Pancreatic cancer

Cancer that forms in the pancreas is called pancreatic cancer. The pancreas is a small organ that sits between the spine and the stomach. It’s about six inches long and has a wide head and a thinner tail, like a pear. Most cancers originate in the head of the pancreas.

As part of the digestive system, the pancreas produces enzymes that break down food. It also makes glucagon and insulin, which are hormones that help the body use energy from food and control blood sugar levels.

Pancreatic cancer is an uncommon disease that accounts for around 3 percent of all cancer cases and 7 percent of all cancer deaths, according to the American Cancer Society (ACS). The risk of developing pancreatic cancer is around one in 64, although several factors can influence and increase a person’s likelihood of developing this condition.

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Pancreatic cancer can generally be divided into two types: 

Exocrine pancreatic cancer

Exocrine tumors of the pancreas make up the large majority of pancreatic cancers (more than 95 percent). These tumors form in the exocrine cells of the pancreas’ exocrine gland and ducts. The exocrine gland produces enzymes that help the small intestine digest food. When someone discusses pancreatic cancer in a general sense, they’re likely referring to exocrine pancreatic cancer.

Adenocarcinoma of the pancreas is the most common type of exocrine tumor, accounting for around 90 percent of pancreatic cancer diagnoses. It may also be referred to as ductal carcinoma. Adenocarcinoma of the pancreas is on the rise in the U.S., occurring in an estimated 64,050 people every year. It typically appears in people older than 50. People who smoke are twice as likely to have this type of pancreatic cancer as nonsmokers. 

Less common types of exocrine pancreatic cancers include:

• Colloid carcinoma: Making up around 1 to 3 percent of exocrine pancreatic cancers, colloid carcinoma is less likely to spread to other areas of the body and has a better prognosis than most other types. It tends to develop from a benign (noncancerous) pancreatic cyst called an intraductal papillary mucinous neoplasm (IPMN). 
• Adenosquamous cell carcinoma: Between 1 and 4 percent of exocrine pancreatic cancers are adenosquamous cell carcinomas. This is a more aggressive form of cancer than adenocarcinoma and usually comes with a poorer prognosis.

Neuroendocrine pancreatic cancer 

Neuroendocrine pancreatic cancers (also called islet cell tumors) form in the cells of the pancreas’ endocrine gland. This gland produces glucagon and insulin hormones that help control blood sugar levels.

Pancreatic neuroendocrine tumors can be functional, meaning they secrete excess hormones that can cause additional symptoms. They may also be nonfunctional, which means they do not produce hormones and any symptoms someone may experience are related to the tumor itself. Some neuroendocrine tumors are benign.

Neuroendocrine pancreatic cancers make up only about 5 percent of pancreatic cancer diagnoses. They usually have a better prognosis than exocrine pancreatic cancers.  

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Pancreatic cancer rarely causes obvious symptoms in its early stages. As the cancer spreads (metastasizes) beyond the pancreas, symptoms of pancreatic cancer may include:  
•    Jaundice (yellowing of the skin or whites of the eyes) 
•    Upper abdominal pain that may travel to the middle part of the back 
•    Unexplained weight loss
•    Unusually dark urine 
•    Light-colored stool  
•    Reduced appetite 
•    Intense fatigue or weakness
•    Nausea and vomiting 
•    Skin itchiness 
•    Frequent abdominal bloating or gas  
•    Blood clots, which may cause swelling of the arms or legs
•    New or worsening diabetes  
•    Anemia or diarrhea (in cases of neuroendocrine pancreatic cancer) 

Severe abdominal or back pain may be one of the first signs of pancreatic cancer. This pain may worsen after eating and improve when bending forward or curling into the fetal position. (The fetal position involves lying on your side with your knees drawn up toward your chest.)  

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The precise cause of pancreatic cancer is unknown. Around 10 percent of cases may be caused by genetic factors such as abnormal gene changes (mutations). What exactly triggers the mutations that lead to pancreatic cancer is still unclear, but genetic, behavioral, and environmental factors likely play a role.   

Cancer in general occurs when changes take place in a cell’s DNA, the portion of a cell which tells the cell how to grow, divide, and die at the end of its lifespan in a healthy way. Changes to DNA instruct cells to grow uncontrollably and to live past their typical lifespan, resulting in an excess of abnormal cells that can bind together and form tumors. Cancer cells can also break off from tumors and travel to other parts of the body.

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Several risk factors for pancreatic cancer have been identified. These are things that can increase a person’s likelihood of developing pancreatic cancer.

Age

Pancreatic cancer most often affects older adults. The majority of diagnoses occur in people between the ages of 65 and 74, with 70 being the median age at diagnosis.

Meanwhile, research indicates that cases are rising among younger adults. A 2023 analysis of data from the National Program of Cancer Registries database shows the incidence of pancreatic cancer is increasing more rapidly in adults younger than 55 than adults older than 55. Still, this cancer is very rare in people younger than 45.

Sex assigned at birth   

People assigned male at birth (AMAB) are slightly more likely to develop pancreatic cancer than people assigned female at birth (AFAB). For every 100,000 people, pancreatic cancer affects around 15 people AMAB and 12 people AFAB, according to the NCI.

Inherited syndromes

As much as 10 percent of pancreatic cancers are linked to inherited gene mutations that are passed from parent to child. These mutations can cause syndromes that increase the risk of pancreatic cancer and other diseases. Examples of inherited syndromes associated with pancreatic cancer include:

• Hereditary breast and ovarian cancer syndrome (related to mutations in the BRCA1 or BRCA2 genes)
• Hereditary breast cancer (related to mutations in the PALB2 gene)
• Familial pancreatitis (usually related to changes in the PRSS1 gene)  
• Peutz-Jeghers syndrome (related to changes in the STK11 gene)  
• Lynch syndrome (usually related to changes in the MLH1 or MSH2 genes)
• Familial atypical multiple mole melanoma (FAMMM) syndrome (related to mutations in the p16/CDKN2A gene)   

Smoking  

Smoking and other forms of tobacco use are a major risk factor for pancreatic cancer. According to the ACS, smoking cigarettes is believed to cause around 25 percent of pancreatic cancer cases. A person who smokes is about twice as likely to develop pancreatic cancer as someone who has never smoked. Once a person quits smoking, their pancreatic cancer risk begins to drop.

Obesity

People who are obese are around 20 percent more likely to develop pancreatic cancer than people who aren’t obese. Risk appears to be higher among people who carry extra weight around their waist.

Diabetes

Pancreatic cancer is more common among people who have type 2 diabetes, which is often linked to obesity. Around one in four people diagnosed with pancreatic cancer already have diabetes, according to the NCI.

Race

Pancreatic cancer is slightly more common in Black people than in people of other races. This may be related to higher rates of obesity, smoking, and diabetes among Black people, along with health equity challenges that can hinder fair and equal access to effective medical care.  

Chronic pancreatitis

Having chronic pancreatitis (a long-term inflammation of the pancreas) is linked to a higher risk of pancreatic cancer. Chronic pancreatitis may be inherited or caused by unhealthy behaviors such as smoking and heavy drinking.  

Chemical exposures

Prolonged, heavy exposure to pesticides and certain chemicals used in the metal working and dry cleaning industries (called petrochemicals) may increase pancreatic cancer risk.  

Family medical history

It’s possible for pancreatic cancer to run in families. This could be due to inherited syndromes or other factors that aren’t well understood. Still, most people with pancreatic cancer don’t have a family history of the disease.  

It’s important to note that having one or more risk factors for pancreatic cancer doesn’t mean you’re sure to be diagnosed with the condition. It’s also possible to develop pancreatic cancer without any known risk factors. To learn more about your individual cancer risk and steps you can take to improve the health of your pancreas, speak with your healthcare provider (HCP).   

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Several tests are used to diagnose pancreatic cancer. Around 90 percent of pancreatic cancers have spread beyond the pancreas at the time of diagnosis, as most people don’t develop symptoms until the disease is more advanced.

The diagnostic process usually begins with a physical exam to check for jaundice, bloating, swelling, and other possible signs of cancer. Your HCP will also ask you questions about your personal and family medical histories and lifestyle habits, such as how much and how often you drink or smoke.

From there, one or more of the following tests may be ordered to learn more about your health and come to a diagnosis:

Blood tests

Bloodwork may appear normal in people with early-stage pancreatic cancer, although a pancreas blood test can reveal signs of pancreatitis and tumor markers in more advanced cases. (Tumor markers are substances that indicate the presence of cancer.) Unusually high levels of the blood proteins carcinoembryonic antigen (CEA) or carbohydrate antigen (CA) 19-9 could point to pancreatic cancer.  

Your HCP may also perform a blood chemistry study and other tests to assess liver function and to check for elevated levels of bilirubin. Bilirubin is a yellow substance that’s part of bile, which is a digestive fluid that’s produced by the liver and stored in the gallbladder. If a tumor is blocking the body’s main bile duct, bilirubin levels can rise and give the skin or whites of the eyes a yellow tint (jaundice). High bilirubin levels may also be the result of noncancerous conditions like gallstones, hepatitis, and mononucleosis.

Imaging tests

Imaging tests can’t always detect pancreatic cancer in its earliest stages. Still, they can help diagnose pancreatic cancer in many cases. Commonly used imaging tests include:

• Computed tomography (CT) scan: A CT scan uses X-ray imaging to take detailed pictures of the body from several different angles. A special dye may be swallowed or fed into a vein before the CT scan to help organs show up more clearly on imaging results. 
   
• Magnetic resonance imaging (MRI): An MRI scan uses radio waves and a magnetic field to create a series of detailed images. To evaluate the pancreas, a special type of MRI called a magnetic resonance cholangiopancreatography (MRCP) is performed. Before the test, a dye is administered through a vein to help highlight the pancreatic and biliary systems on imaging results. (The biliary system includes the organs and structures, such as ducts, that produce and move bile through the body.)
   
• Positron emission tomography (PET) scan: A PET scan screens for cancer cells throughout the body. Before the test, a very small amount of radioactive sugar is fed into a vein. Because cancer cells take up more sugar than healthy cells do, they show up brighter on imaging results. The pet scanner rotates around the body to capture pictures from multiple angles. 
   
• Ultrasound imaging: An ultrasound uses sound waves emitted from a wand-like tool called a transducer to create images of the inside of the body. During an abdominal ultrasound, the transducer is gently glided over a person’s midsection. The sound waves bounce off internal organs and tissues (including tumors) and make echoes, which a computer uses to form a picture (sonogram).
  
  An endoscopic ultrasound (EUS) is another type of ultrasound imaging that may be used to help diagnose pancreatic cancer. During this procedure, an endoscope (a thin, lighted instrument with a viewing lens) is inserted into the mouth. The endoscope features a small ultrasound probe that emits sound waves to create more detailed sonograms from the inside of the body.  
   
• Endoscopic retrograde cholangiopancreatography (ERCP): This procedure uses an endoscope and X-ray technology to examine the ducts that transport bile from the liver to the gallbladder. Pancreatic cancer may block these ducts and hinder the flow of bile, which can lead to jaundice. The endoscope can also be used to remove a piece of tissue for testing, or to insert a small tube (stent) into a blocked duct to help prop it open and improve bile flow.   

If an ERCP can’t be performed, a similar procedure called a percutaneous transhepatic cholangiography (PTC) may be used to X-ray the bile ducts and liver without an endoscope. Instead, the liver is injected with a dye that highlights it on an X-ray, helping expose tumors or other causes of bile duct blockages.

Laparoscopy

A laparoscopy is a minimally invasive surgical procedure that uses a laparoscope—a long, thin tool with a small camera on the end—to examine the inside of the body without large incisions. During a laparoscopy, a laparoscope is inserted into the abdomen through a small incision to check for signs of disease. A laparoscope can also be used to collect samples of tissue or fluid for testing.

Biopsy  

A biopsy involves removing samples of tissue or fluid from the body, which is then tested for cancer cells under a microscope. (This testing is completed by a pathologist—a medical doctor who specializes in evaluating cells for disease.)

As discussed, a biopsy for pancreatic cancer may be performed during an ERCP or laparoscopy. An X-ray or ultrasound-guided needle biopsy may also be used to draw out cells from the pancreas or liver for testing. A biopsy is usually necessary to confirm a pancreatic cancer diagnosis.   

Biomarker and germline testing  

Biomarker testing and/or germline testing may be performed following a pancreatic cancer diagnosis to learn more about the cancer’s characteristics and the role of genetics in its development.  

