Pancreatic cancer arises when cells in the pancreas multiply uncontrollably and form a tumor. The most common form is pancreatic adenocarcinoma, which accounts for about 90% of cases and originates in the ducts that produce digestive enzymes. Other types include neuroendocrine tumors, which are less aggressive and arise from hormone-producing cells.

Causes and Risk Factors

Key risk factors include tobacco smoking (linked to about 25% of cases), obesity, diabetes, certain genetic conditions, and age (most cases occur after age 70). Men and smokers have a higher risk. Family history and some syndromes like Lynch syndrome increase risk as well.

Symptoms

Early stages often show no symptoms. When present, symptoms may include yellowing of the skin (jaundice), abdominal or back pain, unexplained weight loss, light-colored stools, dark urine, nausea, fatigue, and loss of appetite.

Diagnosis and Staging

Diagnosis involves imaging (ultrasound, CT scans), blood tests, and biopsy. Pancreatic cancer is staged from I (early) to IV (advanced), with most cases diagnosed late when cancer has spread, limiting treatment options.

Treatment Options

Surgery (e.g., Whipple procedure or distal pancreatectomy) is the only potential cure but is possible in about 20% of cases at diagnosis. Other treatments include chemotherapy (regimens such as FOLFIRINOX or gemcitabine plus protein-bound paclitaxel), radiation therapy, and palliative care for symptom management.

Prognosis

The prognosis is generally poor, with a 5-year survival rate around 6% in the U.S., partly due to late diagnosis. Survival is better for neuroendocrine tumors and for localized small tumors surgically resected. Pain management is crucial as pancreatic cancer is often very painful. These details reflect current understanding and ongoing research into pancreatic cancer's diagnosis, treatment, and survival outcomes.