Pancreatic cancer can feel confusing and frightening, especially at the time of diagnosis. Many people and families search online and find information that is either too technical or inaccurate. The purpose of this guide is to explain pancreatic cancer in clear, easy-to-understand language without losing medical accuracy — so you can feel informed, supported, and part of your treatment journey.
The pancreas is a long, soft organ that sits deep in the abdomen, behind the stomach. Although hidden, it plays two vital roles:
When healthy pancreatic cells begin growing abnormally and multiply uncontrollably, a tumour forms. When this tumour is cancerous, it can spread to nearby tissue, lymph nodes, and sometimes to distant organs such as the liver or lungs.
Most pancreatic cancers are pancreatic ductal adenocarcinomas (PDAC), meaning they start in the ducts that carry digestive juices.
There is rarely a single cause. Most cases arise from a combination of genetics, age, and environmental or lifestyle factors.
Around 10% of pancreatic cancers are linked to inherited genetic changes passed down in families. Because of this, it’s now recommended that everyone diagnosed with pancreatic cancer undergo genetic testing, even if there’s no family history.
Genes sometimes linked to pancreatic cancer include:
Genetic testing may guide treatment and can also be important for family members.
Early pancreatic cancer may not cause noticeable symptoms. As the tumour grows, signs may include:
Symptoms often develop gradually, which is why many cases are diagnosed later.
Diagnosing pancreatic cancer involves several steps. Your care team may include specialists in radiology, gastroenterology, oncology, pathology and surgery.
These help locate the tumour and check whether it has spread.
These scans also help determine whether surgery is possible.
Sometimes scans need to be combined with endoscopic procedures to obtain tissue or relieve blockages:
A biopsy confirms the diagnosis. This may be:
After diagnosis, tumour samples may be evaluated for:
These results help guide personalised treatment options.
Staging helps determine how advanced the cancer is and guides treatment planning.
Pancreatic cancer is often grouped into:
| Category | Meaning |
|---|---|
| Resectable | Tumour can be removed surgically |
| Borderline resectable | May become operable after treatment |
| Locally advanced/unresectable | Cancer involves major blood vessels and cannot be removed initially |
| Metastatic | Cancer has spread to distant organs such as liver or lungs |
A multidisciplinary team reviews all results to decide the best approach.
Treatment is personalised and depends on cancer stage, patient fitness, tumour biology and preference.
Surgery offers the best chance for long-term control. Common operations include:
Treatment may involve:
Common regimens include modified FOLFIRINOX or gemcitabine-based combinations.
If surgery isn’t possible upfront:
In advanced disease, treatment aims to:
Treatment options include:
If cancer progresses, options may include:
If molecular testing shows certain changes, personalised options may include:
| Tumour Feature | Possible Treatment |
|---|---|
| BRCA or PALB2 mutations | PARP inhibitors |
| MSI-H or mismatch repair deficiency | Immunotherapy |
| HER2 amplification | HER2-directed therapy |
| KRAS G12C mutation | KRAS G12C inhibitors |
| NTRK fusion genes | NTRK inhibitors |
These therapies apply only to selected patients based on test results.
Supportive care (sometimes called palliative care) should begin early, not only at the end of life. It helps manage symptoms and maintain quality of life.
Support can include:
Many patients find that combining active treatment with supportive care allows them to live better with cancer.
