Pancreatic cancer: symptoms and causes

Pancreatic cancer is a cancer that's found anywhere in the pancreas.

What is pancreatic cancer?

Pancreatic cancer is a cancer that's found anywhere in the pancreas.
The pancreas is an organ in the top part of your tummy.
It helps you digest your food and makes hormones, such as insulin.
How serious pancreatic cancer is depends on where it is in the pancreas, how big it is, if it has spread and your general health.

Symptoms of pancreatic cancer

Main symptoms of pancreatic cancer

Pancreatic cancer may not have any symptoms, or they might be hard to spot.

Symptoms of pancreatic cancer can include:

the whites of your eyes or your skin turn yellow (jaundice), and you may also have itchy skin, darker pee and paler poo than usual
loss of appetite or losing weight without trying to
feeling tired or having no energy
a high temperature, or feeling hot or shivery

Other symptoms can affect your digestion, such as:

feeling or being sick
diarrhoea or constipation, or other changes in your poo
pain at the top part of your tummy and your back, which may feel worse when you're eating or lying down and better when you lean forward
symptoms of indigestion, such as feeling bloated

If you have another condition like irritable bowel syndrome, you may get symptoms like these regularly.

You might find you get used to them. But it's important to be checked by a GP if your symptoms change, get worse or do not feel normal for you.

See a GP if:

you've lost a noticeable amount of weight
you have other symptoms of pancreatic cancer that get worse or do not get better after 2 weeks
you have a condition that causes symptoms with your digestion that are not getting better after 2 weeks of using your usual treatments

Important

Some of these symptoms are very common and can be caused by other conditions.

Having the symptoms does not definitely mean you have pancreatic cancer, but it's important to get checked by a GP.

If your symptoms are caused by cancer, finding it early may mean it's easier to treat.

What happens at the GP appointment

The GP may feel your tummy.

They may ask you to give a pee sample or have a blood test.

Referral to a specialist

You may get an urgent referral for more tests or to see a specialist in hospital if the GP thinks you have symptoms that could be cancer. This does not definitely mean you have cancer.

Causes of pancreatic cancer

Who is more likely to get pancreatic cancer

Anyone can get pancreatic cancer. It's not always clear what causes it.

You might be more likely to get it if you:

are over the age of 65 – it's not very common in people under 40
have certain medical conditions, such as chronic pancreatitis
there's a history of pancreatic cancer in your family

Many pancreatic cancers are also linked to your lifestyle.

How to lower your risk of pancreatic cancer

You cannot always prevent pancreatic cancer. But making healthy changes can lower your chances of getting it.

Do

try to lose weight if you're overweight
cut down on how much red and processed meat (such as ham, bacon and salami) you eat
try to cut down on alcohol – avoid drinking more than 14 units a week
try to quit smoking

It's important to get any symptoms of pancreatic cancer checked by a GP, even if you do not think you have a higher chance of getting it.

Anyone can get pancreatic cancer.

Tests and next steps for pancreatic cancer

Main tests for pancreatic cancer

You will need tests and scans to check for pancreatic cancer if a GP refers you to a specialist.

These tests can include:

blood tests
scans, like an ultrasound scan (sometimes from inside your body using a thin, flexible tube called an endoscope), CT scan, PET scan, or MRI scan
collecting a small sample of cells from the pancreas (called a biopsy) to be checked for cancer
a small operation to look inside your tummy, called a laparoscopy
a test called an ERCP – where an endoscope is passed through your mouth to your stomach and X-rays are taken of your pancreas

You may not have all these tests.

These tests can also help find problems in other nearby organs, such as your bile ducts, gallbladder or liver.

Getting your results

It can take several weeks to get the results of your tests.

Try not to worry if your results are taking a long time to get to you. It does not mean anything is definitely wrong.

You can call the hospital or GP if you are worried. They should be able to update you.

A specialist will explain what the results mean and what will happen next. You may want to bring someone with you for support.

If you're told you have pancreatic cancer

Being told you have pancreatic cancer can feel overwhelming. You may be feeling anxious about what will happen next.

It can help to bring someone with you to any appointments you have.

