The pancreas is a leaf shaped organ in your body that can be found between the stomach and backbone and is part of your digestive system.
It has two important functions:
- producing enzymes which break down food to allow the body to absorb nutrients
- producing a range of hormones including insulin which help keep the level of sugar in your blood at a steady level
There are three main parts of the pancreas which are called the head, body and tail.
The head is the widest part of the organ nearest to the small intestine and is the most common site of pancreatic tumour growth. The body is the middle section and around 15% of cancers are found here. Finally, the tail is the thinnest part of the pancreas. Only 5% of pancreatic tumours are found here.
Our bodies are made up of many different kinds of cells that routinely grow and divide in an organised way throughout our lifetime. When these cells multiply and grow in an uncontrolled or abnormal way, then cancer can develop.
Pancreatic cancer occurs when the cells in the pancreas organ begin to grow and form a lump. This growth can interfere with the way that your pancreas functions.
These alterations in cell growth are most commonly caused by changes, called mutations, in the DNA that carries the instructions the cells follow when they grow. Mutations can confuse the cell, which means it does not stop growing when it should. It is not always clear why mutations happen. Some are inherited from your parents and others happen over time while you age. 5-10% of pancreatic cancers are caused by inherited mutations.
Not all cells in the pancreas are the same. They differ depending on the role that they play.
The cells in the pancreas that produce pancreatic enzymes are known as exocrine cells. Exocrine pancreatic tumours are made up of these cells and are the most common type of pancreatic cancer.
9/10 (90%) of exocrine pancreatic cancer is known as pancreatic ductal adenocarcinoma (shortened to PDAC). This particular cancer develops in the channels, known as ducts, which carry pancreatic juice from the pancreas into the small bowel. Other types of exocrine cancers are rare.
The cells that produce hormones are known as endocrine cells. Tumours that grow from these cells are known as endocrine cancers. They account for only 5 in 100 (5%) of all pancreatic cancers. These tumours can also called pancreatic neuroendocrine tumours (PNETS) or islet cell tumours.
Endocrine pancreatic tumours are treated differently to exocrine tumours so it is important to know what kind of pancreatic cancer you have.
The stage of a cancer reflects the size of the cancer and how far it has spread.
By measuring the size of the tumour (T), confirming if there are any cancer cells present in the lymph nodes (N) and confirming if the cancer has spread from the pancreas to any other organs in the body (M), it is possible to assign a stage number to your cancer. This is described as the “TNM” stage of your cancer and it can be converted to a number ranging between 1 and 4. Knowing the stage of your cancer will help your doctor decide whether it is possible to operate to remove the cancer surgically.
Stage 1 - the earliest stage and the cancer is found only in the pancreas.
Stage 2 - the cancer has spread into nearby tissues and/or there is cancer in lymph nodes near the pancreas.
Stage 3 - the cancer has spread into the large blood vessels near the pancreas and/or the stomach, spleen or large intestine.
Stage 4 - the cancer has spread to distant sites such as the liver, lungs or bones.
Early stage pancreatic cancer doesn’t normally have any symptoms. As the cancer grows, it can start to cause symptoms that differ depending on the type and location of the cancer in the pancreas.
The most common symptoms of the most common type of pancreatic cancer include:
- Pain in the tummy
- Yellowish skin (including the whites of the eyes)
- Dark urine
- Weight loss
- Loss of appetite
- Bowel problems, including steatorrhoea
Other less common symptoms include:
- Feeling sick
- Inflammation of the pancreas
- Back pain
- Inflammation of the pancreas
- Fever and shivering
Rare forms of pancreatic cancer can produce slightly different symptoms to those listed above, depending on which type of pancreatic cancer it is, including:
- Severe back pain
- Inflammation of inside cheeks and lips
- Lack of energy
- High blood pressure
These symptoms can also be caused by common illnesses. It is important to go to your doctor if you have symptoms that continue for some time and cannot be explained, or, have symptoms that worsen to find out what the root cause is.