area are at an increased risk of developing pancreatic cancer.
Stomach Ulcer – Stomach Ulcer and Helicobacter pylori infection (a stomach infection).
Genetics – In about 1 in 10 cases, pancreatic cancer is inherited from a person’s parents. Certain genes also increase your chances of getting pancreatitis, which in turn increases your risk of developing cancer of the pancreas.
Symptoms of pancreatic cancer
In the early stages, a tumour in the pancreas doesn’t usually cause any symptoms, which can make it difficult to diagnose.
It’s important to remember that these symptoms can be caused by many different conditions, and aren’t usually the result of cancer. But individuals should contact their GP if concerned, or if these symptoms start suddenly.
The first noticeable symptoms of pancreatic cancer are often:
pain in the back or stomach area – which may come and go at first and is often worse when you lie down or after you’ve eaten
unexpected weight loss
jaundice – the most obvious sign is yellowing of the skin and whites of the eyes; it also causes your urine to be dark yellow or orange and your stools (faeces) to be pale-coloured
Other possible symptoms of pancreatic cancer include:
nausea and vomiting
fever and shivering
Those affected may also develop symptoms of diabetes if they have pancreatic cancer, because it can produce chemicals that interfere with the normal effect of insulin.
Diagnosing pancreatic cancer
The GP will first ask about general health and carry out a physical examination. They may examine the tummy (abdomen) for a lump and to see whether the liver is enlarged.
They’ll also check the skin and eyes for signs of jaundice and may request a urine sample and blood test.
If the GP suspects pancreatic cancer, the person concerned will usually be referred to a specialist at a hospital for further investigation where the following may take place:
an ultrasound scan
a computerised tomography (CT) scan
a magnetic resonance imaging (MRI) scan
a positron emission tomography (PET) scan – where an injection is given of a very small amount of radioactive medication, known as a tracer, which helps to show up cancers in an image
Depending on the results of a scan, further tests may include:
an endoluminal ultrasonography (EUS) endoscopy – a type of endoscopy which allows close-up ultrasound pictures to be taken of the pancreas
an endoscopic retrograde cholangiopancreatography (ERCP) – a type of endoscopy which is used to inject a special dye into the bile and pancreatic ducts; the dye will show up on an X-ray and highlight any tumours
a laparoscopy – a surgical procedure that allows the surgeon to see inside the body using a laparoscopy (a thin, flexible microscope)
A biopsy, where a small sample is taken from a suspected tumour, may also be carried out during these procedures.
In 2015, the National Institute for Health and Care Excellence (NICE) published guidelines to help GPs recognise the signs and symptoms of pancreatic cancer and refer people for the right tests faster.
To find more on this read the NICE 2015 guidelines on Suspected Cancer: Recognition and Referral at https://www.nice.org.uk/guidance
Treating pancreatic cancer
Cancer of the pancreas is difficult to treat. It rarely causes any symptoms in the early stages, so it’s often not detected until the cancer is fairly advanced. If the tumour is large, treating the cancer will be more difficult.
If diagnosed with pancreatic cancer, the treatment will depend on the type and location of the cancer, and how far it’s advanced. Age, general health and personal preferences will also be taken into consideration.
The first aim will be to completely remove the tumour and any other cancerous cells. If this isn’t possible, treatment will focus on preventing the tumour growing and causing further harm to the body.
The three main treatments for pancreatic cancer are:
Some types of pancreatic cancer only require one form of treatment, whereas others may require two types of treatment or a combination of all three.
Recovering from Pancreatic Cancer Surgery
Recovering from pancreatic cancer surgery can be a long and difficult process.
Patients will probably experience some pain after the operation. Adequate pain relief will be prescribed.
After any type of surgery to the digestive system, the bowel will temporarily stop working. This means the patient won’t be able to eat or drink straight away.
The patient will gradually be able to sip fluids, before eventually being able to drink and eat more regularly. Advice will be given about what foods should be eaten following the operation.
After the tumour has been removed, the patient will probably have a six-month course of chemotherapy, which greatly increases the chance of being cured. But because cancer of the pancreas is difficult to diagnose and treat, many people don’t recover completely.
Treatment can be very effective in helping to ease symptoms and make the patient as comfortable as possible. Chemotherapy can help shrink the tumour and slow down its growth.
World Pancreatic Cancer Day -Thursday 17 November
This month, Pancreatic Cancer Month and on Thursday 17 November, World Pancreatic Cancer Day, the CWU will be joining individuals and organisations in the UK and across the globe to show that we are “in it together” in the aim to raise awareness of pancreatic cancer. World Pancreatic Cancer Day is organised by an International Steering Group made up of the following organisations: Pancreatic Cancer Action (UK), Pancreatic Cancer UK, PurpleOurWorld Australia, The JCM Foundation (USA), Craig’s Cause Pancreatic Cancer Society (Canada), European Cancer Patient Coalition (EU), PASYKAF (Cyprus).
Pancreatic Cancer UK
Pancreatic Cancer UK is a charity fighting to make a difference by taking on pancreatic cancer, by supporting those affected by the disease, investing in research, lobbying for greater recognition of pancreatic cancer, and being there for everyone involved in the fight. The Charity wants to make sure that everyone touched by it gets the support and information they need. The Charity is here for everything you need to know about pancreatic cancer.
They provide expert, personalised support and information via a Support Line and through a range of publications
They fund innovative research to find the breakthroughs that will change how we understand, diagnose and treat pancreatic cancer
They campaign for change; for better care, treatment and research, and for pancreatic cancer to have the recognition it needs.
Support Line – Freephone
Pancreatic Cancer UK operates a Freephone ‘Support Line’ which is a lifeline for thousands of patients, families and friends. Available to anyone affected by pancreatic cancer. The Pancreatic cancer specialist nurses understand the issues that individuals might be facing and can support people in coping with pancreatic cancer. They can provide individual specialist information about pancreatic cancer, treatment options and managing symptoms and side effects. As a listening ear, they can also help with your concerns and provide support and discuss sensitive issues with respect and acceptance.
Contact Details – Further Information:
Pancreatic Cancer UK
6th Floor Westminster Tower
3 Albert Embankment
London, England SE1 7SP
Tel: 020 3535 7090
Pancreatic Cancer Action
Pancreatic Cancer Action is another leading charity in the field with a focus on improving early diagnosis of pancreatic cancer and improving the quality of life for those affected by pancreatic cancer. They are on a mission to stamp out late detection which is the reason that the survival rate has remained at between 2% – 4% for nearly 50 years.
Contact Details – Further Information:
Pancreatic Cancer Action
Oakhanger Business Park
Tel: 0303 040 1770
Pancreatic Cancer Fact Sheet
Pancreatic Cancer Risk Factors Fact Sheet
Pancreatic Cancer Sign & Symptoms Fact Sheet
Pancreatic Cancer Poster/Leaflet
National Health, Safety & Environment Officer
Email Attachments – Click to download Attachment 1 – LTB661/16 Pancreatic Cancer Awareness Month & World Pancreatic Cancer Day Thursday 17 November: