Pancreatic Cancer is rarely detected in its early stages as symptoms of the disease often do not occur until it is more advanced. For this reason, the disease often spreads to surrounding organs.
World Pancreatic Cancer Day (15 November) aims to increase people’s awareness of pancreatic cancer symptoms and to highlight the importance of regular screening for high-risk groups.
Your risk of developing pancreatic cancer is determined by certain factors that cannot be changed – your age and family history – and some that can, such as lifestyle choices like smoking.
Smoking is one of the most important risk factors for pancreatic cancer. Between 20 and 30% of pancreatic cancers are believed to be caused by smoking. If you are a smoker, your risk of developing pancreatic cancer is around twice that of a non-smoker.
Being overweight also puts you at risk. If you are obese you are 20% more likely to get pancreatic cancer but even people who are not obese but who carry excess weight around their waist are at increased risk.
Exposure to certain workplace chemicals, particularly those used in dry cleaning and metal working can also increase your risk.
Risk factors that cannot be changed include age. Two-thirds of people who get pancreatic cancer are over the age of 65 and the average age at diagnosis is 71. Men are more at risk than women although the gap has closed in recent years, possibly due to the decline in smoking among men. African American men appear to be particularly at risk, although scientists are not sure why.
Family history is not such a strong risk factor as with other forms of cancer although the disease does recur in some families. This may be due to an inherited gene mutation which can be passed from parent to child.
There are a number of different genetic syndromes, such as familial pancreatitis, which cause up to 10% of incidence of pancreatic cancer.
Type 2 diabetes is linked to an increased risk of pancreatic cancer, as is chronic pancreatitis (long-term inflammation of the pancreas). Cirrhosis of the liver, normally caused by heavy alcohol use or hepatitis, can also increase your risk of developing the disease. Stomach ulcers caused by H.pylori bacteria and excess stomach acid are also risk factors.
The greatest risks
By far the greatest risk occurs in people who smoke and who have long-term diabetes and a poor diet. If you are in a high-risk category, regular screening is recommended. This may include imaging techniques such as ultrasound, CT scan, MRI and PET scans. In some cases you may need an endoscopic ultrasound, where a thin flexible tube is passed down your oesophagus and into your stomach, to obtain images of your pancreas.
If you have a family history of pancreatic cancer or may have a genetic predisposition to the disease, a gastrointestinal doctor will review your family history and may recommend a genetic test to assess your risk of pancreatic and other cancers.
Role of the pancreas
Your pancreas lies behind the lower part of your stomach and its role is to release enzymes that aid digestion and hormones that control blood sugar.
Symptoms that may indicate pancreatic cancer include:
- Loss of appetite and unexplained weight loss
- Pain in the upper abdomen that carries around to your back
- Yellowing of the skin or eyes
There are some steps you can take which may reduce your risk of pancreatic cancer. These include avoiding or stopping smoking, eating a healthy balanced diet, maintaining a healthy weight and exercising.