Pancreatic cancer is more common in:

Overview

• The pancreas is a long, flat gland that sits deep in the abdomen, behind the stomach; it has two important jobs: it makes digestive juices (enzymes) that help break down food and it produces hormones including insulin that control blood sugar levels
• Pancreatic cancer occurs when cells in the pancreas develop DNA changes and begin to grow in an uncontrolled way, forming a tumour

How common is pancreatic cancer?

• Pancreatic cancer is the 12th most commonly diagnosed cancer but the 6th leading cause of cancer-related death worldwide
• In India, the incidence is rising, particularly in north-eastern regions and among populations with obesity, diabetes and smoking

Who is commonly affected?

Pancreatic cancer is more common in:

• People over the age of 50, with most cases occurring between the ages of 60 and 80
• Smoking doubles the risk compared to non-smokers
• People with long-standing type 2 diabetes
• Those with chronic pancreatitis (long-term inflammation of the pancreas)
• People who are obese or overweight
• Those with a close family member who has had pancreatic cancer
• Men are slightly more commonly affected than women

Causes

• Smoking: Smokers are approximately twice as likely to develop pancreatic cancer as non-smokers
• Type 2 diabetes: People with type 2 diabetes have a higher risk
• Chronic pancreatitis: Long-term inflammation of the pancreas (often linked to heavy alcohol use) increases the risk, particularly in people under 40 years old
• Obesity: Being significantly overweight increases the risk, particularly for cancers arising in the body and tail of the pancreas
• Family history: Approximately 10% of pancreatic cancers have a hereditary component; having two or more close family members (parents or siblings) with pancreatic cancer significantly increases personal risk
• Inherited gene mutations also increase the risk of pancreatic cancer
• Age over 50 years: The risk rises steadily with increasing age
• Heavy and long-term alcohol consumption: Linked to chronic pancreatitis, which in turn raises cancer risk
• Diet high in red and processed meat and low in fruits, vegetables and fibre
• Physical inactivity: Sedentary lifestyle contributes to obesity and raised insulin levels, both risk factors
• Workplace exposure to certain chemicals, such as pesticides and petrochemicals, over many years

Common symptoms

• Jaundice
• Unexplained weight loss and loss of appetite
• Pain in the upper abdomen or back
• Nausea and vomiting
• New onset of diabetes, or existing diabetes that becomes suddenly difficult to control
• Indigestion or feeling full quickly after eating a small amount
• Extreme tiredness or weakness (fatigue)
• Itchy skin

Diagnosis and investigations

• Liver function tests (which may show obstruction of the bile duct) and tumour marker tests
• CT scan (Computed Tomography): An imaging test of the pancreas, showing the size and location of the tumour and whether it has spread to nearby blood vessels, lymph nodes or other organs
• MRI / MRCP (Magnetic Resonance Cholangiopancreatography): Detailed imaging of the pancreas, bile ducts and pancreatic ducts without radiation; useful when CT findings are unclear
• Endoscopic Ultrasound (EUS): A thin, flexible tube with an ultrasound probe is passed through the mouth into the stomach; visualise the pancreas and if needed, take a small tissue sample (biopsy) using a fine needle
• ERCP (Endoscopic Retrograde Cholangiopancreatography): A thin tube is passed into the small intestine to examine the bile and pancreatic ducts and a small plastic or metal stent can be inserted to relieve the blockage and reduce jaundice
• PET/CT scan: Used in selected cases to check if the cancer has spread to parts of the body
• Laparoscopy: A small keyhole surgical procedure under general anaesthetic to look directly inside the abdomen for any spread of cancer not visible on scans

Treatment options

Surgery

• Surgery offers the best chance of long-term survival but possi when the cancer is confined to the pancreas and has not grown into major blood vessels
• Whipple procedure (pancreaticoduodenectomy): The most common operation, used for removing the head of the pancreas
• Distal pancreatectomy: Removal of the body and tail of the pancreas, often with the spleen, for tumours in this location
• Total pancreatectomy: Removal of the entire pancreas, used in selected cases

