The pancreas is a gland located in the abdomen, between the stomach and the spine. It makes enzymes that help digestion and hormones that control blood sugar levels. Pancreatic cancer begins when abnormal cells in the pancreas grow and divide out of control and form a tumor. Pancreatic cancer often spreads to the liver, abdominal wall, lungs, bones, and/or lymph nodes.
Types of pancreatic cancer
Pancreatic tumors are either exocrine or neuroendocrine (endocrine) tumors. Their tumor type is based on the type of pancreas cell they start in. Knowing the type of tumor is important because each type acts differently and responds to different treatments.
Exocrine tumors of the pancreas
According to the Pancreatic Cancer Action Network, about 93% of pancreatic cancers occur from exocrine tumors called adenocarcinoma. Adenocarcinomas are a type of cancerous tumor that usually start in the mucus-secreting glands throughout the body and can develop in many different places. In pancreatic cancer, adenocarcinomas typically form in the pancreas ducts. Less often, the acinar cells, the cells that make the pancreatic enzymes that become released in the small intestine to that help your body digest food, can develop a rare, malignant tumor called acinar cell carcinoma (ACC).
Neuroendocrine tumors of the pancreas
Pancreatic neuroendocrine tumors form in hormone-making cells (islet cells) of the pancreas. Tumors that form in islet cells are called islet cell tumors, pancreatic endocrine tumors, or pancreatic neuroendocrine tumors (pancreatic NETs). Pancreatic NETs may be functional, make extra amounts of hormones for the body, or non-functional, and do not make extra hormones. However, most pancreatic NETs are functional tumors, and the different kinds of hormones they produce define their tumor type. Pancreatic NETs may be benign or malignant and often have a better prognosis.
Pancreatic cancer symptoms and diagnosis
Pancreatic cancer may cause only vague unexplained symptoms. Some common symptoms may include:
- Pain, usually in the abdomen or back
- Weight loss
- Jaundice (yellowing of the skin, eyes, or both) with or without itching
- Loss of appetite
- Changes in stool
- Pancreatitis (swelling of the pancreas)
- Recent-onset diabetes
Because these symptoms may overlap with those of other conditions, it is important to get the correct diagnosis to find the right treatment. Make an appointment with your primary care physician if you are experiencing persistent signs and symptoms that concern you.
Pancreatic cancer can be hard to find and diagnose. The pancreas is located deep in the abdomen, so physicians usually cannot see or feel the tumor during a physical exam. Also, pancreatic cancer symptoms are not always obvious and usually develop over time. A pancreatic tumor can only be seen on an imaging study such as a computed tomography (CT) scan, magnetic resonance imaging (MRI), or endoscopic ultrasound (EUS). Then, the physician takes a sample of the tumor tissue to figure out the exact diagnosis. Physicians may use several tests to make a diagnosis, but there is no standard test to diagnose pancreatic cancer, which makes diagnosis even more complicated.