Pancreatic cancer

Pancreatic cancer

A deadly GI cancer, pancreatic cancer progresses rapidly. Pancreatic tumors are almost always adenocarcinomas and most arise in the head of the pancreas. Tumors of the body and tail of the pancreas and islet cell tumors are rare. The two main tissue types are cylinder cell and large, fatty, granular cell.


Pancreatic cancer, the fourth leading cause of cancer-related death in the United States, is slightly more common in men than in women; risk increases with age. Almost one-third of cases result from cigarette smoking; some cases are related to hereditary syndromes.

Possible predisposing factors are chronic pancreatitis, diabetes mellitus, and chronic alcohol abuse.

Signs and symptoms

The most common features of pancreatic cancer are weight loss, anorexia, abdominal or low back pain, jaundice, diarrhea, steatorrhea, fluid and electrolyte imbalances, and bleeding tendencies. If the islets of Langerhans are affected, signs and symptoms of diabetes may be present. (See Types of pancreatic cancer, page 598.)

Other signs and symptoms include fever, skin lesions (usually on the legs), and emotional disturbances, such as depression, anxiety, and premonition of fatal illness.


Definitive diagnosis requires a laparotomy with a biopsy. Other tests used to detect pancreatic cancer include:

  • ultrasound— can identify a mass but not its histology

  • computed tomography scan—similar to ultrasound but shows greater detail

  • angiography— shows vascular supply of tumor

  • endoscopic retrograde cholangiopancreatography—allows visualization, instillation of contrast medium, and specimen biopsy

  • magnetic resonance imaging—shows tumor size and location in great detail.