What is pancreatic cancer?

Pancreatic cancer is an aggressive cancer of the pancreas — often diagnosed late because early symptoms are vague. Red flags include jaundice (yellow skin and eyes), unexplained weight loss, new-onset diabetes in over 50s, pale stools and dark urine, upper tummy pain going through to back, and indigestion not responding to treatment. Only about 10% are suitable for curative surgery. See a GP urgently for jaundice or significant unexplained weight loss — 2-week wait referral. Smoking and chronic pancreatitis increase risk.

What are the early symptoms of pancreatic cancer?

Often none or non-specific — indigestion, appetite loss, fatigue. As tumour grows — weight loss, upper abdominal pain radiating to back, jaundice if bile duct blocked, pale stools, dark urine, new diabetes, deep vein thrombosis without clear cause. Symptoms overlap many benign conditions — persistent or progressive features need scanning.

How is pancreatic cancer diagnosed?

CT pancreas protocol first — identifies mass and staging. MRI or EUS (endoscopic ultrasound) for detail and biopsy. ERCP with stent if jaundiced. CA19-9 tumour marker — not diagnostic alone. Laparoscopy in selected cases before major surgery. Staging determines resectability — only 10–15% resectable at diagnosis.

Can pancreatic cancer be cured?

Surgical resection (Whipple procedure or distal pancreatectomy) offers only curative option — for localised tumours without major vessel involvement or distant spread. Adjuvant chemotherapy (FOLFIRINOX or gemcitabine/capecitabine) after surgery improves survival. Most patients present too late for surgery — palliative chemo extends life and controls symptoms.

What causes pancreatic cancer?

Smoking — strongest modifiable risk — doubles risk. Chronic pancreatitis, obesity, diabetes, family history (BRCA2, Lynch syndrome, Peutz-Jeghers), heavy alcohol. Most cases sporadic without clear cause. Age — peak 65–79.

What is the Whipple procedure?

Pancreaticoduodenectomy — removes head of pancreas, duodenum, part of bile duct and stomach, gallbladder — reconnects bowel. Major operation — 2-week hospital stay, lifelong pancreatic enzyme supplements and often diabetes afterward. Mortality under 5% in high-volume centres.

Pancreatic cancer: Symptoms & Treatment

Pancreatic cancer — why early diagnosis matters

Pancreatic cancer is one of the deadliest common cancers — ~10,500 UK cases/year — 5-year survival under 10% overall because most present with advanced disease.

Pancreatic ductal adenocarcinoma (PDAC) — 90% of cases

Symptoms — when to investigate

High suspicion:

Painless jaundice — pale stools, dark urine, itching
Unexplained weight loss
Upper abdominal pain → back — worse supine
New diabetes + weight loss over 50
Thrombosis — migratory superficial thrombophlebitis (Trousseau sign)

Non-specific (still investigate if persistent):

Indigestion not responding to PPI
Appetite loss
Fatigue

See jaundice symptom guide — not always alcohol or hepatitis

Diagnosis pathway

Urgent CT pancreas — dual phase
Tumour markers — CA19-9 — Lewis antigen negative patients may not express
EUS + FNA biopsy — tissue confirmation
Staging — CT chest/abdomen/pelvis — laparoscopy if borderline resectable

Resectability categories:

Resectable
Borderline — neoadjuvant chemo first
Locally advanced — unresectable
Metastatic

Treatment

Surgery (curative intent):

Whipple (pancreaticoduodenectomy) — head tumours
Distal pancreatectomy — body/tail
High-volume centre — outcomes differ

Chemotherapy:

Adjuvant post-surgery — FOLFIRINOX fit patients
Metastatic — FOLFIRINOX or gem/nab-paclitaxel
Palliative — symptom control, modest survival gain

Supportive:

Biliary stent — ERCP — relieves jaundice
Pancreatic enzymes — steatorrhoea
Pain team — coeliac plexus block

Risk reduction

Stop smoking
Healthy weight
Limit alcohol — chronic pancreatitis risk

Screening only in high-risk families — BRCA, Lynch, FAMMM — specialist programmes

After diagnosis

Pancreatic Cancer UK support line

Clinical nurse specialist

Advance care planning — realistic hope with aggressive treatment where appropriate

Jaundice + weight loss — GP same week — not wait for painless to mean harmless.

Common questions about pancreatic cancer

What are the early symptoms of pancreatic cancer?: Often none or non-specific — indigestion, appetite loss, fatigue. As tumour grows — weight loss, upper abdominal pain radiating to back, jaundice if bile duct blocked, pale stools, dark urine, new diabetes, deep vein thrombosis without clear cause. Symptoms overlap many benign conditions — persistent or progressive features need scanning.
How is pancreatic cancer diagnosed?: CT pancreas protocol first — identifies mass and staging. MRI or EUS (endoscopic ultrasound) for detail and biopsy. ERCP with stent if jaundiced. CA19-9 tumour marker — not diagnostic alone. Laparoscopy in selected cases before major surgery. Staging determines resectability — only 10–15% resectable at diagnosis.
Can pancreatic cancer be cured?: Surgical resection (Whipple procedure or distal pancreatectomy) offers only curative option — for localised tumours without major vessel involvement or distant spread. Adjuvant chemotherapy (FOLFIRINOX or gemcitabine/capecitabine) after surgery improves survival. Most patients present too late for surgery — palliative chemo extends life and controls symptoms.
What causes pancreatic cancer?: Smoking — strongest modifiable risk — doubles risk. Chronic pancreatitis, obesity, diabetes, family history (BRCA2, Lynch syndrome, Peutz-Jeghers), heavy alcohol. Most cases sporadic without clear cause. Age — peak 65–79.
What is the Whipple procedure?: Pancreaticoduodenectomy — removes head of pancreas, duodenum, part of bile duct and stomach, gallbladder — reconnects bowel. Major operation — 2-week hospital stay, lifelong pancreatic enzyme supplements and often diabetes afterward. Mortality under 5% in high-volume centres.

Sources

How we reviewed this page

Medically reviewed by the HealthAnswers UK doctor review panel

First published: 14 June 2026
Medically reviewed: 3 July 2026
Next review due: 3 July 2029 or sooner if NHS or NICE guidance changes

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