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?

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 – Adults of any age can be diagnosed with pancreatic cancer, however, persons over 55 years old are more likely to be diagnosed. Two-thirds of pancreatic cancer patients are older than 65 and 71 is the average age at the time of diagnosis.
• Gender – Men are slightly more likely to be diagnosed with pancreatic cancer than women.
• Family History – A family history of pancreatic cancer is a risk factor, although most individuals diagnosed with pancreatic cancer do not have a family history.
• Gene Mutations – Inherited gene mutations that may increase risk of pancreatic cancer can be passed from parent to child. Gene mutations are estimated to cause up to 10% of pancreatic cancer diagnoses.
• Tobacco Use – Tobacco use is one of the most significant risk factors for pancreatic cancer. A person’s risk for developing pancreatic cancer nearly doubles if they are smokers or actively use tobacco products. About 20% to 30% of pancreatic cancer diagnoses are thought to be the result of cigarette smoking.
• Obesity – Overweight adults are at higher risk of being diagnosed with pancreatic cancer. Obese adults are nearly 20% more likely to develop pancreatic cancer.
• Diabetes – Research has indicated that people diagnosed with diabetes are more likely to develop pancreatic cancer, although the reason for this is not yet known.
• Race – Research has yet to indicate why but African Americans are more likely to be diagnosed with pancreatic cancer. Individuals of Ashkenazi Jewish heritage also are at higher risk for pancreatic cancer.

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?

Unfortunately, early pancreatic cancers don’t often produce any signs or symptoms. By the time any signs or symptoms are noticed, the cancer has often spread outside of the pancreas. However, symptoms that are related to pancreatic cancer include:

• Jaundice and related symptoms such as dark urine, itchy skin, and light-colored or grey stools
• Belly or back pain
• Weight loss and poor appetite
• Nausea and vomiting
• Gallbladder or liver enlargement
• Blood clots
• Fatty tissue abnormalities
• Diabetes

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
• Palliative care

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:

• Pancreaticoduodenecomy (also known as Whipple surgery) is a procedure for patients whose tumor is located in the head or uncinate of the pancreas. This procedure involves removing the tumor, along with a portion of stomach, small intestine and bile duct.
• Partial pancreatectomy is a surgical option for patients whose tumor is located in the neck, body or tail of the pancreas. This procedure involves the surgical removal of part of the pancreas.
  Our surgeons can perform these procedures with minimally invasive techniques, such as laparoscopic or robotic-assisted surgeries in certain cases deemed safe for the patient.

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.