Pancreatic cancer is not the most common cancer, but it is one of the most serious. Because it often grows silently — without obvious symptoms — it is the fourth leading cause of cancer death in Canada. It affects men and women equally, most often after age 45. This article explains the types, symptoms, and treatment options for pancreatic cancer, so you know what to watch for and when to act.
What Is Pancreatic Cancer?
The pancreas is an organ tucked behind the stomach. It does two important jobs. It makes digestive enzymes that break down food, and it produces hormones like insulin that control blood sugar.
Pancreatic cancer starts when cells in the pancreas grow out of control. Because the pancreas sits deep in the abdomen, tumours can grow for a long time before causing noticeable symptoms. This makes early detection very difficult.
According to Health Canada, catching cancer early gives patients the best chance of successful treatment. Unfortunately, most pancreatic cancer cases are discovered at a late stage.
Types of Pancreatic Cancer
Pancreatic cancer is grouped by which part of the pancreas it affects. There are two main categories: exocrine and endocrine.
Exocrine Pancreatic Cancer
The exocrine part of the pancreas makes digestive enzymes. It makes up about 95% of the pancreas. Therefore, it is no surprise that most pancreatic cancers start here.
About 95% of all pancreatic cancer cases are a type called pancreatic adenocarcinoma. This cancer starts in the cells that line the ducts of the pancreas. It is aggressive and often spreads before it is found.
Other, less common types of exocrine pancreatic cancer include:
Adenosquamous carcinoma
Squamous cell carcinoma
Large cell carcinoma
Acinar cell carcinoma
These rare types behave differently from adenocarcinoma, but they are all serious and require prompt medical attention.
Endocrine Pancreatic Cancer
The endocrine part of the pancreas makes hormones like insulin and glucagon. These go directly into the bloodstream. Cancer that starts in these cells is called pancreatic neuroendocrine tumour (PNET), sometimes called islet cell cancer.
Endocrine tumours are much rarer than exocrine cancers. In many cases, these tumours are actually benign (non-cancerous). However, even benign tumours can cause problems if they produce too many hormones or grow very large.
When endocrine tumours are cancerous, they are named after the hormone their original cells produce:
Insulinoma — from insulin-producing cells
Glucagonoma — from glucagon-producing cells
Somatostatinoma — from somatostatin-producing cells
Gastrinoma — from gastrin-producing cells
VIPoma — from cells that produce vasoactive intestinal peptide
Ampullary Cancer
Ampullary cancer (carcinoma of the ampulla of Vater) develops where the pancreatic duct meets the small intestine. Technically, it is not pancreatic cancer. However, it causes very similar symptoms and is treated in much the same way.
Symptoms of Pancreatic Cancer
One of the biggest challenges with pancreatic cancer is that it rarely causes symptoms in its early stages. By the time symptoms appear, the cancer has often already spread beyond the pancreas.
Symptoms can vary depending on where in the pancreas the tumour is located. For example, cancer in the head of the pancreas tends to cause symptoms earlier than cancer in the body or tail.
Local Symptoms Based on Location
Cancer in the head of the pancreas often causes:
Yellowing of the skin and eyes (jaundice)
Weight loss
Fatty or greasy stools
Abdominal pain (not always present)
Cancer in the body or tail of the pancreas more commonly causes:
Abdominal pain that may radiate to the back
Unexplained weight loss
Digestive Symptoms
Because the pancreas plays a key role in digestion, many patients first notice gut-related symptoms. These are often the first clear signs that something is wrong.
Abdominal pain: More than 80% of people with pancreatic cancer develop abdominal pain as the tumour grows. The pain is often a dull ache in the upper abdomen, and it may also spread to the back.
Bloating: Some people feel full after eating only a small amount, or experience uncomfortable bloating.
Fatty stools (steatorrhoea): When pancreatic cancer reduces the pancreas’s ability to produce digestive enzymes, fat passes through undigested. These stools are oily, pale, foul-smelling, and may float.
Pale stools and dark urine: If the bile duct is blocked by a tumour, stools lose their brown colour and become pale or clay-coloured. Urine may turn dark brown.
General Symptoms
As pancreatic cancer grows and spreads, it affects the whole body. General symptoms can include:
Significant, unexplained weight loss
Fatigue and general feeling of being unwell
Loss of appetite
New-onset diabetes or sudden worsening of existing diabetes
Some people with pancreatic cancer develop diabetes because the tumour damages the insulin-producing cells. However, it is important to note that the vast majority of people newly diagnosed with diabetes do not have pancreatic cancer.
Skin Symptoms
Jaundice is one of the most recognisable signs of pancreatic cancer. When the tumour blocks the common bile duct, bile builds up in the blood. This turns the skin and the whites of the eyes yellow.
Some patients also experience intense itching all over the body. This is also caused by bile components circulating in the blood. It can be very uncomfortable and is often one of the first reasons people seek medical care.
How Is Pancreatic Cancer Diagnosed?
If your doctor suspects pancreatic cancer, they will likely refer you for imaging tests. These may include an ultrasound, CT scan, or MRI. A biopsy — removing a small sample of tissue — is usually needed to confirm the diagnosis.
