Pancreatic cancer is a disease of the pancreas — a gland in the upper abdomen that helps digestion and regulates blood sugar. Early on, pancreatic cancer often causes few or vague symptoms, which is why it can be hard to detect; later signs may include jaundice (yellowing of the skin and eyes), unexplained weight loss, upper abdominal or back pain, nausea, bloating, fatigue, and loss of appetite. Treatment options commonly include surgery, chemotherapy, and radiation, with targeted therapies or clinical trials considered for some people depending on the tumor’s type and stage. Because pancreatic cancers are frequently diagnosed at an advanced stage, timely evaluation of warning signs (for example, new-onset diabetes or sudden, unexplained weight loss with back pain) is important — if you notice these symptoms, contact your doctor to discuss evaluation and possible imaging or referral to a specialist.

What is Pancreatic Cancer?

Pancreatic cancer develops when cells in the pancreas acquire genetic changes and start to grow uncontrollably. The pancreas is a gland tucked behind the stomach in the upper abdomen; it produces enzymes that help digestion and hormones (including insulin) that regulate blood sugar. The most common type — pancreatic ductal adenocarcinoma (PDAC) — arises from the lining of the pancreatic ducts and accounts for the large majority of pancreatic cancers, while neuroendocrine tumors (NETs) arise from hormone-producing cells and behave differently.

Because early pancreatic tumors often cause no clear symptoms, the diagnosis is frequently delayed; many people are diagnosed when the cancer has spread beyond the pancreas. Doctors use a combination of imaging and tissue testing to establish a diagnosis: contrast-enhanced CT with a pancreas protocol is commonly used for initial staging, endoscopic ultrasound (EUS) is valuable for biopsy, and MRI or PET may be used in selected cases. A biopsy — taking a small sample of tissue — confirms cancer cells under the microscope and helps determine the tumor type.

Pancreatic cancer is often aggressive, and treatment options depend on the tumor type, stage, and the person’s overall health. Common treatment approaches include surgery (for resectable tumors), chemotherapy, and radiation; targeted therapies or immunotherapy may be options for certain molecular subtypes or within clinical trials. If you or a loved one is undergoing evaluation, ask your doctor about the tumor type, staging results, and the treatment options that best match your case.

What are the Symptoms of Pancreatic Cancer?

Early pancreatic cancer often causes no clear warning signs, which makes diagnosis difficult. Symptoms typically appear as the tumor grows or obstructs nearby structures; they can be grouped as digestive, systemic, or local signs. Below are common symptoms pancreatic cancer may cause, with short explanations to help you know when to see a doctor.

  • Jaundice — yellowing of the skin and eyes, often with dark urine and pale stools; suggests bile duct blockage (more common with tumors in the head of the pancreas).
  • Upper abdominal pain — discomfort or aching in the upper belly that may radiate to the mid-back; pain can come and go and sometimes worsens after eating.
  • Back pain — persistent mid-back pain can be an early sign when paired with other symptoms.
  • Unexplained weight loss — losing weight without trying is common and may reflect the body’s response to cancer or reduced appetite.
  • Loss of appetite, nausea, bloating, or gas — digestive upset and early fullness are frequent complaints.
  • New-onset diabetes — diabetes that starts suddenly in someone without typical risk factors can sometimes be linked to pancreatic tumors.
  • Itchy skin — itching can accompany jaundice due to bile salts building up under the skin.
  • Blood clots — unexplained clots (for example, in a leg) may be associated with pancreatic cancer in some people.
  • Fatigue and weakness — general tiredness that does not improve with rest.

Neuroendocrine pancreatic cancers (NETs) are less common and may cause different symptoms — for example, diarrhea, flushing, or low blood counts (anemia) — in addition to weight loss and jaundice in some cases.

When to see your doctor: Contact your primary care doctor if you have persistent unexplained weight loss, new-onset diabetes, jaundice, ongoing abdominal or back pain, or any combination of these symptoms. Early evaluation can lead to timely diagnosis and improve options for treatment.

What Causes Pancreatic Cancer?

Researchers are still studying the exact causes of pancreatic cancer, but doctors have identified several risk factors that increase the likelihood a person will develop the disease. Some of these factors are modifiable (things people can change), while others relate to inherited genes or aging. Understanding your personal risk can help guide screening and prevention discussions with your doctor or a genetic counselor.