• Biomarker testing (also called molecular testing) evaluates the tumor for specific genetic changes and unique molecular features that can help guide treatment decisions.
• Germline testing screens a blood, saliva, or urine sample for DNA mutations that could signal a genetic predisposition to pancreatic cancer. This can also help guide treatment decisions and provide valuable information to blood relatives of pancreatic cancer patients.

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After identifying pancreatic cancer, an HCP will assess how much cancer is in the pancreas and if it has spread to other organs. This is called staging. Diagnosis and staging are often performed at the same time through imaging and biopsy procedures.  

Most pancreatic cancers (excluding some neuroendocrine tumors) are staged according to the widely used TNM system, which focuses on three key characteristics of cancer: 

• Tumor (T): Size and location of the main tumor
• Node (N): Whether cancer cells have spread to nearby lymph nodes 
• Metastasis (M): Whether cancer cells have spread to distant parts of the body such as distant lymph nodes, organs, and tissues like the bones, liver, lungs, or peritoneum (the tissue membrane that lines the abdominal wall and covers most of the organs in the abdomen)

Based on these characteristics, pancreatic cancer is staged from 0 to 4. Stage four indicates the most advanced disease.

Here’s a breakdown of each pancreatic cancer stage:

Stage 0 pancreatic cancer

Also referred to as carcinoma in situ, stage 0 pancreatic cancer is limited to the very top layers of pancreatic duct cells. It has not spread to deeper tissues or surrounding structures like nearby lymph nodes.

Stage 1 pancreatic cancer

Stage 1 pancreatic cancer can be divided into stage 1A and stage 1B.

• Stage 1A pancreatic cancer is limited to the pancreas and the tumor is no larger than 2 centimeters across.
• Stage 1B pancreatic cancer is limited to the pancreas and the tumor is between 2 and 4 centimeters across.

Stage 2 pancreatic cancer

Stage 2 pancreatic cancer can be divided into stage 2A and stage 2B.

• Stage 2A pancreatic cancer is limited to the pancreas and the tumor is larger than 4 centimeters across.
• Stage 2B pancreatic cancer is limited to the pancreas and the tumor is larger than 2 centimeters across. Cancer cells have spread to as many as three lymph nodes.  

Stage 3 pancreatic cancer

In some cases, stage 3 pancreatic cancer cells have spread to four or more nearby lymph nodes but the tumor is still limited to the pancreas. Other stage 3 pancreatic cancers have grown outside of the pancreas and into surrounding major blood vessels, though lymph nodes may or may not be affected.

Stage 4 pancreatic cancer

Stage four pancreatic cancer has spread to distant parts of the body, such as the liver, abdomen, lungs, or bones. Lymph nodes may or may not be affected.

Other pancreatic cancer staging terms

Pancreatic cancer may also be described as localized, regional, or distant according to the National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results (SEER) Program.

SEER stages for pancreatic cancer are: 

• Localized: The cancer is confined to the pancreas with no evidence of spread. 
• Regional: The cancer has traveled outside of the pancreas to nearby lymph nodes or other tissues.
• Distant: The cancer has traveled to distant structures in the body, such as the bones, lungs, or liver.  

Around 51 percent of pancreatic cancers have reached the distant stage at diagnosis, according to the NCI.

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Pancreatic cancer is difficult to treat. Sometimes, the goal of treatment is to reduce cancer symptoms and support a positive quality of life for as long as possible. If cancer is detected and treated in an early stage, complete remission (a period in which there are no detectable signs of cancer) may be achievable. Up to 10 percent of people who receive an early diagnosis of pancreatic cancer become disease-free after treatment.

Treating pancreatic cancer typically involves a multidisciplinary approach. For instance, a person’s healthcare team may include a:

• Gastroenterologist: a medical doctor who specializes in evaluating and treating digestive system disorders
• Medical oncologist: a medical doctor who specializes in treating cancer with drug therapies like immunotherapy, chemotherapy, and targeted therapy (see below)
• Radiation oncologist: a doctor who specializes in using radiation therapy to treat cancer
• Surgical oncologist: a doctor who specializes in surgically removing cancer 

Other professionals like pain medicine specialists and licensed mental health providers may also play a role in pancreatic cancer care.

