Pancreatic Cancer

Pancreatic cancer develops in the tissues of your pancreas. The pancreas is an organ located high in your abdomen and that lies horizontally behind your stomach. It is a gland that secretes enzymes which help the digestive process and hormones which regulate the metabolism of sugars.

Pancreatic cancer is most common in people who are older (between the ages of 50 and 80) and it is uncommon amongst people aging below 40. There are certain risk factors that have been identified for the disease. These include smoking, age, obesity, and having a history of other medical illnesses (such as diabetes or chronic pancreatitis).

Pancreatic cancer has the tendency to spread quickly, and is often undetected in its early stages. This is because the signs and symptoms of pancreatic cancer may not become visible until after the cancer has become quite advanced.


Pancreatic cancer is often undetected in the early stages of the disease, as a tumour in the pancreas does not often cause visible symptoms. Therefore the cancer may not become clear until it has progressed to a more advanced stage. Nonetheless, some early symptoms pancreatic cancer may include:

  • Pain in your back on around your stomach area

  • Unanticipated weight loss

  • Jaundice​

​Pain in your abdomen can be due to a number of different reasons and in most cases it is not due to pancreatic cancer.​​

If you have any of the above symptoms and are worried, you should seek medical attention from the doctors at the Oncology Service Line​ at the Aga Khan University Hospital. They may recommend you to another specialist for further assessment, such as an oncologist or a gastroenterologist.  ​​
​Your time with your doctor may be limited, so make sure to prepare for your visit beforehand. Here​ are some tips to help get you started.​​
Your doctor will begin your diagnosis by examining your family history and finding more about your medical history. They will then conduct a physical test to see if there are any visible symptoms that can be observed.

Pancreatic cancer can sometimes cause jaundice, so your doctor may look for signs of jaundice by examining your eyes and the colour of your skin. They may also feel around your abdomen to see if they can feel any swelling around the area of your liver. Blood tests are also sometimes conducted to test for levels of a substance (CA 19-9) that is thought to be related to tumour growth.
  • Complete Blood count (CBC): One or more parameters related to red blood cells, white blood cells and platelets might be affected in this condition, giving a clue towards etiology and further diagnostic approach. Therefore, it is an ancillary test in the diagnostic workup of this disease.
Your doctor will probably make use of imaging tests to create pictures of your internal organs, such as an ultrasound, a Computerized Tomography (CT) scan, a Magnetic Resonance Imaging test (MRI), an Endoscopic Ultrasound or an Endoscopic Retrograde Cholangiopancreatography test.

However the only concrete diagnostic test for pancreatic cancer is by a biopsy test, which is when a tissue will be extracted from your pancreas and examined but it may not be always possible.

If it has been confirmed that you have pancreatic cancer, your doctor may conduct further tests to determine the stage the cancer has progressed to. The stages range from stage one to stage four (the most advanced stage). Your doctor will then be able to advise a course of treatment accordingly. 

​Disclaimer: Kindly consult your physician before getting the above-mentioned tests.​

Treatment of pancreatic cancer depends greatly on the type, location and the stage of the cancer. It will also depend on other factors such as your age, medical history, and general health and also your personal preference for certain kinds of treatment. The aim of treatment is to ideally remove the tumour as well as any other cancerous cells that may have developed in your body. However if this is not possible, due to the stage of your cancer for instance, then the aim will be to lessen symptoms and prevent the tumour from growing, spreading and causing greater damage.

Treatment for pancreatic cancer can include one or a combination of the following options:

  • Chemotherapy

  • Radiotherapy

  • Surgery

  • Palliative care for advanced disease or patients not physically fit for other treatments

Surgical treatment:
The most ideal aim surgical treatment for cancer aims to cure cancer by removing the tumour. However this is only possible in about 15% to 20% of patients when the cancer is caught at an earlier stage where it has not spread extensively and become inoperable. If your cancer has progressed, and the tumour has wrapped itself around crucial blood vessels, then the aim of surgery intervention would not be to cure but to lesson or prevent further symptoms of the tumour. There are several different possible kinds of surgery.

  • Whipple Procedure – The most common of surgery for pancreatic cancer is called the whipple procedure. The procedure involves removing the “head” (the wide opening) of your pancreas. Surgery can also be used to remove the duodenum (which is a portion of the bile duct), the gallbladder, and occasionally part of the stomach. The remaining part of the intestine, bile duct, and pancreas will be reconnected by your surgeon.

  • Distal pancreatectomy – This procedure involves removing the “tail” and the “body” of your pancreas. Usually, your spleen will also be removed during surgery. Other removals during surgery may include a portion of your stomach, bowl, left adrenal gland, left diaphragm or left kidney.

Chemotherapy is a form of cancer treatment which contains anti-cancer medications in order to either kill cancerous (malignant) cells that have developed in your body or to stop them from multiplying. This kind of treatment is often given alongside radiotherapy and surgical intervention for pancreatic cancer.​

Please click here​ for some guidelines on “what to do before your surgery”​​
Please click here​ for some guidelines on “what to do on the day of your surgery”​​
The surgical procedures for pancreatic cancer can result in serious complications which does affect many patients. One of the most common complications is the development of a fistula (false channels) starting from the location of the bowel reconnection. Aside from this, other possible complications are:

  • Bleeding

  • Leak from anastomosis

  • Infections in abdomen as well as chest

  • Problems with your stomach emptying itself following a meal

Following the surgery, you will probably be hospitalized for about 10 days before you are discharged to go home. You will also probably need to take medication because the recovery period may be quite slow and painful. Initially, you may only be able to eat small portions of food that is easily digestible. It may also be necessary for you to take pancreatic enzymes to aid digestion, either for a short period of time or long-term. Diarrhoea is another common side effect during the first couple of months while your digestive tract is recovering.  Other complications could include:

  • Weight loss

  • Diabetes​

Please click here​ for some guidelines on “what to do on after your surgery”​​
The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.​
Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.​
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The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.