What is pancreatic cancer?

Pancreatic cancer is a malignant tumor of the pancreas. The pancreas is a large glandular organ located behind and below the stomach. It produces hormones, enzymes, and other substances that are vital to digestion.

The pancreas has two main functions: to secrete digestive juices into the intestines and to produce insulin, which helps regulate blood sugar levels.

Pancreatic cancer is a very deadly disease with a five-year survival rate of less than 5%. There are three main types of pancreatic cancer: adenocarcinoma, exocrine cancer and neuroendocrine tumors. About 85% of all pancreatic cancers are adenocarcinomas.

Pancreatic cancer is one of the most deadly forms of cancer because it often comes to light too late for effective treatment. However, early detection increases your chance of survival by as much as 25 percent.

Pancreatic cancer symptoms include:

• Unexplained weight loss
• Jaundice (yellowing of the skin)
• A change in bowel habits such as constipation or diarrhea
• Fatigue (feeling tired all the time)

Is pancreatic cancer hereditary?

Most pancreatic cancers are not inherited. Only a small percentage of people with pancreatic cancer have a family history of the disease.

The risk of developing pancreatic cancer increases with age, and the majority of patients are older than 60. However, it is possible to inherit an increased risk for developing pancreatic cancer at an earlier age.

The most common inherited cause of pancreatic cancer is a mutation in the BRCA1 or BRCA2 genes. These genes normally work to repair damaged DNA and prevent cancer from occurring. When they aren’t working properly, DNA damage can build up over time and lead to cancerous cells developing in the body.

If you have a strong family history of breast or ovarian cancer, talk to your doctor about genetic testing that can identify mutations in these genes that increase your risk for developing breast and ovarian cancer as well as pancreatic cancer.

Which genetic mutations are associated with pancreatic cancer?

The DNA of pancreatic cancer cells contains several genetic mutations that are associated with the disease. These mutations can be inherited or occur as a result of exposure to environmental factors such as cigarette smoke and alcohol consumption.

Pancreatic ductal adenocarcinoma (PDAC) is the most common type of pancreatic cancer. It develops from the ducts that carry digestive enzymes from the pancreas to the intestine. PDAC is diagnosed in about 87 percent of all cases of pancreatic cancer, according to statistics from the American Cancer Society (ACS).

Genetic mutations in the KRAS, BRAF and PIK3CA genes are associated with PDAC. Individuals with these genetic mutations may develop PDAC at a young age, according to the National Cancer Institute (NCI).

What causes pancreatic cancer?

The exact cause of pancreatic cancer is not known. There are many factors that may contribute to developing this disease, including:

• A diet high in fat
• Excessive alcohol consumption
• A family history of pancreatic cancer and other types of cancer (hereditary)
• Smoking cigarettes or chewing tobacco. Smoking can also damage other parts of your body besides your lungs, such as your heart and blood vessels

Are any symptoms specific to hereditary pancreatic cancers?

There are no specific symptoms of hereditary pancreatic cancer. However, people with a family history of pancreatic cancer may have a higher risk of developing this disease.

Symptoms of hereditary pancreatic cancer may include:

• Jaundice (a yellowing of the skin and whites of the eyes)
• Pain in the upper abdomen or back that radiates to your shoulder blades
• Loss of appetite and weight loss
• Dark urine and pale stools
• Fatigue (feeling tired)

Are pancreatic cancers with genetic mutations treated any differently from those without mutations?

A genetic mutation is an alteration in the DNA sequence of a cell that can be passed on to offspring.

In general, genetic mutations are rare in pancreatic cancer. Most pancreatic cancers have no known genetic mutations. Research suggests that only about 5% of all pancreatic cancers have a gene mutation that has been linked to hereditary cancer syndrome.

Some people with pancreatic cancer have a family history of the disease or other risk factors, but these factors alone do not mean that you will get pancreatic cancer. Even if you have one of these risk genes, your chances of developing pancreatic cancer are still very small (about 1%).

Pancreatic cancers with genetic mutations tend to be diagnosed at an earlier stage and may be more likely to respond to treatment than other types of pancreatic cancer.

Are there any clinical trials available for patients with mutation-driven pancreatic cancers?

The answer is yes, and it’s important to understand the difference between mutation-driven cancers and other types of pancreatic cancer.

Pancreatic cancer is the fourth most common cause of cancer death in the United States. It’s estimated that more than 44,000 people will be diagnosed with pancreatic cancer in 2019.

There are several types of pancreatic cancer. The main ones are adenocarcinoma and neuroendocrine tumors (also called islet cell tumors). These two types account for about 95 percent of cases overall.

Mutations in certain genes drive the growth and spread of certain forms of pancreatic cancer. These mutations can be inherited or present at birth or develop later in life due to environmental factors like smoking or obesity.

Some people with these mutations have a higher risk for developing pancreatic cancer at some point during their lives, while others don’t. The good news is that there are clinical trials available for patients with mutation-driven cancers.