Pancreatic Cancer

What is Pancreatic Cancer?

Pancreatic cancer is a disease where abnormal cells in the pancreas grow and divide uncontrollably. These cells can form a lump or tumour and may, in some cases, spread to other parts of the body. The pancreas is a gland located behind the stomach that helps with digestion and regulates blood sugar by producing hormones like insulin.

Most pancreatic cancers begin in the ducts of the pancreas (known as pancreatic ductal adenocarcinoma), but they can also start in the hormone-producing cells. Pancreatic cancer often develops without early warning signs, which can make it difficult to detect in the early stages. Like many cancers, early detection can greatly improve the chances of successful treatment.

Should I Consider Genetic Pancreatic Cancer Testing?

If you have a family history of pancreatic cancer, or related cancers such as breast, ovarian, prostate, or melanoma, you may want to consider genetic testing. Inherited changes (mutations) in genes such as BRCA2, BRCA1, PALB2, CDKN2A, and ATM can significantly raise the risk of developing pancreatic cancer. Testing can help you find out whether you carry one of these mutations, offering important information for your future health and your family's.

You might be at higher risk if you have two or more close relatives who have had pancreatic cancer, if someone in your family was diagnosed at a young age (under 50), or if there is a known inherited condition like hereditary breast and ovarian cancer syndrome (HBOC) or Lynch syndrome. People of Ashkenazi Jewish descent are also at increased risk for certain inherited mutations. Research suggests that about 5–10% of pancreatic cancers are linked to inherited genetic changes. Understanding your genetic risk can open the door to earlier monitoring, preventative options, and personalised care plans.

What are the Symptoms?

• Unexplained weight loss
• Persistent pain in the abdomen or back
• Loss of appetite
• Jaundice (yellowing of the skin and eyes)
• Changes in stool (pale or greasy stools)
• New-onset diabetes or worsening existing diabetes
• Fatigue

These symptoms can be caused by many other conditions, but if they are new, persistent, or worsening, it is important to seek medical advice. Early diagnosis can improve treatment options and outcomes.

What are the causes?

Pancreatic cancer can be caused by a combination of factors, including age (most cases occur in people over 65), smoking, obesity, diabetes, and family history. In many cases, no single cause can be identified.

Inherited genetic mutations account for about 5–10% of pancreatic cancers. Mutations in genes such as BRCA2, PALB2, ATM, and others significantly increase the lifetime risk of developing the disease. Genetic testing can identify these inherited risks early, giving you and your healthcare team the information needed to plan regular monitoring and possible preventative measures.

What other tests are available?

There are currently no routine screening programmes for pancreatic cancer in the general population. However, if you are at higher inherited risk, specialised screening may be recommended. This can include imaging tests like MRI scans, endoscopic ultrasounds (EUS), and blood tests for tumour markers such as CA19-9.

If you are concerned about a family history of pancreatic cancer, genetic testing can help identify mutations associated with increased risk. Knowing your genetic status allows for earlier intervention and tailored monitoring to help catch cancer at the earliest, most treatable stage.

How is it treated?

Treatment for pancreatic cancer depends on the size, location, and stage of the tumour. Surgery to remove the tumour is often the preferred option where possible, sometimes combined with chemotherapy and radiotherapy to improve outcomes.

For individuals with inherited genetic mutations, treatment options may also include targeted therapies that specifically exploit weaknesses in cancer cells with certain genetic changes, such as PARP inhibitors for BRCA-related cancers. Your care team will work closely with you to develop a personalised treatment plan, focusing on achieving the best possible outcomes while maintaining quality of life.