Risk Factors and Screening
We don’t know what causes most pancreatic cancers, but several risk factors can increase your chance of developing the disease:
- Most cases of pancreatic cancer occur after age 60.
- Cigarette smokers are two to three times more likely than nonsmokers to develop pancreatic cancer.
- The disease is more common in men than women.
- African-Americans tend to get this cancer more often than individuals from other ethnic groups.
- People with diabetes have a greater risk, as do those with a history of chronic pancreatitis, a chronic inflammation of the pancreas.
- If you have immediate family members with a history of pancreatic, breast or lung cancer, melanoma or hereditary pancreatitis, you have an increased risk.
Take these steps to lower your risk:
- If you smoke, quit.
- Maintain a healthy weight.
- Limit your consumption of pork, red meat, and processed meat-such as lunch meat, sausage, and bacon.
- Avoid cooking meats at high temperatures. Doing so can help reduce your exposure to harmful chemicals that are formed in high temperature cooking.
- Include at least five servings of fruits and vegetables in your daily diet.
Noticeable signs or symptoms are not present in the early stages of pancreatic cancer. As the cancer grows, symptoms may include:
- Pain in the middle or upper abdomen or back
- Yellowed skin and eyes
- Weakness or fatigue
- Appetite loss
- Nausea and vomiting
- Weight loss
The signs of pancreatic cancer, when present, are like the signs of many other illnesses, including
- Polyps in the duodenum (the intestine next to the pancreas)
- Scarring or strictures in the pancreas
- Bile duct tumors or strictures
- Cysts of the pancreas and pseudocysts
An accurate diagnosis is critical to determining the right care, but that requires special expertise, because:
- There are no noticeable symptoms in the early stages.
- When signs of disease are present, they often resemble those of many other illnesses.
- The pancreas is hidden behind other organs—the stomach, small intestine, liver, gallbladder, spleen and bile ducts.
Our board-certified radiologists and gastroenterologists are accustomed to caring for a large volume of complex cases, working together to diagnose and stage cancers with an accuracy level exceeding national standards. Not only can they distinguish subtle differences, but they have also developed and perfected unique approaches for greater precision.
Pancreatic cancer is usually diagnosed with external imaging equipment or with thin, flexible tubes (endoscopes) with lights and cameras that are threaded into your mouth and digestive tract—a highly specialized and technically difficult technique in which our gastroenterologists are internationally recognized leaders. Not only can our GI specialists evaluate cancer with endoscopy, they can sometimes also perform a biopsy.
Any of the following tools will most likely be used to establish a diagnosis:
- Endoscopic ultrasound (EUS): Sound waves create images of body tissues where high-energy sound waves are bounced off internal tissues and organs; the echoes are then changed into pictures called sonograms. EUS can also guide the removal of tissue for biopsies.
- Laparoscopy: A laparoscope (a thin, lighted tube) is inserted through an incision in the abdominal wall to determine if the cancer is within the pancreas only or has spread to nearby tissues and if it can be removed by surgery later.
- Endoscopic retrograde cholangiopancreatography (ERCP): An x-ray of the ducts that carry bile from the liver to the gallbladder and from the gallbladder to the small intestine. Because pancreatic cancer can cause these ducts to narrow and block or slow the flow of bile, causing jaundice, the ERCP can detect this blockage. ERCP can also remove tissue for biopsies.
- Percutaneous transhepatic cholangiography (PTC): An X-ray of the liver and common bile ducts.
- Liver function test: A blood test that evaluates how well your liver is working, as pancreatic cancer may affect your liver function.
- Serum bilirubin test: Measures the amount of bilirubin (a fluid produced by the liver) in your blood.
- Biopsy: Cells, tissues, or fluid are removed and viewed under a microscope to see if cancer cells are present.
- Physical exam and history
- Chest X-ray
- CT scan
- PET scan