Frequently Asked Questions About Pancreatic Cancer

At the Henry Ford Cancer Institute, we provide compassionate, expert care. We’ll guide you and your family through the process, including diagnosis, treatment and follow-up care as a survivor.

Our team of doctors, pancreatic cancer surgeons, physical and occupational therapists, radiation and medical oncologists and nurses will make sure you have all the information and support you need. However, at any point during your journey of care, you may have some questions – some of which come up more frequently than others, so we’ve compiled a list of frequently asked questions and answers to get you started.

Pancreatic Cancer Basics

• Who is most likely to get pancreatic cancer?
• Is pancreatic cancer hereditary?
• What is the relationship between pancreatic cancer and diabetes?
• What research is being conducted on pancreatic cancer?

Pancreatic Cancer Symptoms and Diagnosis

• Where is pancreatic cancer found?
• Can pancreatic cancer spread?
• What are the early warning signs of pancreatic cancer?

Pancreatic Cancer Treatment

• How aggressive is pancreatic cancer?
• Is pancreatic cancer treatable?
• Will chemotherapy help pancreatic cancer?
• What surgical procedures are available for pancreatic cancer patients?

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Who is most likely to get pancreatic cancer?

An estimated 53,670 people are diagnosed each year with pancreatic cancer. There are several factors that can impact a person’s chance, or likeliness, of developing pancreatic cancer, such as these risk factors:

• Age over 55
• Personal or family history of pancreatic cancer or pancreatitis
• History of smoking or other tobacco use
• Obesity
• Type 2 diabetes
• Gene mutations
• African-American ancestry

Is pancreatic cancer hereditary?

Pancreatic cancer is a genetic disease, which means it is the result of changes, or mutations, in DNA that can either be inherited (from our parents) or acquired (change after birth.) Familial pancreatic cancer is a term used to describe families with an abnormally high rate of pancreatic cancer, although, inherited genes only account for about 10% of all pancreatic cancers.

If you have a first-degree relative who has been diagnosed with pancreatic cancer, or if you have family members who carry certain genetic mutations, you may be at a higher risk for developing pancreatic cancer. Our team can assess your risk and offer genetic testing and counseling, if appropriate.

What is the relationship between pancreatic cancer and diabetes?

Those who are diagnosed with type 2 diabetes in their adult years are at higher risk for developing pancreatic cancer, although the reason for this is not yet known. However, type 2 diabetes that is linked with pancreatic cancer is often related to being overweight or obese.

It is not yet clear if type 1 (juvenile) diabetes poses a similar risk.

What research is being conducted on pancreatic cancer?

Doctors are continuously working to improve our overall education and understanding on pancreatic cancer, including ways to prevent it, treatment methods, and how to provide the best care for those who have been diagnosed with pancreatic cancer.

Modern research on pancreatic cancer includes using genetics for early detection and responding with targeted therapies and personalized treatment options. To progress such research, the Henry Ford Pancreatic Cancer Center is leading a global, multi-institutional research consortium.

Where is pancreatic cancer found?

Pancreatic cancer is a disease in which cancerous cells form in the tissue of the pancreas – a large gland located behind the stomach and in front of the spine. The pancreas produces digestive juices and hormones that regulate blood sugar.

Because of the deep location of the pancreas, tumors of the pancreas are difficult to detect which makes early identification of pancreatic cancer so difficult.

Can pancreatic cancer spread?

Pancreatic cancer can spread (metastasize) to other organs in the body. It most often spreads to the abdomen and liver first. Pancreatic cancer can also spread to the lungs, other organs, bones and brain. The further pancreatic cancer spreads in the body, the more difficult it can be to treat.

Pancreatic cancer is considered resectable (tumor can be removed with surgery) if the cancer is limited to the pancreas. Pancreatic cancer that has spread to other organs and cannot be removed with surgery is referred to as unresectable.

What are the early warning signs of pancreatic cancer?

Many people do not experience any noticeable symptoms of pancreatic cancer at an early stage. Symptoms may not arise until the cancer has progressed to an advanced stage and possibly spread to other areas of the body.

