Pancreatic Cancer

What is pancreatic cancer?

The pancreas lies quite high up in the abdomen, at the bottom of the breastbone, just behind the stomach. It is about six inches long and shaped a bit like a cone or a leaf. The pancreas is a gland that works with the alimentary tract and intestines. It has two functions: firstly it releases digestive juices which flow down the pancreatic duct into the duodenum (the first part of the small intestine) and mix with the food. The juices contain enzymes that help to break down the food into very small fragments. Secondly, it produces several important hormones including insulin. Insulin helps to keep the level of sugar in the blood stable. When a cancer develops in the pancreas it interferes with these normal functions.
Doctors usually call the wide end of the pancreas “the head”, the thin end “the tail” and the bit in the middle “the body”. Most pancreatic cancers are in the head of the pancreas. The head of the pancreas is closest to the small intestine and the bile duct runs from the liver through the head of the pancreas to open out into the small intestine (duodenum). A common presentation of cancer growing in the head of the pancreas is obstructive jaundice, because the tumour blocks the bile duct.
The vast majority of cancers of the pancreas start in the cells which produce the digestive pancreatic juices, called exocrine cells. More than 9 out of 10 (95%) pancreatic cancers are ductal adenocarcinomas (Macmillan Cancer Support 2016). Nearly all of these start in the cells lining the ducts of the pancreas, the tubes that carry the pancreatic digestive juices to the main pancreatic duct and the duodenum. Other types of pancreatic cancer, such as the endocrine cancers (sometimes called neuroendocrine tumours or NET's), cystic tumours and acinar cell carcinomas are much less common. Endocrine tumours, in the pancreas, usually over  produce hormones such as insulin, gastrin and glucagon.
Most of the people we interviewed said that they had no idea which type of pancreatic cancer they had. However, some were sure they had the most common type, an adenocarcinoma, and two people (Vicky -Interviews 15 and Peter - Interview 36) knew that they had had a neuroendocrine tumour.

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Last reviewed September 2018.
Last updated September 2018.


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