Causes and Diagnoses

Causes and Diagnoses of Pancreatic Cancer

The exact cause of pancreatic cancer is unknown, but it can be associated with mutations in DNA, inherited or caused by lifestyle choices. Other factors that can increase your risk of developing pancreatic cancer include:

  • Age: Most pancreatic cancer occurs in people over the age of 55 years
  • Smoking: Heavy cigarette smokers are two or three times more likely than nonsmokers to develop pancreatic cancer
  • Obesity and physical inactivity: Pancreatic cancer is more common in people who are very overweight and in people who don't get much physical activity
  • Diabetes: Pancreatic cancer occurs more often in people who have type 2 diabetes than in those who do not
  • Gender: More men than women are diagnosed with pancreatic cancer
  • Race: African-Americans are more likely than Asians, Hispanics or whites to be diagnosed with pancreatic cancer
  • Family history: The risk for developing pancreatic cancer is higher if a person's mother, father or a sibling had the disease
  • Cirrhosis of the liver: People with cirrhosis have a higher risk of pancreatic cancer
  • Certain dietary habits: People who eat charred, well-done meat on a regular basis has been linked to an increased risk of pancreatic cancer
  • Workplace exposures: Exposure to certain occupational pesticides, dyes and chemicals used in the metal industry may increase the risk of pancreatic cancer
  • Some genetic syndromes: Certain inherited gene mutations, such as in the BRCA2 gene, increase the risk of pancreatic cancer
  • Chronic pancreatitis: Long-term inflammation of the pancreas has been linked with increased risk for pancreatic cancer

There is no sure way to prevent pancreatic cancer, but reducing your risk factors is a good start. To reduce your risk of developing pancreatic cancer:

  • Don't smoke
  • Lower the red and processed meat in your diet
  • Reduce the amount of charred, well-done meats in your diet
  • Eat more fruits and vegetables
  • Avoid too much weight gain
  • Exercise regularly
  • Be safe when handling chemicals

Diagnoses

To diagnose pancreatic cancer, your physician will assess your medical history and perform a physical exam. Additional diagnostic tests may include:

  • Ultrasound: Using high-frequency sound waves to create an image of the internal organs, including the liver, pancreas, spleen and kidneys and to assess blood flow through various vessels. The ultrasound may be done using an external or internal device:
    • Transabdominal ultrasound: The technician places an ultrasound device on the abdomen to create the image of the pancreas
    • Endoscopic ultrasound (EUS): The physician inserts an endoscope, a small, flexible tube with an ultrasound device at the tip, through the mouth and stomach, and into the small intestine. As the physician slowly withdraws the endoscope, images of the pancreas and other organs are made
  • Computed tomography scan (CT scan): This diagnostic imaging procedure uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. CT scans are more detailed than general X-rays
  • Magnetic resonance imaging (MRI): Using a combination of large magnets, radiofrequencies and a computer, an MRI produces detailed images of organs and structures within the body
  • Endoscopic retrograde cholangiopancreatography (ERCP): This procedure combines X-ray and an endoscope, a long, flexible, lighted tube, to diagnose and treat problems in the liver, gallbladder, bile ducts and pancreas. The scope is guided through the patient's mouth and throat, then through the esophagus, stomach and duodenum (first part of the small intestine). The physician can examine the inside of these organs and detect any abnormalities. A tube is then passed through the scope, and a dye is injected that will allow the bile and pancreatic ducts to be seen on an X-ray
  • Percutaneous transhepatic cholangiography (PTC): A needle is put through the skin and into the liver where the dye (contrast) is injected so that the bile duct structures can be seen by X-ray. This test is generally only done if an ERCP cannot be done
  • Pancreas biopsy: A sample of pancreatic tissue is removed, with a needle or during surgery, for examination under a microscope
  • Special blood tests: Blood tests can show whether any jaundice is due to a blockage in the bile duct or to another cause, such as liver disease. If you have been diagnosed with pancreatic cancer, your physician may give you a special blood test, called CA 19-9 to track the activity of pancreatic cancer cells
  • Positron emission tomography (PET): For this test, a radioactive substance, usually bound to a type of sugar, is injected through a vein before the body is scanned. The radioactive sugar collects in cancer cells, which will show up on images. This test is not as specific as CT scanning, and is not used alone to diagnose pancreatic cancer. A PET/CT scan is often done in combination with a CT scan.

Your oncologist may stage your pancreatic cancer using the following diagnostic methods: