Pancreatic Cancer Information, Facts and Types

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Most of the time, “pancreatic cancer” means pancreatic adenocarcinoma — cancer that begins in the exocrine cells that form the glands and ducts inside the pancreas. A different type of cancer called a neuroendocrine tumor (NET) can also affect the pancreas.

Fred Hutch Cancer Center offers comprehensive treatment for pancreatic cancer and NETs from a team of experts who specialize in gastrointestinal cancers. This page is about pancreatic cancer. To learn more about NETs, visit our dedicated NET section.

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An illustration of the liver, with the stomach underneath it and the pancreas behind it.

Understanding Your Pancreas

Your pancreas is in your abdomen, behind your stomach. It is surrounded by your small intestine, liver and spleen.

Most of your pancreas consists of exocrine cells. These cells produce and secrete enzymes that aid in the breakdown of foods.

  • Lipase breaks down fats.
  • Protease breaks down proteins.
  • Amylase breaks down carbohydrates.

A small portion of your pancreas consists of endocrine cells. These cells produce and secrete hormones, including:

  • Gastrin, which triggers release of acid in your stomach
  • Insulin, which helps lower the level of sugar in your blood

Types of Pancreatic Cancer

It is important to know whether a pancreatic tumor started in the exocrine cells or endocrine cells because the treatment and prognosis differ. The term “pancreatic cancer” is often used to refer to exocrine pancreatic cancer, or cancer that started in the exocrine cells of the pancreas.

Pancreatic Adenocarcinoma

Most exocrine pancreatic cancers are pancreatic adenocarcinomas. Usually, they begin in the small tubes (ducts) that carry pancreas juices and enzymes to the common bile duct. The common bile duct empties into the first section of the small intestine (duodenum). These cancers are call pancreatic ductal adenocarcinoma (PDAC).

Within PDAC, there are two subtypes: classical (about 70% of people with PDAC) and basal (about 30%). Knowing the subtype may help physicians chose the best chemotherapy or match a patient to a clinical trial that’s testing a promising treatment approach.

Fred Hutch pancreatic cancer expert Sita Kugel, PhD, and her colleagues in the Human Biology Division found a way to quickly tell PDAC subtypes apart. Their findings may also lead to new therapies. This is important for both subtypes but especially for the basal subtype, which is more aggressive.

Other Exocrine Cancers of the Pancreas

There are several other less-common types of exocrine cancer that may affect the pancreas. They include:

  • Adenosquamous carcinomas
  • Squamous cell carcinomas
  • Signet ring cell carcinomas
  • Acinar cell carcinomas
  • Undifferentiated carcinomas
  • Undifferentiated carcinomas with giant cells

Pancreatic Neuroendocrine Tumors

Tumors that start in the endocrine cells of the pancreas are called pancreatic NETs. They are also known as neuroendocrine tumors of the pancreas or islet cell tumors, and they are different from pancreatic adenocarcinoma. Learn more about NETs.

Pancreatic Cancer Overview

Pancreatic Cancer Symptoms

Many symptoms of pancreatic cancer — like feeling tired or having belly and back pain — are not specific to this disease. Other conditions may cause the same symptoms. If you have any concerns about your health, start with letting your primary care provider know. They can ask you questions, do an exam and order any tests needed to tell what’s happening in your body and why.

Learn About Pancreatic Cancer Symptoms

Pancreatic Cancer Stages 

Your Fred Hutch care team's treatment plan for pancreatic cancer will be based partly on the stage of your disease. The stage depends on:

  • The size of the tumor
  • If cancer is only in the pancreas
  • Where it has spread if it has gone beyond the pancreas
Learn About Pancreatic Cancer Stages

Pancreatic Cancer Screening and Diagnosis

For many cancers, physicians need to do a biopsy to make the diagnosis. In a biopsy, a physician removes a small sample of tissue to check under a microscope for cancer cells. For pancreatic cancer, imaging tests, like a computed tomography (CT) scan or magnetic resonance imaging (MRI) scan, may be enough to tell that cancer is present. A biopsy can confirm the diagnosis.

Learn About Pancreatic Cancer Screening and Diagnosis

Pancreatic Cancer Causes and Risk Factors

There’s no straightforward way to prevent all cases of pancreatic cancer because physicians don’t know exactly why the disease starts. One way to lower your risk is to avoid smoking. Some families carry a gene that increases the risk for cancer in the pancreas. Knowing if you have one of these genes can help you decide how to best take care of yourself.

Learn About Pancreatic Cancer Risk Factor and Prevention

Pancreatic Cancer FAQ

If you have any signs or symptoms that you worry might be from pancreatic cancer, talk with your primary care provider. Your symptoms may be caused by something else, like a different condition of the pancreas or another organ. Whatever the cause, it’s important to find out so you can get treatment to help. If it is cancer, finding it earlier may mean it’s easier to treat.

Your primary care provider is a good place to start if you have questions or concerns about your risk for getting cancer. They can also help with any symptoms that might be from cancer or another condition. Before you visit your provider, write down your questions. Bring the list to your appointment.

If you’re concerned about risk, here are some questions you may want to ask:

  • Do I have any risk factors for cancer? 
  • Is there any reason to think I’m at higher risk than the average person? 
  • If I am at higher risk, what does this mean for me? Do I need any tests or procedures to check for cancer even if I feel fine? 
  • Is there anything I can do to lower my risk? 

If you have symptoms that concern you, here are some questions to ask:

  • What could be causing my symptoms? 
  • Do these symptoms mean I might have a serious condition? 
  • How can we find out the cause? Do I need any tests? 
  • What should I do if my symptoms don’t get better or if I get new symptoms?

When physicians and scientists talk about cancer survival rates, they typically mean the percentage of people expected to survive their cancer for at least five years after being diagnosed. (The rate doesn’t include the risk of dying during that time for some other reason.)

This rate comes from looking at a large, varied group of people. The chance of surviving cancer at least five years can vary greatly from one person to another. It depends on many factors, like how far the cancer has spread. Your Fred Hutch care team can explain how statistics like survival rates might apply to you.

Learn about pancreatic cancer survival rates.

Pancreatic cancer starts when cells in the pancreas grow out of control. Normally, cells in the body grow and multiply to form new cells as the body needs them. When cells get old or damaged, they die and are replaced. Sometimes, this normal process breaks down. Abnormal or damaged cells grow and multiply when they shouldn’t, forming tumors. Some tumors are cancer, and others are benign (noncancerous).

Pancreatic cancer spreads by growing into, or invading, nearby tissues. If the cancer cells invade nearby lymph nodes or blood vessels, they can travel through the lymph or blood to distant parts in the body. Then they can form new tumors in these places. 

The American Cancer Society estimates that about 68,000 people in the U.S. will be diagnosed with pancreatic cancer each year.

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