Pancreatic Cancer: Signs, Stages, Treatment, Outlook, Quality of Life, and More

Medically Reviewed By Faith Selchick, DNP, AOCNP
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The pancreas is a long, flat organ located behind the stomach. It produces digestive enzymes and a variety of hormones. It is possible to develop pancreatic cancer, and the condition may not cause any symptoms during the early stages. Treatments and options for symptom management are available. The most common type of pancreatic cancer is adenocarcinoma, or cancer of the gland-forming cells in the pancreas. Early pancreatic cancer often occurs without symptoms, and pancreatic cancer is often at an advanced stage when it is discovered.

Depending on the individual situation and extent of spread of the cancer, treatments for pancreatic cancer can include surgery, chemotherapy, and radiation therapy as well as newer or experimental therapies.

Keep reading to learn about the symptoms of pancreatic cancer, and its causes, types, stages, risk factors, diagnosis steps, and treatment options.

What are the symptoms of pancreatic cancer?

a nurse is talking to a patient with pancreatic cancer
PER Images/Stocksy United

Symptoms of pancreatic cancer can result from decreased digestive enzyme production, compression of nearby tissues and organs, and the spread of the disease.

In the very early stages, pancreatic cancer may produce no symptoms or only mild symptoms.

Symptoms of pancreatic cancer include:

What are the different types of pancreatic cancer?

The different types of pancreatic cancer include:

  • Adenocarcinoma of the pancreas: This is the most common pancreatic cancer type. Pancreatic adenocarcinomas usually begin in the cells lining the pancreatic duct. 
  • Acinar cell carcinomas: These begin in the enzyme-producing exocrine gland cells.
  • Adenosquamous carcinoma of the pancreas: This is a rare subtype of exocrine pancreatic cancer that contains both exocrine gland cells and squamous epithelial (skin) cells.
  • Signet ring cell carcinoma: This is a rare subtype of exocrine pancreatic cancer that starts within the duct.
  • Undifferentiated carcinoma with osteoclast-like giant cells: This is an extremely rare subtype of pancreatic cancer.
  • Ampullary cancer: This starts at the intersection of the bile duct and pancreatic duct.

What are the stages of pancreatic cancer?

The size and location of the cancerous pancreatic tumor determine the stage. There are five stages:

Stage 0The cancer consists of small amounts of cells and has not invaded deeper into the duct lining. The cancer has not spread.
Stage 1Stage 1A pancreatic cancer is 2 centimeters (cm) or 0.8 inches (in) across or less. Stage 1B is 4 cm or less. The cancer has not spread from the pancreas.  
Stage 2Stage 2A pancreatic cancer is larger than 4 cm in diameter but has not spread to lymph nodes or to distant sites in the body. Stage 2B pancreatic cancer is either smaller than 2 cm, 2–4 cm, or larger than 4 cm in diameter, and it has spread to three or fewer nearby lymph nodes but not to distant sites.
Stage 3Stage 3A pancreatic cancer is either smaller than 2 cm, 2–4 cm, or larger than 4 cm in diameter, and it has spread to four or more nearby lymph nodes but not to distant sites. A substage of stage 3 is cancer growing outside the pancreas into blood vessels. It may also be in nearby lymph nodes but not at distant sites.
Stage 4Stage 4 pancreatic cancer has spread to distant sites, such as the liver or lungs. This is metastatic pancreatic cancer.

Tumor grade

The tumor grade is a characteristic of the cancer cells themselves. The grade can guide treatment decisions and determine the outlook.

Low-grade tumor cells (grade 1) look like normal pancreas cells and tend to grow slowly and not spread as easily as high-grade tumor cells (grade 3), which look very abnormal and grow fast.

Grade 2 cells are somewhere in the middle between grade 1 and grade 3.

The lower the grade, the better the outlook. Your doctor will discuss your individual diagnosis with you and review available treatment options.

What causes pancreatic cancer?

Cancer occurs when a cell becomes abnormal and control over its growth is lost. Damage and changes in the cell’s DNA and other factors can lead to uncontrollable, cancerous cell growth.

What causes pancreatic cancer is not known, though researchers have identified some risk factors for developing pancreatic cancer.

What are the risk factors for pancreatic cancer?

Risk factors for pancreatic cancer might include:

  • being older than 55 years
  • having chronic pancreatitis (hereditary form)
  • having cirrhosis, or scarring of the liver
  • having diabetes
  • having exposure to certain chemicals, including pesticides, asbestos, benzene, and chlorinated hydrocarbons
  • having a family history of pancreatic cancer
  • not getting enough physical activity
  • being male
  • having midsection fat, even in people who are mildly overweight
  • having obesity
  • having had previous stomach or gallbladder surgery
  • using tobacco, which doubles the risk of pancreatic cancer

Other possible risk factors include heavy alcohol use, hepatitis B infection, Helicobacter pylori infection, and a diet high in red and processed meats.

How do doctors diagnose pancreatic cancer?

The only way to definitively diagnose pancreatic cancer is with a biopsy. A doctor may obtain this biopsy using different methods.