Some symptoms that could be signs of pancreatic cancer include:

• Epigastric abdominal pain that radiates to the spine: The tumor in the pancreas can irritate nerves that cause a dull or aching pain toward your mid-back.
• New onset jaundice: Yellowing of the eyes and skin that often can be preceded by dark-colored urine, pale or gray stool, or itchy skin.
• Weight loss: Unintended weight loss that may be accompanied by a loss of appetite could be a sign of pancreatic cancer.
• Nausea: A tumor can irritate the stomach and cause nausea, pain, and vomiting after eating.
• New onset diabetes mellitus: Previously healthy patients may be diagnosed with diabetes, or if you have a long-standing history of diabetes, sugar glucose control may become progressively more difficult to control. 

How aggressive is pancreatic cancer?

Pancreatic cancer is among the most aggressive of all cancer types. The disease is often diagnosed at later stages due to the difficulties surrounding early diagnosis of pancreatic cancer. With a later diagnosis, the disease have may have already spread to other sites in the body.

In 2010, approximately 43,000 people in the United States were diagnosed with pancreatic cancer, and approximately 36,000 people died of this disease. While significant advancements in the treatment of pancreatic cancer have been made since that time, these numbers demonstrate the aggressiveness and difficulty of diagnosing pancreatic cancer.

Is pancreatic cancer treatable?

The earlier pancreatic cancer is diagnosed, the easier it is to treat. At Henry Ford, our multidisciplinary pancreatic cancer team has a proven track record as a major center for treating pancreatic tumors. Our team will meet with you to go over your treatment options, which may include:

• Surgery
• Radiation therapy
• Chemotherapy
• Clinical trials

Will chemotherapy help pancreatic cancer?

Just like any other form of cancer, chemotherapy can be used to stop or slow the growth of cancer cells. Depending on the state and progression of the pancreatic cancer, chemotherapy may be used before or after surgery and for differing reasons, especially if the cancer is advanced and cannot be removed completely with surgery.

Your medical oncologist will outline your chemotherapy treatment options and what to expect during your chemotherapy treatment.

What surgical procedures are available for pancreatic cancer patients?

The nature and extent of surgery for pancreatic cancer is dependent upon the location and size of the cancerous tumor. However, for tumors that were previously considered inoperable, Henry Ford offers NanoKnife procedures. This technology uses irreversible electroporation to send electrical pulses through small probes placed into a tumor. This causes cell lysis, killing cancer cells while avoiding damage to the surrounding area of the pancreas.

If you have a tumor that has not spread beyond the pancreas, you may qualify for potentially curative surgery.

Depending on the location of your tumor, your surgeon may offer you one of these surgical options:

• Whipple surgery (pancreaticoduodenectomy) is for cancer near the head of the pancreas. This is the widest part of the pancreas near the stomach and small intestine. A Whipple procedure involves removing the tumor, along with a portion of the stomach, small intestine and bile duct.
• Partial pancreatectomy is an option for cancer at the opposite end of the pancreas, near its neck, body or tail. This type of surgery involves removing the affected part of the pancreas.
• NanoKnife®: In select patients who are not eligible for traditional surgery, NanoKnife may be an option. This procedure uses technology to deliver electrical pulses that destroy cancer cells while avoiding damage to nearby healthy tissue. Henry Ford was the first program in Michigan to offer this option.
  

Based on your pre-operative tests and imaging, patients may be offered different treatment options prior to surgery in attempts to shrink the tumor as much as possible. Those options may include chemotherapy, radiation, or a combination of both.

Our team will work with you to determine if surgery will be a part of your treatment plan, based on recommendations from our tumor board.

Your pancreatic cancer team

Our entire multidisciplinary pancreatic cancer team meets with you to plan your treatment needs in a single visit, saving you time and reducing frustration from multiple medical appointments. Your team will include:

• Pancreatic cancer surgeons
• Radiation oncologists
• Medical oncologists
• Nurse navigators
• Dietitians
• Physical and occupational therapists
• Psychologists
• Social workers

This team will be there for you throughout your treatment for medical and personal needs that may arise along the way.