November is National Pancreatic Awareness Month in the United States. Pancreatic cancer is the 12th most common type of cancer in the United States, representing just 3.1% of all new cancer cases. However, it is the 3rd leading cause of death from cancer, because the survival rate is much lower than the average. Pancreatic cancer is diagnosed most often in people between age 65 and 74, and the highest rate of death is for those between 75 and 84. Further, since loved ones in these age groups are often dealing with some other serious health issue, doctors may choose not to recommend the surgery that is currently the only treatment available. Caregivers, home care aides and loved ones need to be aware of the signs and symptoms of pancreatic cancer, because early detection is the best way to outwit this intractable disease.

The pancreas, a gland located between the stomach and the spine, produces both digestive juices and hormones that regulate blood sugar. Exocrine pancreas cells make digestive enzymes that are released into the stomach to help the body digest food. Neuroendocrine pancreas cells produce hormones such as insulin and glucagon that help the body regulate its blood sugar. The bulk of pancreatic cancers start when malignant exocrine cells multiply, form tumors, and stop producing hormones. The first visible, external symptom is typically jaundice, because the tumors and lack of hormones interfere with the liver’s function. The treatments available for most other types of cancer do not affect pancreatic tumors, so the only option for pancreatic cancer right now is a a partial or full pancreatectomy, surgery to remove all or part of the pancreas and surrounding tissue.

Risk factors for this type of cancer include:

  • Smoking
  • Obesity
  • A personal or family history of diabetes, chronic pancreatitis, or pancreatic cancer
  • Several of other hereditary and chronic conditions, including the genetic mutation BRCA2

Symptoms caregivers and home care aides should watch for are

  • Jaundice
  • Dark urine
  • Abdomen or back pain
  • Unexplained weight loss
  • Loss of appetite and fatigue.

Pancreatic cancer is difficult to detect because the recognized symptoms don’t occur in the early stages of cancer, and when they do occur, they can be confused for the symptoms of many other conditions. Like many other cancers, pancreatic cancer can spread to the rest of the body to the surrounding tissue, through the bloodstream, or in the lymph nodes. This explains the low survival rate for seniors, to some degree, because the only treatment option is surgery currently, and many doctors are reluctant to perform surgery on those over 65 who also have conditions or diseases that make surgery risky. Another complication is that most cancer studies work with people under age 50, and can produce results and recommendations that simply aren’t appropriate for those over 65.

Pancreatic cancer is a difficult diagnosis for loved ones over 65, for a few reasons: limited treatment options, no signs or symptoms in the early stages of the disease, and more than half of patients diagnosed only in the metastatic stages. Family, caregivers and home care aides must be aware of the subtle symptoms that do manifest so that loved ones can get tested and treated for this grim disease.