They may start by performing a complete medical history and physical examination and ordering special blood tests. Doctors may also use imaging tests to diagnose pancreatic cancer, including the following:

Diagnostic procedures may include:

  • Endoscopic retrograde cholangiopancreatography: This combines X-ray and an endoscope (a long, flexible, lighted tube) to help the doctor diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas.
  • Percutaneous transhepatic cholangiograph: Doctors introduce a needle through the skin and into the liver where a dye (contrast) is deposited, and the bile duct structures can be viewed by X-ray.
  • Pancreatic biopsy: Clinicians remove a sample of pancreatic tumor tissue with a needle or during surgery for examination under a microscope.

Learn more about how doctors diagnose pancreatic cancer here.

How do doctors treat pancreatic cancer?

Common treatments for pancreatic cancer include:

  • chemotherapy to attack cancer cells
  • surgery to remove the cancer or alleviate symptoms
  • targeted therapy to attack cancer cells
  • immunotherapy to activate the immune system to destroy cancer cells
  • radiation therapy to attack cancer cells
  • radiofrequency ablation to destroy cancer cells
  • embolization to block blood flow to the tumor by injecting a substance into an artery
  • participation in a clinical trial for testing new treatments for pancreatic cancer
  • cryosurgery to freeze and destroy cancer cells
  • microwave thermotherapy to destroy cancer cells with heat

Treatments for symptom management

Other therapies may help with your general state of health and any complications of the cancer or its treatment. Those therapies might include:

  • acid-blockers for the rare pancreatic cancers that increase stomach acid production
  • antinausea medications
  • blood sugar monitoring and treatment if diabetes is present
  • dietary counseling to help maintain strength and nutritional status
  • pain medications as needed to increase comfort
  • palliative care to improve overall quality of life
  • complementary treatments, such as yoga or acupuncture

How does pancreatic cancer affect quality of life?

Most, if not all, treatment options for pancreatic cancer can cause side effects, which can affect your quality of life. For anyone facing a pancreatic cancer diagnosis, it is important for the care team to balance your treatment with the impact it has on your quality of life — including your social, emotional, and physical well-being.

Dealing with the fear of cancer recurrence or worse outcomes is another challenge. Joining a support group with other people who are currently facing or who have survived pancreatic cancer can provide comfort. Time with supportive family and friends can also make life meaningful and enjoyable.

It may also be helpful to seek professional counseling with a therapist who has experience working with people who have cancer.

Pancreatic cancer and its treatments can take a toll on your overall health and wellness. They can cause weakness, pain, fatigue, and poor nutrition. During and after treatment, communicate your symptoms and needs to your care team so that they can connect you with the right healthcare professional, such as a physical therapist, nutritionist, or counselor.

What is the outlook for pancreatic cancer?

Pancreatic cancer survival rates and outlooks depend on many factors, and your prognosis is unique to you.

The following table shows the Surveillance, Epidemiology, and End Results (SEER) as listed on the American Cancer Society website. However, it is important to remember that these numbers do not take every circumstance into account. These data are also from 2017, and people may have a better survival rate now than these numbers show.

SEER stageExplanation5-year survival rate
localizedThe cancer is contained within the pancreas.42%
regionalThe cancer has spread to structures nearby the pancreas.14%
distantThe cancer has spread to structures far away from the pancreas.3%
all stages combinedAll of the SEER stages above are combined.11%

Learn more about the survival rates for pancreatic cancer here.

Other frequently asked questions

Here are some commonly asked questions about pancreatic cancer. The answers have been reviewed by Faith Selchick, D.N.P., AOCNP.

What are the symptoms of pancreatic cancer in a female?

Pancreatic cancer typically affects males and females in the same way, but symptoms can vary from individual to individual no matter their sex or gender. The most common symptoms are abdominal or back pain, weight loss, and indigestion. People may also notice jaundice, a loss of appetite, and changes to their bowel habits.

What is the biggest cause of pancreatic cancer?

Experts do not know exactly what causes pancreatic cancer. However, the most likely risk factors for pancreatic cancer include:

  • older age
  • smoking
  • overweight or obesity
  • family history 
  • pancreatitis
  • diabetes 

How can you tell the difference between pancreatic cancer and pancreatitis?

Pancreatic cancer and pancreatitis may present with similar symptoms. Therefore, contact a doctor as soon as possible if you develop any of these symptoms. A clinician can then diagnose pancreatic cancer as opposed to pancreatitis using a CT scan.

Summary

Common symptoms of pancreatic cancer include yellowing of the skin and whites of the eyes (jaundice), upper abdominal or back pain, digestive problems, and unintended weight loss. Early pancreatic cancer may occur without symptoms, and pancreatic cancer is often at an advanced stage when it is discovered.

Depending on the individual situation and extent of spread of the cancer, treatments for pancreatic cancer can include surgery, chemotherapy, and radiation therapy as well as newer or experimental therapies.

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Medical Reviewer: Faith Selchick, DNP, AOCNP
Last Review Date: 2022 May 30
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