  • Tobacco smoking — the single most important modifiable risk factor; current and former smokers have a higher risk than non-smokers.
  • Obesity and poor diet — excess body weight is linked to higher risk, and weight management may reduce risk over time.
  • Type 2 diabetes — long-standing or new-onset diabetes is associated with increased risk; in some cases a tumor can cause diabetes.
  • Chronic pancreatitis — long-term inflammation of the pancreas (including hereditary chronic pancreatitis) raises lifetime risk.
  • Family history and inherited gene changes — having close relatives with pancreatic cancer or known hereditary syndromes (for example, BRCA1/2 mutations, Lynch syndrome, or hereditary pancreatitis) increases risk; consider genetic testing if multiple family members are affected or if cancers occurred at a young age.
  • Occupational and environmental exposures — some studies link exposure to certain chemicals (for example, particular pesticides or petrochemicals) to increased risk, but the overall evidence varies by agent.
  • Age — risk rises with older age; most cases occur in people over 60.

If you have a family history of pancreatic cancer or multiple risk factors, talk with your doctor about risk-reduction steps (smoking cessation, healthy weight, diabetes management) and whether referral for genetic counseling or testing is appropriate. Early identification of high-risk people can help guide surveillance and potentially improve outcomes.

What are the Stages of Pancreatic Cancer?

Staging describes how far pancreatic cancer has spread and helps doctors choose the best treatment. Clinicians typically use the TNM system (Tumor size, Node involvement, Metastasis) to assign a stage; in plain terms this maps to stages I–IV based on tumor size, whether nearby lymph nodes are affected, and whether cancer has spread to distant organs.

  • Stage I: Cancer is confined to the pancreas (small tumor). The disease is usually considered potentially resectable — meaning surgery may be an option with curative intent.
  • Stage II: The tumor has grown and may involve nearby tissues or small numbers of lymph nodes but has not invaded major blood vessels or spread to distant organs. Many people at this stage are evaluated for surgery plus additional therapy (adjuvant chemotherapy).
  • Stage III: Cancer involves nearby major blood vessels or more extensive regional lymph nodes, making surgical removal more difficult or unsafe. Treatment often focuses on systemic therapy (chemotherapy) and sometimes radiation to control local disease; in selected cases, neoadjuvant therapy may make surgery possible.
  • Stage IV: Cancer has spread (metastasized) to distant organs such as the liver, lungs, or peritoneum. This is advanced disease and is usually treated with systemic therapies (chemotherapy, targeted therapy when applicable) and palliative measures to manage symptoms.

Key points: staging guides prognosis and treatment choices — Stage I and some Stage II cancers may be curable with surgery plus chemotherapy, while Stage III–IV cancers commonly receive systemic therapy aimed at prolonging life and improving quality of life. Ask your oncology team to explain your TNM details and what they mean for treatment options and expected outcomes.

How is Pancreatic Cancer Diagnosed?

Diagnosing pancreatic cancer can be challenging because the pancreas sits deep in the abdomen and early tumors often cause few clear signs. If your doctor suspects pancreatic cancer based on symptoms, examination, or blood tests, they will usually follow a stepwise diagnostic pathway that combines imaging, targeted tests, and sometimes tissue sampling.

  • Imaging tests — Contrast-enhanced CT scan with a pancreas protocol is commonly the first test to evaluate a suspected pancreatic tumor and to stage the disease. Endoscopic ultrasound (EUS) is very useful for detailed images and for guiding fine-needle biopsy. MRI can help characterize lesions and is an alternative in some patients; PET scans are used selectively (for example, to detect occult metastases or for clinical trial workups).
  • Blood tests and tumor markers — Blood work can assess overall health (liver function, blood counts, glucose/insulin), and tumor markers such as CA 19-9 may be elevated in pancreatic cancer. CA 19-9 is not specific enough to diagnose cancer on its own (it may rise with benign conditions) but is useful for monitoring response to treatment in people already diagnosed.
  • Biopsy and tissue diagnosis — A biopsy (often obtained during EUS) provides tissue to confirm cancer cells and identify the tumor type. Pathology results guide treatment decisions and help determine whether targeted therapies or clinical trials are appropriate.
  • Laparoscopy — In select patients, a minimally invasive laparoscopy may be used to look for small metastases not visible on imaging and to assess whether the tumor can be safely removed. A biopsy can be taken during this procedure if needed.
  • Genetic testing — Blood or saliva tests can detect inherited gene changes (for example, BRCA mutations) that increase cancer risk and may affect treatment choices. Doctors may recommend genetic counseling and testing if there is a strong family history or early-onset disease.

What to expect: The diagnostic process typically requires multiple appointments (blood tests, imaging, and possibly an EUS with biopsy). Talk with your doctor about which tests are appropriate for you, how quickly they can be scheduled, and what the results mean for treatment options. If you have jaundice, new-onset diabetes, or unexplained weight loss, contact your doctor promptly so they can arrange the necessary evaluations and appointments.

