Pancreatic cancer happens when cancer cells develop in the pancreas. While the rate of many kinds of cancers are decreasing in the United States, pancreatic cancer cases continue to rise. There’s currently no consensus on recommending pancreatic cancer screening for people who are considered at average risk, but some people who are high risk may benefit from pancreatic cancer screening.
Read on to learn how you can determine your risk for pancreatic cancer and the different pancreatic cancer screening tests that are available. Plus, discover how early detection with imaging tests may find a problem before you even develop symptoms and how you can take charge of your health.
The pancreas is an organ that is located in your abdomen. It’s nestled between the small intestine and the spleen. The two main functions of the pancreas are broken down into two categories: exocrine and endocrine.
The exocrine gland has essential functions that include secreting enzymes crucial for digestion, while the endocrine gland is responsible for releasing hormones needed for blood sugar control which are insulin and glucagon. When the pancreas has problems with releasing insulin, this can lead to diabetes.
Pancreatic cancer is when cancer cells start to grow in the pancreas and form tumors, or masses. Typically, an average-risk individual has an approximately 1 in 64 chance of developing pancreatic cancer in their lifetime.
While pancreatic cancer is the 10th most common cancer in the United States, it ranks third for cancer-related deaths. This is in part due to the difficulty of diagnosing pancreatic cancer early. Often, by the time people develop symptoms, the pancreatic cancer has already metastasized, or spread to other tissues or parts of the body.
Cancer of the pancreas can come from exocrine or endocrine cells, with most pancreatic cancer being exocrine. The most common type of exocrine pancreatic cancer is adenocarcinoma. Endocrine, or neuroendocrine pancreatic cancer, includes pancreatic neuroendocrine tumors. These make up less than 5% of all pancreatic cases. While pancreatic neuroendocrine cancer is rare, it’s an important distinction to make from adenocarcinoma, as treatment options can differ and have better outcomes.
Some benign pancreatic tumors or cysts, also known as intraductal papillary mucinous neoplasms (IPMNs), have the potential to become cancerous over time. Due to this, they’re usually closely monitored.
There are several known risk factors for pancreatic cancer. Pancreatic cancer is more common in men over the age of 45. The biggest modifiable risk factor, or something you can change or control, is smoking. People who smoke are up to three times more likely to develop pancreatic cancer in their lifetime.
Alcohol can also be an indirect risk factor, as people who consume a lot of alcohol can develop chronic pancreatitis, or inflammation of the pancreas. Over time, this can increase the chances of pancreatic cancer. Other risk factors include having diabetes and consuming a diet high in fat.
About 1 in 10 people who develop pancreatic cancer inherit it from their family, known as a gene mutation. Pancreatic cancer can run in families. Certain gene mutations can increase someone’s risk for developing pancreatic cancer.
Some of these inherited genetic mutations include ATM, BRCA1, BRCA2, CDKN2A, PALB2, and STK11. There are also some genetic syndromes that can be inherited.
When people have a family history of pancreatic cancer or are aware that one of these syndromes runs in their family, pancreatic cancer screening may be recommended due to their increased risk.
The first step to being proactive about your health is to limit your risk factors. This includes not smoking, eating foods rich in nutrients, avoiding processed foods, and maintaining a healthy weight.
Unfortunately, there’s no blood test to screen for or detect pancreatic cancer. When a healthcare provider suspects pancreatic cancer, many blood tests may be done in conjunction with imaging tests to support the diagnosis.
Liver function tests are commonly done in cases of suspected pancreatic cancer. Jaundice, or yellowing of the skin, is a common sign of pancreatic cancer. This sign happens due to a buildup of bilirubin in the body, which is a substance that usually passes through the liver and is normally excreted.
Liver function tests can show different levels of bilirubin as well as liver enzymes, which can help distinguish if jaundice is because of problems with the liver or due to a blockage, which could be due to several conditions including a tumor of the pancreas.
Other blood tests that can be useful include tumor markers. These are different substances that are sometimes present in the blood when a person has cancer. Some tumor markers that may be helpful are serum carbohydrate antigen, or CA 19-9, and carcinoembryonic antigen, or CEA. While neither of these tumor markers are accurate enough to diagnose pancreatic cancer on their own, they can be helpful in addition to other tests and imaging studies.
CA 19-9 can be especially helpful to support the diagnosis of pancreatic cancer, along with imaging or biopsies. This blood test can also be used to monitor how someone with pancreatic cancer is responding to their treatment. Sometimes both CA 19-9 and CEA can be used in people who have a history of localized pancreatic cancer that was removed to monitor if the cancer is coming back.
Genetic testing can also be very useful for those with a first-degree relative who had pancreatic cancer. Your parents, siblings, and children are all first-degree relatives. If a certain genetic mutation or syndrome is found during the genetic testing, then pancreatic cancer screening may be recommended. In such cases, it’s important to have follow-up with a genetic counselor, as they may have further recommendations for screening for other types of cancer.
There’s no current imaging test recommended for pancreatic cancer screening for people who are not showing symptoms or who don’t have a first-degree relative with the disease. This is because for most people, the risk of pancreatic cancer is relatively low.
However, for those patients who are at high risk or who are showing symptoms, multiple imaging tests including computed tomography (CT) scan and magnetic resonance imaging (MRI) are typically used for diagnosing pancreatic cancer.
Based on American Gastroenterological Association recommendations, people who are at high risk for developing pancreatic cancer should start annual screening at either age 50 or 10 years before the onset of cancer in their family member, whichever is sooner. In certain genetic syndromes, the age of screening could decrease to 35 years of age.
MRI is useful for detecting pancreas tumors and is also helpful in detecting tumors that may have spread to other parts of the body, such as the liver. Procedures such as endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) can be very effective in not only visualizing pancreatic cancer but gathering biopsies of pancreatic lesions, or masses, as well as samples of surrounding lymph nodes.
Pancreatic cancer often doesn’t show any symptoms early on. These are the symptoms associated with pancreatic cancer that you should watch for:
If you notice one or more of these symptoms on a regular basis, make an appointment with your doctor. They may decide that you should undergo an evaluation of your pancreas.
When it comes to detecting pancreatic cancer, the key is to find it early. The early detection of pancreatic cancer is crucial for improving survival. Localized pancreatic cancer, or cancer that is limited to the pancreas, has a much better survival rate compared to pancreatic cancer that has spread, or metastasized. In fact, while the average 5-year survival rate of pancreatic cancer is 12.5%, that number increases to 44.3% in cases that are localized.
Apart from making good lifestyle choices, you can assess your own cancer risk with Ezra’s Cancer Risk Calculator. Within five minutes, you can have a better idea about what cancers you may be at higher risk for.
Take it one step further by considering Ezra’s Full Body MRI Scan, which not only can detect early pancreatic tumors such as IPMNs but scans the rest of your body in about an hour. With the ability to detect over 500 conditions, this can provide you and your family with a wealth of information to empower you and potentially change your future.