Pancreatic cancer

Pancreatic cancer is a type of cancer that starts as a growth of cells in the pancreas. The pancreas lies behind the lower part of the stomach. It makes enzymes that help digest food. It also makes hormones that help manage blood sugar.

The most common type of pancreatic cancer is pancreatic ductal adenocarcinoma. This type of cancer starts in the cells that line the ducts that carry digestive enzymes out of the pancreas.

Another, much less common type of pancreatic cancer starts in the hormone-making cells of the pancreas. These cancers are called pancreatic neuroendocrine tumors. They make up only a small share of cancers that start in the pancreas.

Pancreatic cancer rarely is found in its early stages when the chance of curing it is greatest. That's because pancreatic cancer often doesn't cause symptoms until after it has spread to other organs.

Treatment for pancreatic cancer is based on the cancer's stage and whether it has spread outside the pancreas. Treatment may include surgery, chemotherapy, radiation therapy, immunotherapy, targeted therapy or a mix of those options.

Pancreatitis is inflammation of the pancreas. It is a different condition from pancreatic cancer. But long-lasting pancreatitis, called chronic pancreatitis, can raise the risk of pancreatic cancer.

Pancreatic cancer often doesn't cause symptoms until the disease is advanced. When signs and symptoms occur, they may include:

• Belly pain that spreads to the sides or back.
• Weight loss.
• Yellowing of the skin and the whites of the eyes, called jaundice.
• Tiredness or weakness.
• Loss of appetite.
• Dark urine.
• Nausea.
• Light-colored or floating stools.
• New diagnosis of diabetes or diabetes that's getting harder to manage.
• Pain and swelling in an arm or a leg, which might be caused by a blood clot.
• Itching.

When pancreatic cancer spreads

Pancreatic cancer can spread to other parts of the body. It most often spreads to the liver, the lungs and the tissue that lines the inside of the belly. Less often, it spreads to the bones.

When pancreatic cancer has spread, fluid may build up in the belly. This is called ascites.

When to see a doctor

Make an appointment with a healthcare professional if you have symptoms that worry you.

It's not clear what causes pancreatic cancer. There are some things that might raise the risk of this type of cancer. They include smoking and having a family history of pancreatic cancer.

Understanding the pancreas

The pancreas is about 6 inches, which is about 15 centimeters (cm), long and looks something like a pear lying on its side. It makes hormones, including insulin. These hormones help the body process the sugar in the foods you eat. The pancreas also makes digestive juices to help the body digest food.

How pancreatic cancer forms

Pancreatic cancer happens when cells in the pancreas get changes in their DNA. A cell's DNA holds the instructions that tell a cell what to do. In healthy cells, the instructions tell the cells to grow and multiply at a set rate. The cells die at a set time. In cancer cells, the DNA changes give different instructions. The changes tell the cancer cells to make many more cells quickly. Cancer cells can keep living when healthy cells would die. As a result, too many cells build up.

The cancer cells might form a clump of cells called a tumor. The tumor can grow to invade and destroy healthy body tissue. In time, cancer cells can break away and spread to other parts of the body.

Most pancreatic cancer begins in the cells that line the ducts of the pancreas. This type of cancer is called pancreatic ductal adenocarcinoma or pancreatic exocrine cancer. Less often, cancer can form in the hormone-making cells of the pancreas, called neuroendocrine cells. These cancers are called pancreatic neuroendocrine tumors or pancreatic endocrine cancer.

The risk of pancreatic cancer may go up due to:

• Smoking.
• Type 2 diabetes.
• Swelling of the pancreas that lasts over time, called pancreatitis.
• Family history of DNA changes that can raise cancer risk. These include changes in the BRCA2 gene, Lynch syndrome and familial atypical multiple mole melanoma syndrome.
• Family history of pancreatic cancer.
• Obesity.
• Older age. Most people with pancreatic cancer are 65 or older.
• Drinking a lot of alcohol.

As pancreatic cancer gets worse, it can cause a number of health concerns called complications.

