Pancreatic cancer: symptoms, causes, diagnosis and treatment

The NHS says pancreatic cancer may not have any symptoms, or they might be hard to spot. Cancer Research UK says symptoms vary depending on where the cancer is in the pancreas and can be vague, and can be caused by other conditions, but it is important to get them checked by a doctor.

Many of these symptoms are very common and have other causes. Having them does not mean you have pancreatic cancer, but the NHS says it is important to get checked, because if the symptoms are caused by cancer, finding it early may mean it is easier to treat.

The NHS adds that if you have another condition such as irritable bowel syndrome you may get symptoms like these regularly and get used to them, but it is important to be checked by a GP if your symptoms change, get worse or do not feel normal for you.

The NHS says to ask for an urgent GP appointment or get help from NHS 111 if the whites of your eyes or your skin turn yellow, you have been sick for more than 2 days, you have had diarrhoea for more than 7 days, or you have symptoms you are worried about but are not sure where to get help.

It says to see a GP if you have lost a noticeable amount of weight, have other symptoms of pancreatic cancer that get worse or do not get better after 2 weeks, or have a condition that causes digestion symptoms that are not getting better after 2 weeks of your usual treatments.

At the appointment the NHS says the GP may feel your tummy and may ask for a pee sample or blood test. You may get an urgent referral for more tests or to see a hospital specialist if the GP thinks you have symptoms that could be cancer. This does not definitely mean you have cancer.

Cancer Research UK says that a large number of people are diagnosed after they go to A&E feeling unwell, while others see their GP. See your doctor if you notice a change that is not normal for you.

The NHS describes pancreatic cancer as a cancer found anywhere in the pancreas. The pancreas sits in the top part of the tummy, helps you digest food and makes hormones such as insulin. How serious the cancer is depends on where it is in the pancreas, how big it is, whether it has spread and your general health.

Cancer Research UK says pancreatic cancer can develop in the head, body or tail of the pancreas. Most start in the cells that produce digestive juices and are called exocrine tumours, and the most common type is ductal adenocarcinoma.

Cancer Research UK says we do not know what causes most pancreatic cancers, but some factors may increase your risk. Having one or more risk factors does not mean you will definitely get the cancer.

• Getting older: almost half of all new cases are diagnosed in people aged 75 and over, and it is very rare under 40.

• Smoking: more than 15 in 100 cases in the UK are caused by smoking, and the risk for people who stopped smoking 20 years ago is the same as for people who have never smoked.

• Overweight and obesity: more than 10 in 100 cases in the UK are caused by being overweight or obese.

• Family history: the risk is increased with a first degree relative with it, especially two or more or one diagnosed at a younger age.

• Inherited gene changes: BRCA2, PALB2 and, with mixed evidence, BRCA1; also Peutz-Jeghers syndrome, FAMMM and Lynch syndrome.

• Long-term inflammation of the pancreas (chronic pancreatitis), including hereditary pancreatitis.

• Diabetes: Cancer Research UK says a growing pancreatic cancer may cause some cases of diabetes, and that most people with diabetes will not get pancreatic cancer.

• Gallstones.

The NHS says you will need tests and scans if a GP refers you to a specialist, and you may not have all of them. Results can take several weeks; the NHS says not to worry if they take a long time and that you can call the hospital or GP for an update.

If you are told you have pancreatic cancer, specialists use the results of tests and scans to find out the size of the cancer and how far it has spread (the stage). A group of specialists will look after you, including a clinical nurse specialist who will be your main point of contact. Cancer Research UK says there is no national screening programme, although people at high risk may be able to have tests.

The NHS says pancreatic cancer can be difficult to treat. The treatment you have depends on the size and type of cancer, where it is, whether it has spread and your general health. It may include surgery, chemotherapy, radiotherapy and supportive care. Your specialist team will explain the treatments, benefits and side effects and create a plan with you.

The NHS says supportive care can help with problems eating and weight loss, including prescribing enzyme replacement tablets to help you digest food better, relieving pain, tiredness and feeling or being sick. Your care team can advise on changes to your diet to help you digest food.

If the cancer cannot be cured, the NHS says the aim of treatment is to limit the cancer and its symptoms and help you live longer. You will be referred to a palliative care or symptom control team who work with you to manage symptoms and make you more comfortable, and the clinical nurse specialist or palliative care team can help you and your loved ones get support.

Macmillan Cancer Support runs a free helpline, which the NHS lists on its tests and next steps page.

On the NHS the route is usually through a GP, who can arrange an urgent referral if symptoms could be cancer. Diagnosis and treatment are then managed by a specialist hospital team. Cancer Research UK notes that some people are diagnosed after attending A&E.

Private appointments and scans are available for people who want a faster opinion or a second opinion. Treatment for pancreatic cancer is complex and usually coordinated by a specialist multidisciplinary team, so ask who will coordinate your care and how your results will be shared with your GP.