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Can Pancreatic Cancer Be Detected Early?

Risk factors, warning signs, and when to see your doctor.

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Dear Doctor,

A friend of mine was losing weight and having digestive problems and back pain for about a month. Last week, he was diagnosed with pancreatic cancer that had already spread to his liver, and they say his prognosis isn’t great. Now I find myself worrying about every stomach cramp. Should I get screened for pancreatic cancer?

“Worried and Wondering”

Dear Worried and Wondering:

Unlike a mammogram for breast cancer or a colonoscopy for colon cancer, we still do not have effective routine screening tests to catch pancreatic cancer in its early stages. Why? The pancreas is located deep within the body, so you can’t feel a lump or see a spot using standard imaging tests. And the pancreas, which produces digestive enzymes and releases hormones like insulin to regulate blood glucose, can often function normally even while cancer is growing. Unfortunately, even after symptoms do appear, they are often confused with other gastrointestinal disorders.

There are certain factors that put some people at higher risk of developing pancreatic cancer. One of the biggest is family history—about one of every 10 people diagnosed with pancreatic cancer has a family history of the disease.

Your risk also increases if you have hereditary pancreatitis, a condition that causes recurrent inflammation of the pancreas, or long-standing diabetes. However, recent studies suggest that a new onset of diabetes in adults who are not obese and have no family history of the disease could be the first manifestation of underlying pancreatic cancer. And people who have had a gastrectomy—surgical removal of the stomach—also have a higher risk of pancreatic cancer, because they no longer produce digestive enzymes that kill cancer cells.

The incidence of pancreatic cancer is higher in African-Americans than in people of Caucasian, Hispanic or Asian heritage, and slightly higher in men than in women. And as with most cancers, the risk of developing pancreatic cancer increases with age.

While you can’t change your age or your family history, there are other lifestyle factors you can address to help reduce your chance of developing pancreatic cancer.

People who smoke cigarettes are twice as likely to develop pancreatic cancer than those who have never smoked. The risk is also greater in people who are heavy drinkers. So staying tobacco-free and drinking alcohol in moderation can significantly reduce your risk of pancreatic cancer. A healthy diet, high in fruits and vegetables and low in red and processed meats, may also help lower your risk.

But I have patients who say, “I don’t drink, I don’t smoke, I eat a healthy diet, and I have no family history. How did I get this disease?” I have to say that I don’t know. Some people who develop pancreatic cancer simply have no known risk factors.

Even if you do not have significant risk factors, there are some signs to watch out for:

  • New-onset diabetes in an otherwise healthy person. If you’re in your 40s or 50s, at a normal weight, and don’t have other risk factors, suddenly developing diabetes can be a sign of pancreatic cancer
  • Yellowing of your skin or the whites of your eyes. This could be jaundice caused by a tumor blocking the bile duct
  • Unexplained weight loss
  • Stomach and digestive issues such as loss of appetite, indigestion, nausea, diarrhea, constipation, and bloating
  • Back pain

Staying vigilant and knowing what to look for can help you identify symptoms so that you can promptly discuss them with your doctor.

“While you can’t change your age or your family history, there are other lifestyle factors you can address to help reduce your chance of developing pancreatic cancer.”

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Published March 26th, 2019
A young woman with dark curly hair is using mobile phone. Female is smiling while holding smart phone. She is lying on sofa at home.

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