Pancreatic Cancer

Expert Care and Treatment for Pancreatic and Biliary Cancers

The Pancreas and Biliary Tumor Center includes professionals who have experience with all stages of pancreatic and biliary diseases.

Your care team will collaborate to develop a comprehensive, personalized treatment plan that offers the most advanced therapies and an array of supportive resources. 

Pancreas and Biliary Tumor Center

What Is Pancreatic Cancer?

Pancreatic tumors are sometimes discovered during imaging studies (MRI or a CT scan) performed to investigate the onset of new symptoms or during evaluation for another condition. They may also be identified during screening for families with a known history of pancreatic cancer. 

The pancreas produces fluids that help digest (break down) food and hormones, such as insulin, to help control blood sugar levels. 

  • The digestive fluids are produced by exocrine pancreas cells, and the hormones are produced by endocrine pancreas cells. About 95 percent of pancreatic cancers begin with the exocrine cells, and are called pancreatic ductal adenocarcinoma or other types of carcinomas. 
  • Another type of pancreatic tumor is called a pancreatic endocrine tumor, and these tumors originate from the endocrine cells. Making the distinction between these two kinds of pancreatic cancer is important, as patients with these two tumor types are treated differently. 

Pancreatic cancer is a very complex condition to treat, since symptoms are often not apparent until the cancer has advanced to the point where it has spread beyond the pancreas. It is the fourth leading cause of cancer-related death in the United States. 

But now, more than ever, patients with pancreatic cancer have good reason to be optimistic about their futures. We are at the frontier of promising new therapies to treat this disease. In the past 10 years, our knowledge about pancreatic cancer has increased dramatically, and our treatment approaches have improved. This is partly due to an increased ability to remove tumors surgically, and also due to new chemotherapy programs that are more effective. 

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Incidence 

Nearly 45,000 people in the United States are diagnosed with pancreatic cancer every year. Most people are diagnosed after the age of 55 years, and 71 years is the median age at diagnosis. 

Risk Factors 

Risk factors for pancreatic cancer include: 

  • Pancreatic cysts 
  • Smoking 
  • Long-standing diabetes 
  • Chronic pancreatitis (inflammation of the pancreas, especially in people who smoke) 
  • Age (55+ years) 
  • Obesity 
  • Race (African-Americans are more likely to develop pancreatic cancer than white, Hispanic, or Asian-Americans) 
  • Family history of pancreatic cancer 
  • Genetic factors; one or more inherited genetic mutations, including as part of the following familial cancer syndromes: 
    • Hereditary pancreatitis, multiple endocrine neoplasia type 1 syndrome, hereditary breast-ovarian cancer (HBOC), hereditary nonpolyposis colon cancer (HNPCC; Lynch syndrome), von Hippel-Lindau syndrome, ataxia-telangiectasia, and the familial atypical multiple mole melanoma syndrome (FAMMM). 

Signs and Symptoms 

The majority of symptoms arise because of the tumor's location in the pancreas and the relationship of the pancreas to other organs: 

  • Jaundice (a painless yellowing of the skin and in the whites of the eyes) 
  • Dark yellow urine 
  • Pain in the upper or middle part of the abdomen and back 
  • Unexplained weight loss 
  • Loss of appetite 
  • Vomiting, diarrhea 
  • New development of diabetes 
  • Fatigue 
  • Light-colored stool and general itchiness 

Center for BRCA and Related Genes

Mutations in BRCA1, BRCA2, and BRCA-related genes confer increased risk of certain cancers when inherited. These mutations can also be acquired by the cancers themselves. The Mellen and Eisenson Family Center for BRCA and Related Genes provides comprehensive care for patients with inherited and acquired mutations, including clinical therapeutic trials, trials of risk-reducing strategies, and studies of novel early detection markers.

Genetic Risk Assessment for Pancreatic Cancer 

Our dedicated genetics team has specialized expertise in the evaluation and management of patients with a personal history or family history of pancreatic cancer. In some cases, identifying a genetic syndrome may impact the care of a patient with pancreatic cancer or their family members. 

Genetic screening is available to all of our patients and is particularly important if you have family members who were diagnosed with pancreatic cancer at a young age or have a strong family history of: 

  • Breast or ovarian cancer 
  • Gastrointestinal cancer 
  • Melanoma 
  • Multiple benign colon polyps 
  • Chronic pancreatitis 

In the Center for Cancer Genetics and Prevention, an in-depth risk assessment is performed. The risk assessment includes a detailed family lineage analysis, genetic evaluation using state-of-the-art molecular tests, and tailored cancer screening and prevention recommendations for you and your family members. If we find a genetic syndrome that could contribute to developing pancreatic cancer, we can coordinate a screening regimen. 

Evaluations are provided by the Center for Cancer Genetics and Prevention.  

Why Choose Us

At the Pancreas and Biliary Tumor Center at Dana-Farber Brigham Cancer Center, our team of experts work together to provide compassionate, comprehensive, and highly coordinated care for patients with pancreatic lesions. Our center includes leaders in the field who provide our patients with the highest level of care in state-of-the-art facilities. We also perform leading-edge basic scientific and clinical research, with numerous opportunities for patients to participate in clinical trials and other research studies. 

We provide comprehensive services to patients with these cancers, including:  

  • Advanced diagnostics to understand each patient’s tumor at the molecular level and provide sophisticated therapies tailored to your tumor 
  • Access to an expansive portfolio of clinical trials
  • Home to one of the region’s only pancreatic cyst clinic 
  • The investigators who are translating discoveries into improved patient outcomes at the Hale Family Center for Pancreatic Cancer Research
  • Multidisciplinary care delivered by specialists from Dana-Farber Cancer Institute and Brigham and Women’s Hospital