Blood tests can check for markers like CA 19-9, which is sometimes elevated in pancreatic cancer. However, this test alone is not enough to diagnose the disease. In Canada, your family doctor will coordinate these referrals through your provincial health plan.
For more detailed information on diagnosis and staging, visit the Mayo Clinic’s pancreatic cancer diagnosis guide.
Treatment Options for Pancreatic Cancer
Treatment depends on the type, location, and stage of the cancer, as well as the patient’s overall health. The main treatment options include surgery, chemotherapy, radiation, and targeted therapy.
Surgery
Surgery offers the best chance of a cure, but it is only possible when the cancer has not spread. The most common surgery is the Whipple procedure (pancreaticoduodenectomy), which removes the head of the pancreas along with parts of the stomach, small intestine, and bile duct.
A distal pancreatectomy removes the tail and body of the pancreas. It is used when the cancer is located in those areas. Both surgeries are complex and are performed at major cancer centres across Canada.
Chemotherapy
Chemotherapy uses drugs to kill cancer cells or stop them from growing. It is often used after surgery to reduce the risk of the cancer returning. It is also the main treatment when surgery is not possible.
Common chemotherapy regimens for pancreatic cancer include FOLFIRINOX and gemcitabine-based combinations. Your oncologist will recommend the best option based on your specific case. Chemotherapy is covered under provincial health plans for eligible patients in Canada.
Radiation Therapy
Radiation uses high-energy beams to target and destroy cancer cells. It is sometimes combined with chemotherapy. In some cases, it is used before surgery to shrink a tumour, or after surgery to destroy any remaining cancer cells.
Targeted Therapy and Clinical Trials
Some patients with specific gene mutations — such as BRCA1 or BRCA2 — may benefit from targeted therapy drugs. These drugs attack specific weaknesses in cancer cells. In addition, Canada has active clinical trials for pancreatic cancer. Ask your specialist whether a trial may be right for you.
The World Health Organization’s cancer fact sheet provides a broader global context on cancer treatment advances.
When to See a Doctor
You should speak with your family doctor if you notice any of the following symptoms, especially if they are new, persistent, or getting worse:
Yellowing of the skin or eyes
Unexplained weight loss
Persistent abdominal or back pain
Pale, greasy, or foul-smelling stools
Dark urine
Intense itching with no obvious cause
New onset of diabetes, especially after age 50
If you do not have a family doctor, visit a walk-in clinic or contact your provincial health line (such as Health811 in Ontario or 811 in most other provinces). Do not wait to get these symptoms checked. Early action always gives the best outcome.
Please speak with a qualified healthcare provider before making any medical decisions. This article is for informational purposes only and does not replace professional medical advice.
Frequently Asked Questions About Pancreatic Cancer
What are the first warning signs of pancreatic cancer?
The early stages of pancreatic cancer often cause no symptoms at all. However, some of the first warning signs include yellowing of the skin or eyes (jaundice), unexplained weight loss, and a dull upper abdominal pain that may spread to the back. Because these symptoms can have many causes, it is important to see your family doctor if they persist.
Is pancreatic cancer curable?
Pancreatic cancer can be curable if it is caught at an early stage before it has spread. Surgery, particularly the Whipple procedure, offers the best chance of long-term survival. Unfortunately, most pancreatic cancer cases are diagnosed at an advanced stage, which makes treatment much more difficult.
What causes pancreatic cancer?
The exact cause of pancreatic cancer is not always clear. Known risk factors include smoking, long-term diabetes, obesity, a family history of pancreatic cancer, and certain inherited gene mutations such as BRCA1 and BRCA2. Reducing controllable risk factors — like quitting smoking — can help lower your risk.
How is pancreatic cancer different from other cancers?
Pancreatic cancer is particularly dangerous because it grows silently in the early stages and is rarely detected before it spreads. Unlike some other cancers, there is currently no routine screening test for pancreatic cancer in Canada. This is why it has one of the highest cancer mortality rates despite not being the most common cancer.
Can pancreatic cancer cause diabetes?
Yes, pancreatic cancer can cause diabetes or make existing diabetes worse. This happens because the tumour can damage the insulin-producing cells in the pancreas. However, it is very important to know that the vast majority of people with newly diagnosed diabetes do not have pancreatic cancer.
How is pancreatic cancer treated in Canada?
In Canada, pancreatic cancer treatment is coordinated through provincial cancer programmes and typically includes some combination of surgery, chemotherapy, and radiation therapy. Treatments are covered under provincial health plans for eligible patients. Your family doctor or specialist will refer you to a regional cancer centre for a personalised treatment plan.
Key Takeaways
Pancreatic cancer is the fourth leading cause of cancer death in Canada, despite not being the most common cancer. It affects men and women equally, most often after age 45. About 95% of cases are pancreatic adenocarcinoma, which starts in the exocrine part of the pancreas. Symptoms often do not appear until the cancer is advanced. Jaundice, unexplained weight loss, and abdominal pain are key warning signs. Treatment options include surgery, chemotherapy, radiation, and targeted therapy, depending on the stage and type. Early detection gives the best chance of survival. See your family doctor or visit a walk-in clinic if you have persistent or unexplained symptoms. For more information, explore resources from <a href=“https://www.canada.ca
