What is pancreatic cancer?

Last medical review:

Pancreatic cancer starts in the cells of the pancreas. A cancerous (malignant) tumour is a group of cancer cells that can grow into nearby tissue and destroy it. The tumour can also spread (metastasize) to other parts of the body.

The pancreas is an organ in your abdomen. It is shaped like a slim pear and is about as long as your hand. It is a part of both the digestive system and the endocrine system. Exocrine cells, which make up the part of the pancreas that is a part of the digestive system, release digestive enzymes into the small intestine to help with digestion. Endocrine cells, which make up the part of the pancreas that is a part of the endocrine system, release hormones into the blood to help regulate bodily functions including digestion, blood sugar levels and growth.

Diagram of the digestive system
Diagram of the digestive system

Cells in the pancreas sometimes change and no longer grow or behave normally. These changes may lead to non-cancerous (benign) tumours such as serous cystic neoplasms (SCNs) or pseudocysts.

Changes to the cells of the pancreas can also cause precancerous conditions. This means that the abnormal cells are not yet cancer, but there is a chance that they will become cancer if they aren't treated. The most common precancerous condition of the pancreas is pancreatic intraepithelial neoplasia (PanIN).

But in some cases, changes to pancreatic cells can cause pancreatic cancer. Pancreatic cancer usually starts in exocrine cells called ductal cells, a type of epithelial cell that lines the inside of the pancreatic ducts. This type of cancer is called adenocarcinoma of the pancreas or pancreatic ductal adenocarcinoma.

Rare types of pancreatic cancer can also develop. These include sarcoma or adenosquamous carcinoma of the pancreas.

Another rare type of tumour can start in endocrine cells of the pancreas. These types of tumours are called pancreatic neuroendocrine tumours (pNETs). Depending on how different the cells are from normal cells (called differentiation) and how fast the cells are growing (called grade), pNETs can be classified as precancerous or cancerous. A cancerous pNET is called pancreatic neuroendocrine carcinoma. Find out more about pancreatic neuroendocrine tumours (pNETs).

Other types of cancer can spread to the pancreas, but this is not the same disease as primary pancreatic cancer. Cancer that starts in another part of the body and spreads to the pancreas is called pancreatic metastasis. It is not treated in the same way as primary pancreas cancer.

Expert review and references

  • Winter JM, Brody JR, Abrams RA, Posey JA, Yeo CJ. Cancer of the pancreas. DeVita VT Jr, Lawrence TS, Rosenberg S. eds. DeVita Hellman and Rosenberg's Cancer: Principles and Practice of Oncology. 12th ed. Philadelphia, PA: Wolters Kluwer; 2023: Kindle version, chapter 55, https://read.amazon.ca/?asin=B0BG3DPT4Q&language=en-CA.

The pancreas

The pancreas is a part of the digestive system and the endocrine system. The digestive portion releases enzymes to help in digestion. The endocrine portion releases hormones that control digestion and metabolism.

Cancerous tumours of the pancreas

Pancreatic ductal adenocarcinoma (PDAC) is the most common type of pancreatic tumour. There are also rare types of pancreatic tumours.

Precancerous conditions of the pancreas

Precancerous conditions of the pancreas are changes to cells that make them more likely to develop into cancer.

Non-cancerous tumours of the pancreas

Pancreatic cysts, such as serous cystic neoplasms and pseudocysts, are the most common non-cancerous pancreatic tumours.

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