Pancreatic Cancer

The cause of pancreatic cancer is not fully understood. There are some risk factors that increase your chances of getting the disease. Having some risk factors does not mean you will definitely get pancreatic cancer and you can get pancreatic cancer even if you don’t have any of the risk factors.

Pancreatic cancer risk factors include:

• Being over the age of 75. It is uncommon in people under 40 years of age.
• Smoking
• Being overweight or obese
• A history of pancreatic cancer in your family
• Having certain medical conditions, such as long-term chronic pancreatitis, diabetes, gallstones, and women with metabolic syndrome
• Drinking a lot of alcohol
• Eating red and processed meats

In most cases, pancreatic cancer doesn’t run in families. Only a small percentage of pancreatic cancer cases are hereditary. It includes:

• families with two or more first-degree relatives (parent, brother, sister or child) with pancreatic cancer
• families with three or more relatives with pancreatic cancer on the same side of the family
• families with a family cancer syndrome and at least one family member with pancreatic cancer. Family cancer syndromes are rare genetic conditions where a faulty gene increases the risk of pancreatic cancer

Although family history is a risk factor, most people who get pancreatic cancer do not have a family history of it.

In the early stage of pancreatic cancer, there may not be any symptoms or they might be hard to spot. As cancer grows, symptoms may develop that include:

• Jaundice – yellowing of the whites of your eyes or your skin. You may also have itchy skin, darker urine and paler stools than usual.
• Appetite or weight loss without trying.
• Tiredness or no energy.
• High temperature, or feeling hot or shivery.

Some symptoms can affect your digestion, such as:

• Pain in your stomach or back, which may worsen when eating or lying down and improve when you lean forward.
• Feeling or being sick.
• Bowel changes that include pale coloured and smelly stools, diarrhoea or constipation.
• Indigestion, such as feeling bloated.

It is important to see your GP if you have these symptoms and they get worse or they do not feel normal for you.

If you are experiencing pancreatic cancer symptoms, you may need several tests to help diagnose the cause and if you have cancer of the pancreas.

These tests can include:

• Blood tests - to check your blood count, how well your liver and kidneys are working, and your general health. If you have jaundice, a blood test will show how severe it is. Blood tests can also check for chemical substances produced by cancers called tumour markers. They are used together with other tests to make a diagnosis as not all pancreatic cancers produce tumour markers and other non-cancerous conditions can also produce them. 
• Scans – including:
• ultrasound scan of your abdomen – high-frequency sound waves create a picture of the inside of your body. It shows blood flow and changes in your abdomen including abnormal growths.
• CT scan - uses x-rays and a computer to create a 3D picture of the inside of your body to show if there are any changes in your pancreas or nearby structures, such as your liver.
• PET-CT scan - combines a CT scan and a PET scan and uses a harmless radioactive substance to build up a clearer picture of the cancer and learn more about its stage and how best to treat it.
• MRI scan – uses magnets and radio waves to build up detailed pictures of your pancreas and surrounding areas to find out if you have pancreatic cancer, its size and whether it has spread.
• Endoscopic ultrasound (EUS) - a long flexible tube with a tiny camera and light on the end, called an endoscope, is placed in your stomach via your mouth. An ultrasound probe at the end of the endoscope uses high-frequency sound waves to create a picture of the inside of your body.
• Biopsy – to collect a small sample of cells from your pancreas to be checked under a microscope for cancer. There are several ways to take a biopsy depending on the position of the tumour in your pancreas. You may have a biopsy during a CT scan, EUS, endoscopic retrograde cholangiopancreatography (ERCP) or laparoscopy.
• ERCP (endoscopic retrograde cholangiopancreatography) - uses an endoscope and a similar procedure to an EUS, but also uses dye and x-rays to show any blockages. It may confirm a diagnosis of pancreatic cancer or help unblock a blocked bile duct using a stent.
• Laparoscope - a thin tube with a light and a camera, called a laparoscope, is passed through a small cut in your stomach to check the area around your pancreas, including the liver.

Find out more about screening tests and diagnostic tests at Ramsay Health Care.

Your doctors will use your test results to help decide the best treatment for you. It will depend on where your cancer is, whether it has spread (the stage), the type of cancer, how abnormal the cells look under a microscope (the grade) and your general health.

Treatments for pancreatic cancer include:

• Surgery – to remove your pancreatic cancer if it is found early and it has not spread or if cancer cannot be removed and surgery can help control some pancreatic cancer symptoms. Surgery can remove all or part of your pancreas and all or parts of other organs around your pancreas. Pancreatic surgery can also be used to unblock your bile duct or stop it from getting blocked, unblock your duodenum or stop it from getting blocked, or bypass a blockage in your bile duct or duodenum. Surgery is often performed using endoscopy.
• Chemotherapy - uses medicines to kill your cancer cells. It is used to control and improve symptoms if you cannot have surgery or if the cancer cannot be removed by surgery, to treat early cancer, before surgery to help reduce the size of the cancer, and after surgery to help stop the cancer from coming back. It is sometimes combined with radiotherapy, called chemoradiotherapy.
• Radiotherapy- uses high-energy radiation rays to kill cancer cells. It is not often used for pancreatic cancer but may treat early cancer if you are not able to have surgery or your cancer cannot be removed by surgery (often combined with chemotherapy). It can also be used with chemotherapy before surgery to help reduce the cancer tumour and to help with symptoms of advanced cancer.
• Supportive care – to help you feel better and improve the symptoms of pancreatic cancer such as problems eating and weight loss, pain relief, tiredness, and feeling sick.

Pancreatic cancer is cancer that starts in your pancreas.

Here at Ramsay Health Care UK, we have a team of expert cancer specialists on hand to advise, diagnose, and treat pancreatic cancer.

We understand the anxiety that pancreatic cancer symptoms can bring and the importance of early testing to bring peace of mind and to help diagnose symptoms early for a better treatment outcome.

We offer convenient appointments to talk through the benefits and risks of all tests and treatments so that you are fully informed and understanding of all implications.