One of the biggest hurdles is timing. Most people aren’t diagnosed until the disease has spread to other parts of the body. This can limit treatment options and affect outcomes.

“One of the challenges with pancreatic cancer is that it can be silent early on,” says Yaseen Alkaddoumi, MD, oncologist and hematologist at Northwestern Medicine. “By the time symptoms appear, the disease may already be more advanced. That’s why it’s important to pay attention to persistent or unexplained changes in your body.”

What Is Pancreatic Cancer?

Pancreatic cancer begins when cells in the pancreas grow abnormally and form tumors. The pancreas is a small organ located behind your stomach and in front of your spine. It helps with digestion and keeps your blood sugar in balance.

The most common type is pancreatic adenocarcinoma, which starts in the ducts that carry digestive enzymes. About 90% to 95% of pancreatic cancer diagnoses fall into this category.

Other, less common forms include:

• Pancreatic neuroendocrine tumors
• Adenosquamous carcinoma
• Squamous cell carcinoma

Each type of pancreatic cancer behaves differently, but pancreatic adenocarcinoma is generally the most aggressive.

Why Early Detection Matters

Pancreatic cancer is rarely found in the early stages, which is one reason treatment remains challenging.

When pancreatic cancer is caught early and remains only in the pancreas, the five-year survival rate is about 44%. If it spreads, that number drops to about 3%. Overall, the five-year survival rate is about 13%.

It is important to remember that these numbers don’t tell the whole story. Treatment is improving, and scientists continue to make progress.

Risk Factors for Pancreatic Cancer

While anyone can develop pancreatic cancer, certain risk factors may increase your chances. These include:

• Age (most people are older than 65 when diagnosed)
• Smoking
• Obesity
• Type 2 diabetes
• Chronic pancreatitis (long-term inflammation of the pancreas)
• Family history of pancreatic or related cancers

Genetic mutations also play a role. Variants like BRCA1 and BRCA2, often linked to breast and ovarian cancers, can raise your risk of developing pancreatic cancer.

If you have a strong family history, your care team may recommend genetic counseling or screening.

Recognizing Symptoms

Pancreatic cancer is often called a “silent disease” because symptoms can be subtle at first. They may include:

• Fatigue
• Weight loss
• Loss of appetite
• Abdominal (stomach) or back pain

“Symptoms often depend on where the tumor is located,” says Dr. Alkaddoumi. “Tumors in the head of the pancreas may cause jaundice earlier, while those in the body or tail can go unnoticed longer.”

Tumors in the head of the pancreas

These tumors may press on nearby bile ducts, causing:

• Yellowing of the skin or eyes (jaundice)
• Dark urine
• Light-colored stool

This happens because a tumor blocks the flow of bile, leading to a buildup of bilirubin in the body. Bilirubin is a waste product from the body recycling old blood cells.

Tumors in the body or tail

These may grow quietly for longer but can eventually cause:

• Ongoing abdominal discomfort
• Mid-back pain
• Nausea or digestive issues

In some cases, people without a history of diabetes may suddenly develop Type 2 diabetes. While uncommon, this can be an early signal that should be evaluated by your doctor.

Not all of these symptoms mean cancer. Many of them are common and can be caused by other conditions. Still, it’s a good idea to check in with your doctor if something doesn’t feel right.

How Pancreatic Cancer Is Diagnosed

If symptoms raise concern, your physician may recommend imaging tests, such as a computed tomography (CT) scan or magnetic resonance imaging (MRI). Doctors often need a tiny piece of tissue from the body, called a biopsy, to confirm cancer.

After diagnosis, additional testing determines whether the cancer has spread to other parts of the body. This process, called staging, helps guide pancreatic cancer treatment decisions.

Treatment Options for Pancreatic Cancer

Treatment options depend on the stage, tumor location and overall health. A multidisciplinary team can help determine the right treatment for each person.

“Pancreatic cancer care is complex, which is why a multidisciplinary, team-based approach is important,” says Dr. Alkaddoumi. “It allows for a more coordinated and individualized treatment plan.”

Common approaches include:

Surgery

Surgery often offers the best chance for long-term survival, but it is only possible when the cancer is found early.

Chemotherapy

Chemotherapy uses powerful medications to destroy cancer cells or slow their growth. It is often part of pancreatic cancer treatment, especially for later-stage disease.

Radiation therapy

Radiation therapy uses high-energy beams to target cancer cells. It may be used alongside chemotherapy to shrink tumors or ease symptoms.

Targeted therapies

These advanced treatments focus on specific genetic mutations in tumors, offering a more personalized approach.

A Shift in Treatment

More than 90% of pancreatic cancers have mutations in the KRAS gene, which drives cancer cell growth. For years, KRAS was considered difficult to target with medications, but that is beginning to change.

A targeted therapy called daraxonrasib has shown promise in clinical trials. It works by blocking signals that allow cancer cells to grow.

In a large phase 3 trial, patients with metastatic pancreatic cancer — cancer that has spread to other parts of the body — lived an average of 13.2 months when treated with daraxonrasib, compared with 6.6 months for those who received standard chemotherapy. Patients who received daraxonrasib also experienced fewer severe side effects.

Daraxonrasib is not yet approved by the U.S. Food and Drug Administration specifically for pancreatic cancer. This is known as off-label use, and receiving it as part of treatment depends on your physician’s clinical judgment and your individual situation.

Northwestern Medicine scientists are also advancing therapies. In one clinical trial, medication developed in Northwestern University labs improved one-year survival rates for patients with advanced disease when combined with chemotherapy.

“We’re seeing progress in how pancreatic cancer is treated,” says Dr. Alkaddoumi. “Much of it is driven by clinical trials and a move toward more personalized therapies.”

Why Awareness Matters

Because symptoms can be subtle, it helps to stay aware of changes in your body, especially if you have known risk factors.

Talk with your physician if you notice:

• Ongoing abdominal or back pain
• Unexplained weight loss
• New-onset diabetes
• Yellowing of the skin or eyes

Most people will never develop pancreatic cancer. But knowing what to watch for can help you seek care sooner if something changes.

Moving Forward

Pancreatic cancer remains challenging, but research continues to move care forward. Improved surgical techniques, targeted therapies and clinical trials are expanding options and helping people live longer and with a better quality of life.