There are several factors a healthcare team must consider when planning a patient’s pancreatic cancer treatment. This includes the cancer’s stage, type, and location, and whether it’s believed to be surgically removable (resectable).

• Resectable pancreatic cancer may be fully removed through surgery. (Around 15 to 20 percent of pancreatic tumors are considered resectable.)
• Borderline resectable pancreatic cancer has grown into surrounding tissues, organs, or a major blood vessel. While the tumor may be removable, cancer cells will likely still remain in the body.
• Locally advanced pancreatic cancer has grown near or into surrounding blood vessels or lymph nodes, so the cancer can’t be fully removed through surgery.
• Metastatic pancreatic cancer has traveled to distant organs and generally isn’t treated with surgery.

Based on these factors and the patient’s care preferences, a pancreatic cancer treatment plan may involve a combination of:

Surgery

Pancreatic cancer surgery may be recommended if a surgeon believes they can remove all or most of the cancer. For this to be the case, the cancer must be confined to the pancreas. Even still, removing all of the cancer may not be possible, and many pancreatic tumors recur (or grow back) after surgery.

Surgical removal of tumors or the pancreas is the only way to cure pancreatic cancer. These procedures are very complex, partially due to how difficult it is to reach the pancreas, which is located deep within the abdomen.

There are three main types of pancreatic cancer surgery:

• Whipple procedure: This removes the head of the pancreas, the bile duct, a portion of the small intestine, a portion of the stomach, and the gallbladder. A section of the pancreas is left intact to produce insulin and digestive enzymes. What remains of the bile duct and pancreas is then reattached to the small intestine to rebuild the digestive tract.
• Distal pancreatectomy: This removes the tail of the pancreas and a portion of the pancreas head, sometimes along with the spleen.  
• Total pancreatectomy: This removes the entire pancreas, along with the gallbladder, spleen, bile duct, surrounding lymph nodes, and a portion of the small intestine and stomach. Because all of the pancreas is removed, a person who undergoes this procedure will need to take insulin shots and pancreatic enzyme pills for the rest of their life in order to help their body process blood sugar and digest food.

Chemotherapy

Chemotherapy (chemo) uses potent anti-cancer drugs to destroy cancer cells throughout the body. Several rounds of chemo may be given intravenously (by IV, or directly into a vein) or by mouth in pill form.

Before pancreatic cancer surgery, chemo may be administered to help shrink tumors and make them easier to remove. It’s also sometimes given after surgery to help destroy any remaining cancer cells. Someone with advanced pancreatic cancer who isn’t a candidate for surgery may receive chemo as a standalone treatment to help slow the spread of cancer.

Radiation therapy

Radiation therapy uses precisely aimed, high-energy X-rays to destroy or damage cancer cells in a certain area. It may be given before surgery, after surgery, or as a standalone treatment to help slow cancer growth and reduce symptoms.

Chemo is sometimes administered at the same time as radiation therapy to enhance the effects of both methods. This is called chemoradiation, a combined treatment approach that can be used to treat certain types of cancer such as lung cancer, bladder cancer, and cervical cancer in addition to pancreatic cancer.

Targeted therapy

Targeted therapy uses drugs to disrupt certain processes that facilitate cancer growth. It’s often combined with other pancreatic cancer treatments, such as radiation therapy. Examples of targeted therapy drugs for pancreatic cancer include entrectinib, olaparib, erlotinib, and larotrectinib.  

Immunotherapy

Immunotherapy harnesses the disease-fighting abilities of the body’s own immune system to target pancreatic cancer. (The immune system is the intricate network of organs and cells that defends the body against threats like germs.) Ordinarily, cancer cells are able to hide from the immune system. Immunotherapy drugs essentially expose cancer cells and help the immune system better identify and attack them. A combination of immunotherapy drugs and other treatments (like radiation therapy or targeted therapy) are usually recommended to treat pancreatic cancer.

Clinical trials

A clinical trial is a research study that involves human volunteers. There are many clinical trials underway with the goal of improving outcomes for people with pancreatic cancer. To learn more about pancreatic cancer clinical trials, browse current research initiatives on the National Cancer Institute website. 

