What it is?

Pancreatic cancer begins when cells in the pancreas start growing uncontrollably.  Most pancreatic cancers begin in the part of the pancreas that makes digestive juices. These are called exocrine tumors, and the most common type is pancreatic ductal adenocarcinoma (PDAC), accounting for the majority of cases.

  • Exocrine tumors, the most common, include pancreatic ductal adenocarcinoma (PDAC) (~90% of cases), acinar cell carcinoma, cystadenocarcinoma, and several rare forms such as pancreatoblastoma and adenosquamous carcinoma.
  • Neuroendocrine tumors (NETs) make up about 1–2% of cases and arise from hormone-making cells. These can be functional (produce hormones like insulin or gastrin) or non-functional.

Doctors group pancreatic cancer based on how much it has spread:

  • Resectable, meaning it can be removed completely by surgery
  • Borderline resectable, where it’s close to important blood vessels and needs special care to determine if surgery is possible
  • Locally advanced, meaning it cannot be removed by surgery due to involvement with nearby vessels or tissues
  • Metastatic, where the cancer has spread to distant organs
  • Recurrent, if the cancer has come back after treatment (Instituto Nacional do Câncer)

Main symptoms:

Early stages often have no signs. As the cancer grows, you may notice:

  • Yellow skin or eyes (jaundice)
  • Pain in the upper belly or back
  • Weight loss without trying
  • Changes in stool color, dark urine, loss of appetite, bloating or fatigue.

Standard treatment:

  • Surgery, when possible: Whipple procedure, distal pancreatectomy, or total pancreatectomy aim to remove the tumor.
  • Chemotherapy before or after surgery
  • Radiation therapy uses high-energy rays to kill cancer cells; it is used to shrink tumors or relieve symptoms.
  • Targeted drugs uses special drugs that attack specific parts of cancer cells, responsible for the cancer growth or survival; sparing most healthy cells. Mainly used in metastatic cancer.
  • Immunotherapy helps the immune system fight the cancer. Mainly used in metastatic cancer.

Radiotheranostics:

Radiotheranostics is a type of treatment that combines therapy and diagnostics. It uses special radioactive substances that are injected in the patient, finds and destroys the cancer cells.

For pancreatic neuroendocrine tumors (NETs), one approved radiotheranostic option is 177Lu-DOTATATE. This treatment combines a radioactive particle (lutetium-177) with a targeting molecule that seeks out somatostatin receptors, which are often found on NET cells. Once bound, it delivers radiation directly to the cancer, helping shrink tumors and control symptoms while sparing most healthy tissue.

For other types of pancreatic cancer, including pancreatic ductal adenocarcinoma (PDAC), radiotheranostic treatments are not yet standard but are currently being studied in clinical trials. These experimental approaches aim to develop targeted radioactive drugs that can both find and treat cancer cells in the pancreas.

Your doctor can help you understand which treatment is right for you

To know more about: 

Patient associations

Europe: Talk Blue Flanders (BEL), Digestive Cancers Europe (EU), Pancreatic Cancer Europe Network (EU), Selbsthilfegruppe Pankreaskarzinom (AUT), Fondation ARCAD, Aide et Recherche en CAncérologie Digestive (FRA), TEB (pancreatic cancer) (DEU), Der Arbeitskreis der Pankreatektomierten e. V. – AdP (DEU), Nastroviola (pancreatic cancer) (ITA), EuropaColon Latvia (LVA), EuropaColon Slovakia (SVK), Dutch Pancreatic Cancer group (NLD), Living With Hope (LWH) (pancreatic cancer) (NLD), Dutch Pancreas Association (AVKV) (NLD), MDLS (stomach, intestinal and liver disorders) (NLD)

Worldwide: Pancreatic Cancer Action Network, The Lustgarten Foundation, Pancreatica.org, Pancreatic Cancer Action Network (PanCAN), Hope for Stomach Cancer