By Elsa Pichardo, MD
The rate of pancreatic cancer among younger women, particularly Black women is rising rapidly, according to a nationwide study released earlier this year.
And while the disease remains more common in men, the study shines a light on the need for a better understanding of how it affects women and how lifestyle changes may decrease risk.
There are currently no reliable screening tests for pancreatic cancer and often no definitive signs that someone has the disease.
That is why alerting your doctor to any changes in your health is so important. From diagnosis through recovery, Penn Medicine Princeton Cancer Center at Princeton Medical Center provides a multidisciplinary approach to care for pancreatic cancer. As part of Penn Medicine, the experts at Princeton Cancer Center work with teams at the Abramson Cancer Center, a world leader in cancer research, patient care, and education.
Understanding Pancreatic Cancer
The pancreas, located just behind the stomach, secretes enzymes and hormones that help the body digest food and process sugar.
Pancreatic cancer is a fast-growing cancer that occurs when normal cells in the pancreas mutate and start to grow uncontrollably.
Doctors classify pancreatic cancer into two main types:
- Exocrine cancers arise from exocrine gland cells inside the pancreas. These cells aid the digestion process. Exocrine cancers (mostly adenocarcinoma) make up most pancreatic
cancers. - Pancreatic neuroendocrine tumors (NETs) develop from islet cells within the pancreas. These islet cells make hormones that keep blood sugar levels steady. NETs make up less than 5% of all pancreatic cancers.
- The American Cancer Society estimates that, in 2023, more than 64,000 people will be diagnosed with pancreatic cancer this year, and one out of every 64 Americans may develop the disease in their lifetime.
- Moreover, pancreatic cancer has the highest mortality rate of all major cancers, accounting for 3% of all cancer deaths in the United States.
Why Are Rates Among Women Increasing?
In a recent study published in the medical journal Gastroenterology, investigators found that rates of pancreatic cancer increased among both women and men.
However, unexpectedly, rates among women under the age of 55 rose 2.4% higher than rates among men of the same age, while similar increased rates were observed among older men and women.
Furthermore, rates among young Black women rose 2.23% higher than among young Black men.
Researchers are still trying to understand the cause of the increase, but some suspect it pertains to the type and location of tumors. Rates of pancreatic head adenocarcinoma, an especially aggressive and deadly type of tumor situated at the head of the pancreas, appear to be increasing, the investigators found.
Additionally, some experts believe diet may play an important role. The consumption of processed foods and red meat, combined with younger adults eating fewer leafy green vegetables, could contribute to the increase. Americans are also moving less and being sedentary is believed to lead to increased cancer risk.
Another factor that may contribute to the increase is spending years at an unhealthy weight or being obese.
Other risk factors for pancreatic cancer, include smoking, family history, diabetes, and chronic pancreatitis — a long-term inflammation of the pancreas commonly associated with heavy alcohol use and smoking.
Alert Your Doctor to Symptoms
There often are no clear signs of pancreatic cancer. Typically, by the time pancreatic cancer causes serious symptoms, it has grown large or spread outside of the pancreas. If you experience any of the following symptoms, alert your doctor right away.
- Abdominal or mid-back pain.
- Nausea and vomiting.
- Unexplained weight loss.
- A burning feeling in the stomach.
- Inability to digest fatty foods.
- Jaundice, a yellowing of the eyes and skin.
- Swelling in the gallbladder or liver.
Diagnosis and Treatment
Unlike with some other types of cancer, there is no single diagnostic test that can tell if a patient has pancreatic cancer.
A definitive diagnosis requires a review of a patient’s medical history; a physical exam; a series of imaging scans (such as a CT scan, MRI or ultrasound); blood tests; and a biopsy.
Treatment for pancreatic cancer depends on the stage and location of the cancer as well as the patient’s overall health and personal preferences.
When surgery is recommended, depending on the tumor’s location within the pancreas it may be able to be performed laparoscopically, sometimes robotically, which offers smaller incisions and easier recovery.
If surgery is not an option initially, usually because of the size of the tumor, chemotherapy may reduce the size of the tumor to allow for surgery.
Penn Medicine Princeton Cancer Center at Princeton Medical Center offers a range of surgical options to treat pancreatic cancer, including the Whipple procedure, which is the most common surgical treatment for pancreatic cancer.
The Whipple procedure is a complex surgery to remove tumors on the head of the pancreas, the area next to the small bowel and bile ducts, part of the small intestine, part of the bile duct, the gallbladder, and associated lymph nodes.
Lower Your Risk
According to the American Cancer Society, there are lifestyle steps that everyone can take to lower their risk of developing pancreatic cancer.
Specifically:
- Don’t smoke.
- Eat a healthy diet, which means avoiding processed and red meats and sugary drinks.
- Limit alcohol use.
- Maintain a healthy weight.
- And stay physically active.
It is also important to note that because genetic mutations can increase the risk of cancer, people with a family history of the disease should seek genetic counseling and testing.
To find a physician affiliated with Penn Medicine Princeton Health, call 888.742.7496, or visit princetonhcs.org.
Elsa Pichardo, MD, is board certified in general surgery and is fellowship trained in hepatobiliary and pancreas surgery. She is a member of the Medical Staff at Penn Medicine Princeton Health.