How is Pancreatic Cancer Treated?

Treatment for pancreatic cancer is personalized and often combines several approaches. Which treatments are recommended depends on the tumor’s type and stage, whether the cancer is resectable (removable by surgery), and the person’s overall health. Below are the main treatment paths your oncology team may discuss.

Curative-intent treatment (early-stage / resectable)

Surgery is the main potential cure for localized pancreatic cancer. The Whipple procedure (pancreaticoduodenectomy) removes the head of the pancreas and nearby structures and is used when the tumor is in the pancreatic head; distal pancreatectomy removes tumors in the body or tail. Surgery is usually followed by adjuvant chemotherapy to reduce recurrence risk. In some cases, doctors recommend neoadjuvant chemotherapy (treatment before surgery) to shrink the tumor and improve the chance of a complete resection.

Locally advanced or borderline resectable disease

If the tumor involves nearby blood vessels or lymph nodes, a multidisciplinary team may use chemotherapy (often FOLFIRINOX or gemcitabine-based regimens) sometimes combined with radiation to try to control growth and potentially make surgery possible. Decisions about timing and type of treatment are individualized by the treatment team.

Advanced (metastatic) disease

When cancer has spread to distant organs (advanced cancer), systemic therapy is the primary approach. Common chemotherapy regimens include FOLFIRINOX (a combination chemotherapy used in fitter patients) and gemcitabine with or without nab‑paclitaxel. Targeted therapies or immunotherapy may be options for patients whose tumors carry specific genetic changes (for example, BRCA mutations or MSI‑high tumors). Clinical trials can provide access to new cancer treatments and should be discussed with your doctor.

Radiation and palliative care

Radiation therapy can help control local tumor growth, relieve pain, or treat specific symptomatic sites. For many people with advanced disease, palliative care — focused on symptom relief, nutrition, and quality of life — is an essential part of cancer treatment alongside systemic therapy.

Team approach and practical steps

Your care team usually includes surgical, medical and radiation oncologists, gastroenterologists, radiologists, pathologists, and supportive specialists (nutritionists, pain and palliative care, social work). Ask your doctors about treatment options, likely side effects (for example, chemotherapy can affect blood counts, appetite, and energy), and whether genetic testing or clinical trials are appropriate. Consider a second opinion if you have any doubt about the recommended plan.

Example scenarios: a person with a small, resectable tumor may have surgery followed by adjuvant chemotherapy; someone with metastatic disease will often receive systemic chemotherapy to control cancer cells and improve symptoms. Discussing goals of care, potential benefits, and risks with your treatment team helps align therapy with your priorities.

Frequently Asked Questions

  • What are the main types of pancreatic cancer? The most common type is pancreatic ductal adenocarcinoma (often simply called adenocarcinoma), which accounts for the large majority of pancreatic cancers (over 90%). These tumors arise from the lining of the pancreatic ducts. A less common group — pancreatic neuroendocrine tumors (NETs) — originate from hormone-producing cells and often have different symptoms, behavior, and treatment options.
  • How quickly do symptoms develop? Early pancreatic cancer frequently causes no clear symptoms. Some people notice vague signs (loss of appetite, abdominal or back pain, unexplained weight loss) months before diagnosis, while others have minimal warning until the disease is more advanced. Because timing varies, any persistent red-flag symptoms should prompt evaluation.
  • When should I seek urgent care? Seek prompt medical attention if you develop sudden jaundice (yellowing of skin/eyes), severe abdominal pain, sudden new-onset diabetes or rapidly worsening unexplained weight loss. These can be signs that need expedited diagnosis and treatment.
  • What affects prognosis? Prognosis depends mainly on stage at diagnosis (whether the cancer is confined to the pancreas, involves nearby structures, or has spread to distant organs), tumor type, and the person’s overall health. Early-stage, resectable cancers have the best chance for curative treatment with surgery plus additional therapy; advanced cancer is usually treated with systemic therapy to control disease and manage symptoms.
  • When is genetic testing recommended? Genetic testing is often advised when there is a strong family history of pancreatic or related cancers, multiple affected relatives, or early-onset disease. Testing can identify inherited mutations (for example, BRCA) that may influence both risk to relatives and treatment options.

Next steps: If you or a loved one has symptoms suggestive of pancreatic cancer, start with your primary care doctor or a gastroenterologist to arrange appropriate imaging and referrals. Prepare for appointments by noting symptoms, recent weight changes, and family history. Ask about staging, treatment options, clinical trials, and supportive care services — and request timely appointments so evaluation and treatment decisions can proceed without delay.