Pancreatic cancer is one of the most difficult cancers to detect and treat, often diagnosed at advanced stages due to subtle early symptoms and the lack of a routine screening test. During Pancreatic Cancer Awareness Month, learn about its risk factors, warning signs, diagnostic challenges, current and emerging treatments, and how you can help raise awareness and support ongoing research.

What is pancreatic cancer?

Pancreatic cancer originates in the cells of the pancreas, an organ in the abdomen behind the lower part of the stomach. A normally functioning pancreas has two functions: manufacturing digestive enzymes and the production of insulin. Parts of the pancreas include the head, neck, body, and tail.

Pancreatic ductal adenocarcinoma is the most common pancreatic cancer, while pancreatic neuroendocrine tumors (NETs) make up less than 2% of all cases.

Pancreatic cancer is one of the most challenging cancers to prevent, diagnose, and treat. There is no screening test, such as a colonoscopy for colon cancer or mammograms for breast cancer. As a result, it is often diagnosed at a late stage with limited treatment options. In fact, it is estimated that around 80% of pancreatic cancer is diagnosed in the advanced stage, either after it has spread from the pancreas or when surgery is no longer an option. Additionally, early pancreatic cancer often has no symptoms or very vague symptoms. Lack of awareness about these warning signs often leads to late diagnosis.

Worldwide, it is the seventh most common cause of cancer-related deaths, and global trends are now suggesting that pancreatic cancer may become the second leading cause of cancer death in Western nations.

When is Pancreas Cancer Awareness Month?

November is Pancreatic Cancer Awareness Month, and World Pancreatic Cancer Day falls on November 20, 2025, with the theme “Shine a Light: Early Detection Saves Lives.”

What are some risk factors that predispose someone to pancreatic cancer?

While no single risk factor leads to the development of pancreatic cancer, there have been certain patient-specific characteristics that have been identified to confer a higher risk of developing pancreatic cancer. These include:

1. Smoking
2. Heavy alcohol use
3. Obesity
4. Diabetes (Approximately 2-fold increased risk in patients with type 2 diabetes [3])
5. Chronic pancreatitis
6. Cirrhosis
7. Work exposure to chemicals in the dry cleaning and metalworking industries
8. Family history

Symptoms of Pancreatic Cancer and Its Warning Signs

One of the factors that makes pancreatic cancer so challenging to diagnose in early stages is the wide variety of nonspecific symptoms that it presents with. These symptoms could also be attributed to other gastrointestinal causes initially.

The most commonly encountered symptoms in pancreatic cancer include

1. Weight loss
2. Loss of appetite
3. Abdominal pain, typically radiating towards the back
4. Fatigue
5. Change in stool consistency

As growth in the pancreas can obstruct the biliary tract and lead to increased amounts of bile in the body, symptoms of biliary obstruction are also seen. These include :

1. Painless yellowing of skin and eyes (jaundice)
2. Nausea
3. Generalized itching

Other symptoms can include :

1. New onset diabetes (As the pancreas is not functioning effectively to secrete insulin, the deficiency of which leads to diabetes)

How is Pancreatic Cancer Diagnosed?

The most definitive way to diagnose pancreatic cancer is a biopsy via an upper endoscopic ultrasound-fine-needle aspiration (EUS-FNA) of the pancreatic mass. This involves a tube that is passed down the oral cavity, esophagus (feeding tube), ultimately reaching the stomach. Then an ultrasound is used to look into the pancreas and find tissue to biopsy.

Blood tests, such as liver function tests, can be abnormal in pancreatic cancer, and a tumor marker called CA-19-9 can be elevated; however, both of these can be abnormal in other conditions and cannot be used to diagnose pancreatic cancer definitively.

After examination of the biopsy tissue is found to be positive for malignancy, staging is performed through radiographic methods, such as a computed tomography (CT) scan of the abdomen. There may be a specific type of CT, called “pancreatic protocol” CT, performed to assess how the tumor affects blood vessels and to determine if surgery would be a good option.

Following the above steps, pancreatic cancer can be staged into resectable, borderline resectable (generally the most favorable category), locally advanced, and metastatic cancer (with distant spread beyond the pancreas). Due to a lack of effective screening and non-specific symptoms as noted above, it is estimated that only 10-20% of patients with pancreatic cancer have resectable disease at the time of diagnosis.

Standard Treatment Options

If resectable, surgery remains the best option, and two types of surgery are commonly performed:

• Whipple procedure: For tumors in the head of the pancreas
• Distal pancreatectomy: For tumors in the body and tail of the pancreas

Despite surgical resection, many trials have shown that giving chemotherapy after surgery prevents recurrence of the tumor. Sometimes, chemotherapy can be given prior to surgery, especially in patients with borderline resectable cancer. Radiation is also an option used in patients who are not amenable to resection and do not have distant metastases.

Patients with metastatic pancreatic cancer have very low survival rates, which have not changed significantly in several decades.

Emerging Treatment Options for Pancreatic Cancer

While several cancers have mutations that drugs can specifically target, the mutation associated with a large proportion of pancreatic cancer, KRAS, has notably been difficult to combat with targeted drugs. Additionally, immunotherapy is thought to be less effective due to difficulty penetrating the protective microenvironment around the tumor.

New advances include :

1. Manufacturing drugs that can target the KRAS mutation and prevent resistance development
2. Pancreatic cancer vaccines that can boost the immune system to fight early pancreatic tumor cells
3. Profiling pancreatic cancer into different types to help in more effective treatment options
4. Advancing drugs that can fight the tumor microenvironment

How to Contribute to Pancreatic Cancer Awareness Month

1. Understanding the symptoms of pancreatic cancer and spreading awareness can improve detection rates
2. Making healthy food choices, limiting alcohol and smoking, and being aware of family history, if any
3. Celebrate Purple Day (November 20) by visiting workplaces, schools, and local businesses to encourage people to participate in pancreatic cancer awareness
4. Organizing events such as Purple Stride/ Local Awareness Runs
5. A lot of trials are ongoing to find better treatment options for pancreatic cancer. Donations can significantly advance research to enhance patient lives

About Author

Chandra Kakarala, MBBS, is an internal medicine resident interested in hematology/oncology, global health, and medical education. She is passionate about improving cancer detection rates and preventive care.

Works Discussed

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Pant, S. (2025, October 9). 3 recent advances in pancreatic cancer research. MD Anderson Cancer Center. https://www.mdanderson.org/cancerwise/3-recent-advances-in-pancreatic-cancer-research.h00-159780390.html

Stoffel EM, Brand RE, Goggins M. Pancreatic Cancer: Changing Epidemiology and New Approaches to Risk Assessment, Early Detection, and Prevention. Gastroenterology. 2023;164(5):752-765. doi:10.1053/j.gastro.2023.02.012

Govindan R, Morgensztern D, Ghobadi A. The Washington Manual of Oncology. 4th ed. Wolters Kluwer; 2021.

Park W, Chawla A, O'Reilly EM. Pancreatic Cancer: A Review. JAMA. 2021;326(9):851-862. doi:10.1001/jama.2021.13027