Pancreatic Cancer and Why the Treatment is So Challenging


Like many people, you may be unaware of the location of your pancreas and the functions it performs. The pancreas is a long and flat gland that sits deep within your abdomen. You typically can’t feel it. However, the pancreas is an integral part of the digestive system. It also helps to control blood sugar.

One part of the pancreas lies between the spine and stomach while the remainder lies in the curve of the first part of the small intestine called the duodenum. Because of the deep location of the pancreas within the abdomen, it’s difficult to feel any palpable tumors that indicate cancer. This helps to explain why many people don’t experience symptoms of pancreatic cancer until the tumor has spread to the nearby gallbladder, liver, duodenum, or stomach.

Symptoms and Risk Factors of Pancreatic Cancer

Every person experiences symptoms of pancreatic differently, but it’s common not to have any symptoms at all until the original tumor has spread to other parts of the body. Even when symptoms appear earlier, you may attribute them to another causes such as stress or the flu. It’s only when the symptoms persist that most people visit a doctor for diagnostic testing.

The most common symptoms that catch their attention include:

  • Fatigue
  • Pain in the upper back and/or abdomen
  • Nausea
  • Vomiting
  • Indigestion
  • Lack of appetite
  • Significant weight loss without dieting
  • Jaundice, which means a yellow color to your eyes and skin as well as urine that appears darker than normal

According to the National Cancer Institute, people who meet certain risk factors have a higher likelihood of developing pancreatic cancer. These include:

  • Age over 45
  • Having chronic pancreatitis
  • Smoking, especially among those who smoke two to three packs of cigarettes per day
  • African-American race as people with this heritage have a higher risk than Asians, Caucasians, and Hispanics of receiving a pancreatic cancer diagnosis
  • Male gender as men are twice as likely than women to develop this disease
  • Having diabetes

Pancreatic Cancer Diagnostic Challenges

Although pancreatic cancer is the third most fatal type of cancer, it doesn’t have the same high profile as other types. Breast cancer is a prime example. According to the American Cancer Society, pancreatic cancer is notoriously difficult to detect and treat. It’s even difficult to study due to its location and typical late diagnosis.

Unlike routine mammograms for breast cancer and colonoscopies for locating colon cancer, no standard diagnostic tool exists yet for pancreatic cancer. The disease doesn’t get the attention it deserves because so few people survive and advocate for it. In fact, the five-year survival rate is just eight percent. The National Cancer Institute (NCI) lists the following three reasons as the primary factors for why pancreatic cancer is difficult to diagnose and treat:

  • It’s uncommon to detect the disease early enough to treat it through surgical removal of tumors. The late appearance of symptoms and lack of a standard diagnostic test also contribute to the late detection.
  • This type of cancer quickly spreads to other internal organs because it sits at the intersection of several of them within the abdomen.
  • Pancreatic cancer often returns even after the earlier removal of tumors.

Types of Pancreatic Cancer and Benign Tumors

The most common type of pancreatic cancer is adenocarcinoma of the pancreas. It occurs when a tumor develops in the lining of the duct of the pancreas. Two other uncommon types are cystadenocarcinoma and acinar cell carcinoma.

Diagnostic Tools for Pancreatic Cancer

At this point, you may be wondering how the providers at UPMC Western Maryland diagnose pancreatic cancer when it’s so challenging. If you suspect you have this disease, the first thing your provider will do is ask you to describe symptoms in detail and complete a thorough physical examination. Next, your provider will order one or several of the following types of tests to help diagnose or rule out pancreatic cancer:

  • Biopsy
  • CT Scan
  • Laboratory tests
  • Laparoscopy
  • MRI
  • Ultrasound
  • X-ray

After arriving at a diagnosis, your provider will make a referral to a UPMC Western Maryland oncologist who will discuss the next steps with you and your close family members. This may include surgery to remove the cancerous tumor, chemotherapy, radiation, or a combination of these things. Although pancreatic cancer is aggressive and notoriously difficult, the best thing you can do to fight it is make healthy lifestyle choices and schedule a screening at the first sign of any of the symptoms listed above.

Please note, the information provided throughout this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and video, on or available through this website is for general information purposes only. If you are experiencing relating symptoms, please visit your doctor or call 9-1-1 in an emergency.