It’s important to note that participating in a pancreatic cancer clinical trial comes with some measure of risk. Many trials are performed to test new and unproven treatments. Before deciding to participate in a clinical trial, be sure to speak with your HCP about its potential risks and benefits.

Palliative care

Because many pancreatic cancers are diagnosed in an advanced stage, much of treatment focuses on easing cancer symptoms and maintaining a patient’s quality of life for as long as possible. This is known as palliative care. 

Palliative care may differ for each person. In some cases, palliative surgery may be performed to address painful complications of pancreatic cancer, such as blockages in the bile duct or intestines.

Because pancreatic cancer can cause significant pain, palliative care often comes in the form of pain management. Taking prescription pain medicine (as directed by an HCP) can help relieve discomfort from cancer, as can certain procedures that block, numb, or cut nerves that are transmitting pain signals.  

Palliative care also involves supporting patients as they plan for the future and face the emotional, practical, and financial challenges of living with late-stage cancer. HCPs who may provide palliative care include medical doctors, nurses, clinical social workers, counselors, or supportive care professionals who specialize in helping patients and families affected by cancer.  

End-of-life care (or hospice care) is another form of palliative care. It focuses on helping caretakers make important decisions and keeping patients comfortable as they near the end of life. All in all, the goal of palliative and end-of-life care is to help people with cancer feel better.

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As pancreatic cancer spreads, several complications can occur. Some of the most common include:

• Jaundice: Pancreatic cancer that obstructs bile flow from the liver can cause jaundice (yellowing of the skin and whites of the eyes). Jaundice may be accompanied by widespread itchiness from the accumulation of bile salt crystals beneath the skin.
   
• Spleen enlargement (splenomegaly): Pancreatic cancer that blocks the vein responsible for draining the spleen (a small organ that controls blood cell levels) can result in spleen enlargement. This may cause a feeling of fullness and significant pain in the upper left part of the abdomen, which can worsen when breathing in.
   
• Esophageal varices: Blockages from pancreatic cancer can cause veins to become enlarged and swollen, leading them to twist around the stomach and esophagus (the tube that connects the back of the throat to the stomach). If these veins rupture, severe bleeding may occur.
   
• Bowel blockages: Pancreatic cancer can spread to or press against the upper part of the small intestine, causing an obstruction that can block the flow of food through the bowels. Severe pain, nausea, a feeling of fullness, or constipation may be signs of a bowel obstruction.
   
• Diabetes: As much as one-half of people with pancreatic cancer develop diabetes. Healthy cells in the pancreas produce the hormone insulin, which plays a key role in controlling blood sugar levels. Having too little insulin causes diabetes. As cancer grows in the pancreas, healthy, insulin-producing cells are replaced with cancer cells. The damage to the pancreas caused by cancer can affect its ability to produce and use insulin, which can lead to a type of diabetes called type 3c diabetes (also called pancreotogenic or brittle diabetes).
   
• Malabsorption: A healthy pancreas produces digestive enzymes that help break down food and allow the body to absorb important nutrients. Pancreatic cancer can disrupt this process, resulting in nutrient malabsorption and problems like vitamin deficiencies, excess gas, bloating, diarrhea, and weight loss.

Contact your HCP right away if you’re experiencing possible signs of a pancreatic cancer complication. Complications that involve blockages of the spleen, bile duct, or bowels may be addressed through surgery, while diabetes can be managed with medication.

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It’s always a good idea to speak with your HCP if you develop new or unusual symptoms that persist, such as abdominal pain or back pain, nausea, or unexplained weight loss. 

If you’ve already been diagnosed with cancer, be sure to keep your HCP informed of any changes in your health, even if they seem insignificant. It’s also important to seek immediate medical care if any of the following symptoms occur, as they could indicate a life-threatening emergency:  

• Sudden confusion  
• Blood in urine  
• Shortness of breath 
• Chest pain  
• An intense headache with a stiff neck   
• Chills and shaking 
• A fever higher than 100.4 degrees Fahrenheit that persists or doesn’t respond to fever-reducing measures  

Pancreatic cancer screenings  

There currently isn’t an established screening method for healthy adults at an average risk of pancreatic cancer. People with a strong family history of pancreatic cancer or a genetic syndrome associated with this disease, however, may be candidates for screening.  