Chemotherapy

• Given after surgery (adjuvant chemotherapy) to reduce the risk of the cancer returning
• Given before surgery (neoadjuvant chemotherapy) to try to shrink the cancer enough to allow surgery

Radiotherapy

• Uses high-energy rays to destroy cancer cells; it may be given alongside chemotherapy (chemoradiation) for locally advanced cancer that cannot be surgically removed
• Also used to help relieve pain or discomfort caused by the tumour pressing on nerves or other structures

Targeted therapy and emerging treatments

• People with specific gene mutations may be eligible for targeted drugs, which can be used after chemotherapy

Relieving symptoms (palliative procedures)

• Biliary stenting: If the bile duct is blocked, a small metal or plastic tube (stent) can be placed to keep the duct open, relieving jaundice and itching
• Coeliac nerve block: Pain-relieving injection that can help manage severe abdominal or back pain

Lifestyle and prevention

Recommended diet

• A diet rich in fruits, vegetables, whole grains and fibre
• Lean proteins such as fish, pulses and legumes
• Reduce intake of red and processed meats, refined sugars and high-fat foods
• Stay well hydrated

Exercise

• Regular moderate physical activity (such as walking, swimming, or gentle cycling) helps maintain a healthy body weight, improves energy and reduces fatigue during and after treatment

Long-term care

• Stop smoking
• Manage diabetes and weight carefully
• Attend all follow-up appointments and take all prescribed medicines

Myths and facts

Myth 1: Pancreatic cancer always causes obvious symptoms early on

Fact: Pancreatic cancer is called a 'silent' disease because it almost never causes symptoms in its early stages. By the time jaundice, pain, or weight loss appear, the cancer has often already progressed. This is why it is so frequently diagnosed late.

Myth 2: Pancreatic cancer cannot be treated at all

Fact: While pancreatic cancer is challenging to treat, surgery offers the chance of long-term survival when the cancer is caught early enough. Modern chemotherapy regimens (such as FOLFIRINOX) and newer targeted therapies have meaningfully improved outcomes even for advanced disease.

Myth 3: Only people with a family history of pancreatic cancer will develop it

Fact: Only approximately 10% of pancreatic cancers are linked to a hereditary cause. The majority occur in people without any family history. Risk factors such as smoking, diabetes, obesity and chronic pancreatitis account for the majority of cases.

Myth 4: Diabetes always leads to pancreatic cancer

Fact: Most people with type 2 diabetes will never develop pancreatic cancer. However, long-standing diabetes does modestly increase the risk and new-onset diabetes in an older adult without an obvious cause warrants further investigation.

Frequently asked questions (FAQs)

Q1. Can pancreatic cancer be prevented?

There is no guaranteed prevention. However, stopping smoking, maintaining a healthy body weight, controlling diabetes, limiting alcohol consumption and eating a balanced diet with regular physical activity can all lower the risk.

Q2. What does the Whipple procedure involve and how long is the recovery?

The Whipple procedure is a major operation that takes several hours under general anaesthetic. Most patients spend 7–14 days in hospital and require several weeks to months to recover fully at home. Your team will provide detailed guidance on eating, activity and follow-up after the operation.

Q3. What is pancreatic enzyme replacement therapy (PERT) and why is it important?

When the pancreas is unable to produce enough digestive enzymes — either because of the cancer itself or after surgery — food is not properly absorbed, leading to weight loss, diarrhoea and nutritional deficiencies. PERT tablets, taken with every meal and snack, replace these enzymes. They are essential and should not be skipped.

Q4. Are there any screening tests for pancreatic cancer?

Currently, there is no recommended screening test for the general population, as no test has been shown to reliably detect early pancreatic cancer at a stage where it changes outcomes. However, people with a high inherited risk (due to gene mutations or a strong family history) may be offered specialist surveillance with MRI or endoscopic ultrasound at specialist centres.