The pancreas is a crucial organ that aids digestion by breaking down food and producing hormones to regulate blood sugar and manage energy storage. Pancreatic cancer begins when abnormal cells in the pancreas grow uncontrollably, forming tumors. This cancer type accounts for about 3% of all cancers in the United States, with over 60,000 new cases diagnosed annually.

Pancreatic cancer is known to remain without symptoms in people until it reaches an advanced stage. The lack of symptoms make it difficult to detect early. By the time symptoms appear, the cancer has often already spread beyond the pancreas, making it more challenging to treat effectively.

Pancreatic screening aims to detect pancreatic cancer in its early stages, when it's more likely to be treatable.

For individuals with a strong family history of pancreatic cancer, a known genetic predisposition to pancreas cancer, or certain medical conditions like chronic pancreatitis, regular screening can be lifesaving. Detecting pancreatic cancer early can significantly improve treatment options and increase the chances of long-term survival.

There is no single diagnostic test that can tell you if you have pancreatic cancer. Definitive diagnosis requires a series of imaging scans, blood tests and biopsy — and those tests are typically only done if you have symptoms. However, recognizing the importance of early detection in improving patient outcomes has prompted considerable interest in developing reliable screening strategies. By explaining the benefits of pancreatic cancer screening, not only can timely interventions be initiated, but also the potential for reducing mortality rates and improving overall survival becomes substantial.

What are the symptoms of pancreatic cancer?

Screening is important because most early pancreatic cancers do not have any symptoms. When symptoms are present, here are some signs to look for:

• Jaundice: Yellowing of the skin and whites of the eyes due to the buildup of bilirubin caused by a blockage in the bile duct.
• Abdominal or mid-back pain: Persistent, dull pain in the abdomen or mid-back.
• Unexplained weight loss: Significant and unexplained weight loss, often accompanied by loss of appetite.
• Digestive problems: Nausea, vomiting, or feeling full quickly when eating.
• New-onset diabetes: Development of diabetes without a clear cause, especially in individuals over 50.
• Fatigue: Feeling unusually tired or weak, even after adequate rest.
• Loss of appetite: A reduced desire to eat, which can contribute to weight loss.

Who should be screened for pancreatic cancer?

Most doctors recommend pancreatic cancer screening for people at higher risk, such as those with:

• Family history of pancreatic cancer in 2 or more close relatives
• Inherited abnormalities and syndromes with a close relative with pancreatic cancer, such as mutations in the BRCA/PALB2/ATM genes, Lynch syndrome, or familial pancreatitis
• Chronic pancreatitis or an inherited predisposition to pancreatitis (a painful inflammation of the pancreas)
• New onset diabetes over the age of 50

What type of screenings are used for pancreatic cancer?

• Imaging Tests:
• Computed Tomography (CT) Scan: Provides detailed cross-sectional images of the pancreas and nearby structures.
• Magnetic Resonance Imaging (MRI) Scan: Uses magnetic fields and radio waves to produce detailed images of the pancreas.
• Endoscopic Ultrasound (EUS): Combines an endoscope with ultrasound to examine the pancreas and nearby lymph nodes.
• MRI and EUS are preferred over CT given radiation exposure with repeated CT scans

• Blood Tests:
• CA 19-9: Measures levels of a tumor marker called CA 19-9, which can be elevated in pancreatic cancer.
• A1c or glycohemoglobin: The new onset of diabetes is a risk factor for pancreas cancer.

• Genetic Testing:
• Genetic counseling and testing may be recommended for individuals with a family history of pancreatic cancer or known genetic mutations associated with the disease, such as mutations in the BRCA2, ATM, STK11, CDKN2A, or PALB2 genes.

• Endoscopic Biopsy:
• Tissue samples of the pancreas can be obtained during an endoscopic procedure and examined under a microscope for signs of cancer.

Commonly asked questions regarding pancreatic screening:

Sylvester Pancreatic Cancer Screening Program

At Sylvester, part of the University of Miami Leonard M. Miller School of Medicine, we offer advanced expertise and sophisticated testing to find pancreatic cancer at the earliest stages. It’s comforting to know you’re working with a highly experienced team.

These are just a few reasons why patients depend on our expertise:

• World-renowned cancer experts. If cancer is found, you work with prostate cancer specialists who provide an accurate diagnosis and the most targeted treatments – including highly skilled minimally invasive surgeons. We offer leading-edge approaches you won't find anywhere else nearby.
• Advanced diagnostic capabilities. We use sophisticated imaging equipment to find cancer at the earliest stages. We’re able to distinguish between normal and abnormal findings that are often misdiagnosed. Our team specializes in minimally invasive endoscopic approaches and performs a high volume of procedures.
• Experienced endoscopic surgeons. Our surgeons have advanced experience in endoscopic procedures performed through the rectum, providing a less invasive approach to traditional surgery. These approaches offer less pain and scarring, a shorter hospital stay, and a faster recovery.

Let's reduce the risk of pancreatic cancer together.

There's no sure way to prevent cancer, but adopting healthy lifestyle behaviors can help reduce cancer risk. In the U.S., 40% of all cancers and 45% of cancer deaths are related to modifiable risk factors like smoking, excess body weight, and alcohol consumption, physical inactivity and/or poor nutrition.

Eating healthy is an important part of improving your health and reducing your cancer risk. Focus on a plant- based diet, highlighting vegetables, fruits, whole grains and avoiding red and processed meats, added sugars and alcohol.

For more information on healthy weight, nutrition, exercise and tobacco cessation, visit Lifestyle Interventions and Cancer pPrevention

Our comprehensive cancer prevention services ensure people at high risk of developing GI cancer receive screening and support to manage their risks.

The experts at Sylvester specialize in:

Genetic testing and counseling
Genetic testing can tell you whether you've inherited a genetic change (mutation) to your genes, which significantly increases your risk of developing cancer. Our genetic counselors can educate you about genetic testing and help you decide whether testing is right for you. They can also talk to you about your results and your options.

Exercise physiology
According to the American Cancer Society, exercise can help lower your risk of many types of cancer, including GI, colorectal, and uterine cancers – up to 13 different types. Regular exercise helps you maintain a healthy weight, regulate hormone levels, boost your immune system, reduce swelling, and more. Our exercise experts can design an exercise program to help you get moving.

Acupuncture
If you feel anxious or worried about your elevated cancer risk, acupuncture may let you feel more at ease. Acupuncture is a traditional Chinese medicine approach that applies extremely thin needles to various points (acupoints) in the body. It's been shown to enhance mental and physical well-being, including improving sleep and relieving stress and anxiety.

Nutrition counseling
A nutritious diet can help you reduce your cancer risk. Some foods, such as processed foods and red meats, can raise your cancer risk, while other foods, like whole grains, vegetables, and high-fiber foods, can enhance your health. Our registered dietitians offer personalized guidance to eat better, control your weight, and lower your cancer risk.

Risk-reduction surgery referrals
If you're at high risk of developing cancer, preventive surgery may be recommended. Surgery is a difficult decision; we're here to help you understand all the risks and benefits. We help you understand genetic testing results and offer emotional support every step of the way. We make sure you know all your preventive options so that you can make an informed choice.

Pharmacologic Prevention
This preventive approach uses medicines such as aspirin or non-steroidal anti-inflammatory medications to lower your cancer risk. Your care team will talk to you about the possible side effects and risks of chemoprevention and help you decide if it's right for you.