What is a Pancreatic Cancer?
The most common type of pancreatic cancer is adenocarcinoma. It is the ninth most common tumour in Spain. However, due to its high fatality rates, it represents the third most common cause of death from cancer. The rapid spread of the tumour, the usually advanced stage of the disease when it is diagnosed, and the lack of effective therapies explain the poor prognosis. The frequency of new cases increases with age, with most diagnosed after the age of 65.
The term ‘cancer’ encompasses a large group of diseases characterised by the development of abnormal cells, which divide and grow uncontrollably. This can happen in any part of the body. Most pancreatic cancers (known as adenocarcinoma) originate in the disordered growth of cells in the pancreatic gland.
The pancreas is located behind the stomach, between the spleen and the duodenum, in line with the first and second lumbar vertebrae and next to the adrenal glands.
The pancreas is composed of two different types of tissues with different functions: the exocrine pancreas (which secretes enzymes into the digestive tract to help break down fats and proteins) and the endocrine pancreas (which secretes glucagon and insulin into the bloodstream to control blood sugar levels).
Pancreatic cancer occurs in the exocrine pancreas in more than 80% of cases. Around 75% of all exocrine pancreas cancers occur in the head or neck of the pancreas. 15% to 20% are found in the body, and 5% to 10% in the tail of the pancreas. From a histological perspective, the most common type of pancreatic cancer is adenocarcinoma. Other types include acinar cell carcinoma and pancreatoblastoma.
Another very rare type of pancreatic tumour known as an neuroendocrine tumour can also appear in the endocrine pancreas. The diagnosis and treatment of this type of tumour is different from the diagnosis and treatment of the exocrine tumours described in this section.
Pancreatic cancer can spread to neighbouring tissues such as the surrounding fat, the duodenum and the mesenteric arteries. It can also spread further, leading to metastasis (the spread of a cancerous focal point to an organ other than the one in which it started), especially to the liver. Treatment usually includes adjuvant chemotherapy in these cases.
Intraductal papillary mucinous neoplasm (IPMN) is a premalignant lesion that accounts for 20%-50% of all cystic neoplasms of the pancreas. It is important to properly characterise the IPMN, as the risk of malignancy determines whether surgical treatment is indicated.
How many people are affected by pancreatic cancer?
Pancreatic cancer is the ninth most common tumour in Spain. However, because of its high lethality, it is the third leading cause of cancer deaths. In Spain, it is estimated that 7,765 new cases will be diagnosed every year. In Europe and the USA, it is the fourth leading cause of cancer death. It is expected to become the second leading cause by 2030. The rapid spread of the tumour, the advanced stage of the disease when it is diagnosed, and the lack of effective therapies explain the poor prognosis.
The frequency of new cases increases with age, with most cases diagnosed after the age of 65. However, in patients with a family history of this type of neoplasm, especially when the tumour develops in the context of a hereditary disease, onset is usually earlier, typically before the age of 50.