A group of specialists will look after you throughout your diagnosis, treatment and beyond.

Your team will include a clinical nurse specialist who will be your main point of contact during and after treatment.

You can ask them any questions you have.

Macmillan Cancer Support has a free helpline that's open every day from 8am to 8pm.

They're there to listen if you have anything you want to talk about.

Call 0808 808 00 00.

Next steps

If you've been told you have pancreatic cancer, the specialists will use the results of some of the tests and scans to help find out the size of the cancer and how far it's spread (called the stage).

You may need to have more tests done.

The specialists will use the results of these tests and work with you to decide on the best treatment plan for you.

Treatment for pancreatic cancer

Main treatments for pancreatic cancer

Pancreatic cancer can be difficult to treat.

The treatment you have will depend on:

the size and type of pancreatic cancer you have
where it is
if it has spread
your general health

It may include surgery, chemotherapy, radiotherapy and supportive care.

The specialist care team looking after you will:

explain the treatments, benefits and side effects
work with you to create a treatment plan that is best for you
help you manage any side effects, including changes to your diet to help you digest your food

You'll have regular check-ups during and after any treatments. You may also have tests and scans.

If you have any symptoms or side effects that you are worried about, talk to your specialists. You do not need to wait for your next check-up.

Surgery

Your treatment will depend if the cancer can be removed or not.

if pancreatic cancer is found early and it has not spread, you may be able to have surgery to remove it
if the cancer cannot be removed, you may have surgery to help control some of your symptoms

Surgery to remove pancreatic cancer

There are several surgeries used to treat pancreatic cancer.

Surgery will remove part or, in a small number of cases, all the pancreas. All or parts of other organs around the pancreas may also need to be removed.

Recovery from surgery to treat pancreatic cancer can take a long time. The specialist team looking after you will discuss all the benefits and side effects.

Surgery to help control symptoms of pancreatic cancer

This can include surgery to:

unblock the bile duct or stop it getting blocked, which helps with jaundice
unblock the first part of the small intestine (duodenum) or to stop it getting blocked, which helps with feeling or being sick
bypass a blockage in the bile duct or small intestine (duodenum), which helps with jaundice and feeling or being sick

Many of these procedures are done using endoscopy, where the surgeon uses a long, thin, flexible tube to reach the blockage or organ.

The aim of these operations is to help improve your symptoms, not to cure the cancer.

Chemotherapy

Chemotherapy uses medicines to kill cancer cells.

You may have chemotherapy for pancreatic cancer:

to control symptoms if you're not able to have surgery because you are very unwell, or the cancer cannot be removed by surgery – it may be combined with radiotherapy (chemoradiotherapy)
after surgery to help stop the cancer coming back
before surgery to help make the cancer smaller
to treat early cancer

Radiotherapy

Radiotherapy uses high-energy rays of radiation to kill cancer cells.

Radiotherapy is not often used to treat pancreatic cancer. But you may have radiotherapy:

to treat early cancer if you are not able to have surgery because you are very unwell or the cancer cannot be removed by surgery – it's usually combined with chemotherapy (chemoradiotherapy)
with chemotherapy before surgery to help make the cancer smaller
to help control and improve the symptoms of advanced cancer

Supportive care

There are several other treatments that can help you feel better and improve the symptoms of pancreatic cancer. This is called supportive care.

Treatments can help with many symptoms of pancreatic cancer, including:

problems eating and weight loss, including prescribing enzyme replacement tablets to help you digest your food better
relieving any pain
tiredness
feeling or being sick, including prescribing anti-sickness tablets

The specialists will talk to you about what supportive care you might need.

What happens if you've been told your cancer cannot be cured

If you have advanced pancreatic cancer, it might be very hard to treat. It may not be possible to cure the cancer.

If this is the case, the aim of your treatment will be to limit the cancer and its symptoms, and help you live longer.

You will be referred to a special team of doctors and nurses called the palliative care team or symptom control team.

They will work with you to help manage your symptoms and make you feel more comfortable. The clinical nurse specialist or palliative care team can also help you and your loved ones get any support you need.

Pancreatic cancer