The pancreas is a gland approximately 13 cm long that is situated behind the stomach. It lies across the back wall of the abdomen, between the spleen on the left and the first part of the small intestine (called the duodenum) on the right.
Roughly 1% of the gland produces the hormones insulin and glucagon, which regulate the production, storage and uptake of glucose by the body’s tissues. The other 99% of the gland produces pancreatic fluid, which is excreted into the duodenum to aid in the process of digestion. This fluid is made up of digestive enzymes and other substances secreted by a network of small ducts in the pancreas (called acinus) which join larger ducts secreting sodium bicarbonate. This mixture combines to form the digestive fluid of the pancreas, which flows through a central pancreatic duct until it joins the common bile duct from the gallbladder and liver and enters the duodenum.
For descriptive purposes, the pancreas is divided into various parts: the head, the body and the tail. Tumours can grow in any of these areas or diffusely throughout the entire organ. The most common site of pancreatic cancer is in the pancreatic head, which is situated next to the duodenum.
Commonly, the term pancreatic cancer refers to pancreatic adenocarcinoma, which is a cancer of the cells that make up the ducts in the pancreas. Pancreatic adenocarcinoma occurs when these cells grow in an uncontrolled, irregular and prolific manner. As they grow, these mutated cells begin to disrupt the function of the pancreas and also press upon surrounding organs. Like other cancers, pancreatic cancer can spread either by invading areas of the body next to where it started growing (known as the ‘primary’ site), or by spreading through the bloodstream or lymphatic system to other areas distant from the primary tumour. These distant areas of cancer are known as ‘secondaries’ or ‘metastases’ and in pancreatic cancer are often in areas such as the liver, lungs and bones. Because the early symptoms of pancreatic cancer are not overt and there are no effective screening tools to detect the disease at an early stage, often by the time the disease is diagnosed the cancer has already spread (metastasised) and as a result prognosis is extremely poor.
Statistics on Pancreatic Cancer (Adenocarcinoma of the Pancreas)
Cancer is Australia’s leading cause of burden of disease. Although not one of the most common types of cancer in Australia, accounting for only 2.3% of all cancers in 2007, pancreatic cancer is associated with an extremely high mortality rate. It has the fifth highest rate of mortality and accounts for 5.6% of all deaths from cancer. Of those people with pancreatic cancer, 89% will die from the disease.
Men are 1.4 times more times likely to develop pancreatic cancer than women, and a person’s risk of developing pancreatic cancer increases with age. The risk of developing pancreatic adenocarcinoma by age 70 is approximately 0.5% or 1 in 200 people.