Endoscopic ultrasounds and MRI are the most widely used methods of pancreatic cancer screening. Early-stage pancreatic tumors have successfully been identified through these tests, which are typically performed on an annual basis. To learn if pancreatic cancer screening could be appropriate for you, speak with your HCP.   

Genetic testing for pancreatic cancer  

If you’re concerned about your pancreatic cancer risk, you may want to consider genetic testing. These tests screen for gene changes associated with genetic syndromes that increase the risk of developing cancer. The ACS strongly encourages people to consult with an HCP or genetic counselor before getting tested, as it’s important to understand the limitations of these tests and what the results may or may not mean for your health and individual cancer risk.   

What questions should you ask your healthcare provider?  

Receiving a pancreatic cancer diagnosis is a significant life event that can leave you with plenty of questions. To ensure you can get the most out of your medical appointments and make educated and confident decisions about your care, it’s important to be candid with your HCP and voice any questions or concerns you may have.  

You may find it helpful to keep a running list of questions for your healthcare team. A few basic questions to get you started include:  

• What type of pancreatic cancer do I have?  
• What is the stage of my cancer and what does it mean?  
• What is the goal of pancreatic cancer treatment? Can my cancer be removed through surgery?   
• What are my treatment options? Can you explain the benefits, risks, and side effects associated with each treatment?   
• What clinical trials are available? Am I a candidate for a clinical trial?  
• How should I prepare for pancreatic cancer treatment? What can I expect?  
• How will cancer and its treatment affect my daily routine? 
• What should I eat during pancreatic cancer treatment?  
• Am I allowed to exercise during treatment? What activities should I avoid?  
• What symptoms should I watch for and when should I contact you?   
• Can you connect me to a cancer support group?  
• Should I consider palliative care? What steps should I take to plan for the future?  

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There’s no surefire way to prevent pancreatic cancer, but you can lower your risk of getting this disease. Here’s how:

• Avoid or quit smoking. If you’re ready to quit smoking, consider joining a smoking cessation program.
• Maintain a healthy weight. Carrying excess body weight increases cancer risk.
• Get regular physical activity. Engaging in regular exercise can help you maintain a healthy weight and lower your cancer risk.
• Be mindful of your diet. Try to limit red meat and highly processed foods like sausages, potato chips, fast food, and commercially baked goods. Cut down on foods and drinks with added sugars and aim to eat more fresh vegetables, fruits (like avocados), and whole grains.
• Limit exposure to certain chemicals, if possible. This includes petrochemicals (those derived from petroleum) and pesticides.
• Drink alcohol in moderation, if at all. If you choose to drink alcohol, limit your intake to no more than one standard drink per day (if you’re assigned female at birth) or two standard drinks per day (if you’re assigned male at birth). 

The National Institutes of Health defines a standard drink as one that contains around 0.6 fluid ounces of pure alcohol. This translates to:

• 1.5 ounces of cognac, brandy, whiskey, vodka, tequila, gin, or rum
• 5 ounces of table wine
• 8 to 10 ounces of malt beverages like hard seltzer
• 12 ounces of beer

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Pancreatic cancer is a particularly aggressive disease with few effective treatment options. According to the latest data from the NCI SEER Program, the five-year relative survival rate for pancreatic cancer is 12.5 percent. This means that 12.5 percent of people with pancreatic cancer were still alive five years after being diagnosed. 

By stage at diagnosis, the five-year relative survival rate for pancreatic cancer is:

• 44.3 percent for localized cancer
• 16.2 percent for regional cancer
• 3.2 percent for distant cancer

People between the ages of 65 and 74 make up close to one third of all pancreatic cancer deaths, according to the NCI. The median age at death among people with pancreatic cancer is 72.

The overall prognosis for pancreatic cancer is poor, but it’s important to remember that current cancer survival rates reflect the outcomes of a set group of people who were diagnosed several years ago. Multiple factors, including your pancreatic cancer type, stage, and how much of the cancer is surgically removable well as your age and overall health—will influence your individual prognosis.

Experts around the world are working to improve pancreatic cancer outcomes. Some progress has been made. For instance, today’s five-year survival rate of 12.5 percent is an improvement from the observed survival rate of 1.5 percent in 1977. Still, there’s much left to learn about this disease and how it can be stopped.