Weight loss

People with pancreatic cancer might lose weight as the cancer uses more of the body's energy. Nausea and vomiting caused by cancer treatment or cancer pressing on the stomach might make it hard to eat. Sometimes the body has trouble getting nutrients from food because the pancreas isn't making enough digestive juices.

Jaundice

Pancreatic cancer that blocks the liver's bile duct can cause jaundice. Symptoms of jaundice include yellowing of the skin and the whites of the eyes. Jaundice can cause dark-colored urine and pale-colored stools. Jaundice often happens without belly pain.

If the bile duct is blocked, a plastic or metal tube called a stent can be put inside it. The stent helps hold the bile duct open. This is done using a procedure called endoscopic retrograde cholangiopancreatography (ERCP).

During ERCP, a healthcare professional puts a long tube with a tiny camera, called an endoscope, down the throat. The tube goes through the stomach and into the upper part of the small intestine. Then, through a small tube that fits through the endoscope, contrast material is put into the pancreatic ducts and bile ducts. The contrast material helps the ducts show up on X-ray images. Those images are used to place a stent at the right spot in the duct to help hold it open.

Screening tests

Routine screening for pancreatic cancer isn't recommended for adults without symptoms who aren't at high risk. Also, there are no accurate, validated blood tests for screening the general population for pancreatic cancer.

Screening may be an option for people at high risk of pancreatic cancer. These include some people with a strong family history of pancreatic cancer or an inherited DNA change that raises cancer risk.

Screening may include imaging tests such as MRI and endoscopic ultrasound. These tests often are repeated at regular intervals. The goal is to find pancreatic cancer or concerning changes when they are small and may be easier to treat.

Screening also has possible harms. For example, a test may find a change that leads to more testing or surgery but later turns out not to be cancer. Talk with your healthcare team about the possible benefits and risks of screening and whether it may be right for you.

Genetic testing for cancer risk

If you have a family history of pancreatic cancer, talk about it with a healthcare professional. The health professional can review your family history and help you understand whether genetic testing might be right for you.

Genetic testing can find DNA changes that can be passed down in families and raise the risk of cancer. If you're interested in genetic testing, you might be referred to a genetic counselor or another healthcare professional trained in genetics.

Ways to lower risk

You might lower your risk of pancreatic cancer if you:

• Stop smoking. If you smoke, talk with a member of your healthcare team about ways to help you stop. These might include support groups, medicines and nicotine replacement therapy.
• Stay at a healthy weight. If you are at a healthy weight, try to stay there. If you need to lose weight, aim for a slow, steady weight loss of 1 to 2 pounds (0.5 to 1 kilogram) a week. To help you lose weight, exercise most days of the week. Slowly increase how long you exercise over time. Choose a diet rich in vegetables, fruit and whole grains in smaller portions.

To diagnose pancreatic cancer, a healthcare professional may ask you about your symptoms and do an exam. The healthcare professional may use imaging tests to make pictures of the pancreas to look for anything concerning. Other tests might include blood tests, genetic tests and removing some tissue for testing.

Imaging tests

Imaging tests take pictures that show the inside of the body. Imaging tests used to diagnose pancreatic cancer include ultrasound, CT scans and MRI scans. Sometimes, you may have positron emission tomography (PET) scans.

Treatment for pancreatic cancer depends on the stage of the cancer and its location. The healthcare team also considers a person's overall health and preferences when making a treatment plan. For most people, the first step is to start treatment. If that isn't possible, the focus may be on improving quality of life and keeping the cancer from growing or causing more harm or symptoms.

Pancreatic cancer treatments may include surgery, radiation, chemotherapy, immunotherapy, targeted therapy or a mix of those options. If the cancer is advanced, treatment may help slow the growth of the cancer and ease symptoms.

Surgery

Surgery is the only potential cure for pancreatic cancer. But it's not an option for everyone, and the cancer often comes back after surgery. Surgery might be used to treat cancer that hasn't spread to other organs. Surgery may be possible depending on how much the cancer affects nearby blood vessels. Treatment may start with chemotherapy, sometimes combined with radiation therapy. After treatment, surgery may be possible for some people.

