Carl R. Darnall Army Medical Center - Health Library

Cancer InDepth: Pancreatic Cancer

Cancer is a disease in which cells grow in an abnormal way. Normally, the cells divide in a controlled manner. If cells keep dividing when new cells are not needed, a tumor forms.

A tumor can be benign or malignant. A benign tumor is not cancer. It will not spread to other parts of the body. A malignant tumor is cancer. Cancer cells spread and cause damage around them. They can also enter the lymph and blood streams. This makes it easier to spread cancer to other parts of the body.

Cancer Cell Growth
Cancer Cell Growth

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Normal Anatomy and the Development of Pancreatic Cancer

The pancreas sits behind and to the right of the stomach. It's near the liver, gallbladder, and intestines. The pancreas is part of the digestive system. It plays a central role in breaking down food so it can be used by the body for energy.

There are 3 parts:

  • Head—on the right side, closest to the first part of the small intestine
  • Body—in the middle, located behind the stomach
  • Tail—on the left side, closest to the spleen

The Pancreas
The Pancreas

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The pancreas is made up of 2 types of cells. These are the endocrine and exocrine. The endocrine, or islet cells, make many hormones. Hormones enter the bloodstream and travel throughout the body. They help control many functions, and balance how the body works. The pancreas makes insulin. Insulin breaks down and uses or stores sugars from food.

The exocrine cells make digestive juices. These juices help break down food in the small intestine. They travel from the pancreas through a system of ducts. These digestive juices help break down fat, protein, and carbohydrates in food.

Tumors can cause blocks. If digestive juices or insulin are blocked, you may not get enough nutrition even when eating as you should. If the tumor grows beyond the pancreas, the cancer can pass into nearby structures. The cancer can interfere with how they work as well. The cancer can also spread to lymph nodes or blood vessels. When it does, it spreads to other parts of the body. The most common sites are the lining of the belly, liver, and lungs.

Types of Pancreatic Cancer

There are many types of pancreatic cancer. They're based the cell type and where the cancer starts. The types are:

  • Ductal adenocarcinoma—Starts and grows in the ducts that pass digestive juices. This type makes up nearly all pancreatic cancers.
  • Acinar cell carcinoma—Arise from the exocrine cells that make pancreatic enzymes for digestion. There are other, more rare types of exocrine cancers. They are named for where they start and how they look when tested in a lab:
    • Adenosquamous carcinoma
    • Squamous cell carcinoma
    • Signet ring cell carcinoma
    • Undifferentiated carcinoma with or without giant cells
  • Pancreatic neuroendocrine tumors (PanNET)—Come from the islet cells. These can also be benign, but it is often hard to know. Sometimes, cancer can't be diagnosed until the tumor spreads from the original site. There are different types of PanNets:
    • Functioning—Make up half of PanNet tumors. They make hormones and can be found in the digestive tract. They are named for hormone that is produced by the tumor cells such as gastrinoma (stomach) or insulinoma (pancreas).
    • Non-functioning—Tumors don't cause symptoms because they don't make enough excess hormones. As a result, they may not be found until they grow to a large size.
  • Ampullary—Starts the part of the bile duct where it empties into the small intestine. For the most part, it's found earlier than other types.

This fact sheet is about ductal adenocarcinoma.

REFERENCES:

General information about pancreatic cancer. National Cancer Institute website. Available at: https://www.cancer.gov/types/pancreatic/patient/pancreatic-treatment-pdq. Updated May 23, 2018. Accessed October 23, 2018.

Pancreatic cancer. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114527/Pancreatic-cancer. Updated August 31, 2018. Accessed October 23, 2018.

Pancreatic cancer. EBSCO Nursing Reference Center website. Available at: https://www.ebscohost.com/nursing/products/nursing-reference-center. Updated July 6, 2018. Accessed October 23, 2018.

Pancreatic cancer. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/gastrointestinal-disorders/tumors-of-the-gi-tract/pancreatic-cancer. Updated October 2017. Accessed October 23, 2018.

What is pancreatic cancer? American Cancer Society website. Available at: https://www.cancer.org/cancer/pancreatic-cancer/about/what-is-pancreatic-cancer.html. Updated May 31, 2016. Accessed October 23, 2018.

Last reviewed September 2018 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP  Last Updated: 10/23/2018