Earlier detection and the role of genetics in pancreatic cancer occurrence is a major focus of current research. Other initiatives are focused on:

• Improving radiation therapy delivery methods
• Reducing the invasiveness of pancreatic cancer surgery (notably the Whipple procedure)
• Testing new chemotherapy combinations
• Evaluating new immune therapies, including cancer treatment vaccines   
• Matching targeted cancer drugs with tumors that contain specific types of mutations 
• Investigating targeted therapies directed toward RAS genes (the family of genes linked to more than 90 percent of pancreatic cancers)

Advances in pancreatic cancer research are promising and improvements in cancer care and patient outcomes are on the horizon. To stay up to date on the latest breakthroughs in pancreatic cancer research, visit the National Cancer Institute website.

Navigating life with pancreatic cancer comes with distinct challenges. Just remember that your healthcare team can provide the personalized guidance you need. Helpful resources like support groups and counseling are also available for caregivers and loved ones of people with cancer.  

Generally speaking, many people living with pancreatic cancer find it helpful to:

Prioritize nutrition

The pancreas helps the body absorb nutrients from food and use it for energy. Pancreatic cancer can disrupt this process, leading to malnutrition, rapid weight loss, and worsening fatigue.

To help counteract the effects of pancreatic cancer, it’s important to nourish your body with nutrient-rich foods like:

• Easily digestible lean proteins, such as (unfried) fish, chicken, turkey, eggs, beans, nuts, tofu, and low-fat dairy products
• Whole grains, such as brown rice, oatmeal, quinoa, farro, and whole-grain pastas and breads
• Fruits and vegetables (at least five servings every day). Because raw vegetables can sometimes be hard to digest, you may want to cook them before eating.
• Healthy fats, such as olive oil, avocados, fatty fish, nuts, and seeds

Pancreatic cancer can quickly shrink your appetite, so it may be helpful to eat several small meals or snacks throughout the day (as opposed to a few large meals). Some people find it easier to get nutrition through soft, palatable foods and liquids like smoothies, shakes, bone broths, soups, and yogurts.

It’s important to stay hydrated by drinking plenty of water and avoiding or limiting dehydrating beverages like alcohol and coffee. Most people with pancreatic cancer should avoid fatty or fried foods, sugary drinks, and sweets that don’t offer any nutritional value.  Your HCP can provide dietary guidance based on your specific health needs. They may also refer you to a registered dietitian who can help you maintain a healthy weight and improve well-being through nutrition.  

Stay on the move

Exercising while living with pancreatic cancer can be difficult. Still, if you have the energy to do so, gentle activities like walking around the block, gardening, or trying low-impact exercises like yoga or tai-chi can help boost your physical and mental health. Engaging in physical activity (to the best of your ability) may also increase your appetite and help you get more beneficial nutrients. 

Before increasing your activity levels or trying a new exercise, be sure to speak with your HCP. They may refer you to an occupational therapist or physiotherapist who can help improve your well-being through movement.

Share your feelings and connect with others  

A pancreatic cancer diagnosis can take a toll on your mental health. It’s common and perfectly acceptable to feel overwhelmed, hopeless, frustrated, or sad. Even so, debilitating anxiety or depression doesn’t have to be a part of living with pancreatic cancer.

Sharing your feelings with trusted loved ones or connecting with others through in-person or online pancreatic cancer support groups can bring some relief. You may also want to speak with a licensed mental health provider, such as a psychiatrist, psychologist, counselor, or clinical social worker, who can help you understand and cope with the strong emotions associated with this disease.

Additionally, some people with pancreatic cancer find it beneficial to:

• Do art or music therapy
• Meditate or practice mindfulness
• Keep a journal
• Pray or attend spiritual gatherings  
• Try acupuncture

Remember, your healthcare team is there to support you throughout your pancreatic cancer experience. To learn more about pancreatic cancer support groups, palliative care, or caregiver support options, check out resources from reputable organizations, including:

• National Cancer Institute
• American Cancer Society
• Pancreatic Cancer Action Network

• Why is Pancreatic Cancer So Deadly?  
• 5 Ways to Support the Health of Your Pancreas  
• 8 Ways to Enjoy Eating During and After Chemo