Surgeries used to treat pancreatic cancer include:

• Surgery for cancers in the pancreatic head. The Whipple procedure, also called pancreaticoduodenectomy, is surgery to remove the head of the pancreas. It also involves removing the first part of the small intestine and the bile duct. Sometimes the surgeon removes part of the stomach and nearby lymph nodes. Then the remaining organs are joined together to allow food to move through the digestive system.
• Surgery for cancers in the body and tail of the pancreas. Surgery to remove the body and tail of the pancreas is called distal pancreatectomy. With this procedure, the surgeon also might need to remove the spleen.
• Surgery to remove the whole pancreas. This is called total pancreatectomy. If you have this surgery, you take medicine for the rest of your life to replace the hormones and enzymes that the pancreas makes.
• Surgery for cancers that affect nearby blood vessels. When cancer in the pancreas grows into nearby blood vessels, a more complex procedure might be needed. It may involve taking out and rebuilding parts of the blood vessels and other organs. These complex operations should be done at centers with a lot of experience in pancreatic and blood vessel surgery.

Each of these surgeries carries the risk of bleeding and infection. After surgery, some people have nausea and vomiting if the stomach has trouble emptying. This condition is called delayed gastric emptying. The recovery time is long for all of these surgeries. You'll likely spend several days in the hospital and then recover for several weeks at home.

Research shows that pancreatic cancer surgery tends to have fewer complications when done by highly experienced surgeons at centers that do many of these surgeries. Ask about your surgeon's and hospital's experience with pancreatic cancer surgery. If you have any doubts, get a second opinion.

Chemotherapy

Chemotherapy uses strong medicines to kill cancer cells. Treatment might involve one chemotherapy medicine or a mix of them. Most chemotherapy medicines are given through a vein. But some are taken in pill form.

Chemotherapy often is the first treatment when surgery cannot be done right away. Radiation therapy sometimes is given with chemotherapy. These treatments can shrink the cancer enough to make surgery possible. This approach usually is offered at centers with a lot of experience treating pancreatic cancer.

Chemotherapy often is used after surgery to kill any cancer cells that might be left behind.

When the cancer is advanced and has spread to other parts of the body, chemotherapy can help manage it. Chemotherapy might help ease symptoms, such as pain.

Radiation therapy

Radiation therapy uses powerful energy beams to kill cancer cells. The energy can come from X-rays, protons or other sources. During radiation therapy, you lie on a table while a machine moves around you. The machine directs radiation to precise points on your body.

Radiation therapy may be used before surgery, after surgery or when surgery isn't possible. When you can't have surgery right away, chemotherapy usually is the first treatment. You may have radiation therapy after chemotherapy, or sometimes with chemotherapy, to help control the cancer or make surgery possible.

When the cancer has spread to other parts of the body, radiation therapy can help ease symptoms, such as pain.

Immunotherapy

Immunotherapy is a treatment with medicine that helps the body's immune system kill cancer cells. The immune system fights off diseases by attacking germs and other cells that shouldn't be in the body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the immune system cells find and kill the cancer cells. Immunotherapy might be an option when the pancreatic cancer has specific DNA changes that make the cancer likely to respond to these treatments. A healthcare professional can determine whether immunotherapy is right for you.

Targeted therapy

Targeted therapy uses medicines that attack specific features of cancer cells. In August 2026, the U.S. Food and Drug Administration (FDA) approved daraxonrasib (Rasonque) for adults with pancreatic adenocarcinoma that has spread to other parts of the body. It may be used after at least one treatment with medicines that travel throughout the body. It also may be an option for people who can't receive a combination of cancer medicines. Daraxonrasib blocks RAS proteins that can help cancer cells grow.

Daraxonrasib is taken as a pill. A healthcare professional can determine whether it may be an option for you.

Clinical trials

Clinical trials are studies of new therapies. These studies offer a chance to try the latest treatments. The risk of side effects might not be known. Ask your healthcare professional whether you may be able to join a clinical trial.

Palliative care

Palliative care is a special type of healthcare that helps people with a serious illness feel better. If you have cancer, palliative care can help ease pain and other symptoms. The palliative care team may include doctors, nurses and other specially trained professionals. The team's goal is to improve quality of life.

Palliative care specialists work with you and your care team to help you feel better. They provide an extra layer of support while you have cancer treatment. You can have palliative care while you get cancer treatments, such as surgery, chemotherapy or radiation therapy.

When palliative care is used along with other treatments, people with cancer may feel better and have an easier time managing symptoms.

Alternative therapies shouldn't replace medical treatments for pancreatic cancer. But some integrative medicine therapies may be used along with medical treatments to help manage symptoms or side effects.

Treatments to help you cope with distress

People with cancer often have distress. Distress might feel like worry, anxiety, anger or sadness. If you have these feelings, you may find it hard to sleep. You might think about your cancer all the time.

Talk about your feelings with a member of your healthcare team. Specialists can help you sort through your feelings. They can help you find ways to cope. Sometimes medicines may help.

Some therapies that also may help you cope with your feelings include:

• Art therapy.
• Exercise.
• Meditation.
• Music therapy.
• Relaxation exercises.
• Spirituality.

Talk with a member of your healthcare team if you'd like to try some of these options.

Learning that you have pancreatic cancer may feel stressful and overwhelming. To cope with these feelings, you may find some of the following suggestions helpful:

• Learn about your cancer. Learn enough about your cancer to help you make decisions about your care. Ask a member of your healthcare team about the details of your cancer and your treatment options. Ask about trusted sources of more information.

  If you're doing your own research, good places to start are the American Cancer Society and the Pancreatic Cancer Action Network.

• Find someone to talk with. Although friends and family might be a good source of support, sometimes they may find it hard to cope with your diagnosis. It might help to talk with a therapist, a counselor, a medical social worker, or a pastoral or spiritual counselor. Ask a member of your healthcare team for a referral.
• Connect with other people with cancer. You may find comfort in talking with other people living with cancer. To find cancer support groups in your area, ask a member of your healthcare team or contact your local chapter of the American Cancer Society. Find support online through Mayo Clinic Connect, a community where you can connect with others for support, practical information and answers to everyday questions.
• Consider hospice. Hospice care provides comfort and support to people at the end of life. Nurses, social workers and trained volunteers provide care and comfort in a person's home or in a hospice setting. Hospice care also offers emotional, social and spiritual support.

Start by seeing a healthcare professional if you have any symptoms that worry you. If your health professional thinks you may have pancreatic cancer, you might then be referred to:

• A gastroenterologist. This is a doctor who diagnoses and treats digestive conditions.
• An oncologist. This is a doctor who treats cancer.
• A radiation oncologist. This is a doctor who uses radiation to treat cancer.
• A surgical oncologist. This is a surgeon who specializes in surgery to remove cancer.

What you can do

When you make the appointment, ask if there's anything you need to do before your appointment, such as not eating or drinking for a certain amount of time. Make a list of:

• Your symptoms, including any that don't seem related to the reason for your appointment.
• Key personal information, including major stresses, recent life changes and family medical history.
• All medicines, vitamins and other supplements you take, including the doses.
• Questions to ask your healthcare professional.

Take a family member, friend or another trusted person with you, if possible, to help you remember the information you get.

For pancreatic cancer, basic questions to ask your healthcare professional include:

• Do I have pancreatic cancer?
• What is the stage of my cancer and has it spread?
• Will I need more tests?
• Can my cancer be cured?
• What are my treatment options?
• Can any treatment help me live longer?
• What are the potential risks of each treatment?
• Is there one treatment you think is best for me?
• What is your experience with pancreatic cancer diagnosis and treatment? How many surgeries for this type of cancer does this medical center do each year?
• What can be done to help ease my symptoms?
• What clinical trials are available for pancreatic cancer? Can I take part in any of them?
• Do you have brochures or other printed material that I can take? What websites do you recommend?

What to expect from your doctor

Your healthcare professional is likely to ask you questions, such as:

• When did your symptoms start?
• Are your symptoms always present, or do they come and go?
• What, if anything, makes your symptoms better?
• What, if anything, makes your symptoms worse?