Pancreatic cancer is when cancer cells form within thepancreas, a glandular organ located behind thestomach. Signs and symptoms of pancreatic cancer may include abdominal or back pain, yellow skin, unexplained weight loss, light colored stools, dark urine and loss of hunger. Early on there are often no symptoms.[1] By the time of diagnosis the cancer has usually spread to other parts of the body.[2]
’’’胰臟癌’’’（{{lang-en|pancreatic cancer}}）是癌細胞生長於[[胃]]後方的[[腺]]體器官[[胰臟]]的疾病。胰臟癌的症狀表現包含[[腹痛]]或[[背痛]]、[[黃疸]]、不明原因[[減肥|體重減輕]]、[[臉|臉色]]蒼白、糞便顏色變淡、深色尿、無飢餓感。疾病早期通常沒有症狀<ref name=PDQ2014>{{cite web|title=Pancreatic Cancer Treatment (PDQ®) Patient Version|url=http://www.cancer.gov/cancertopics/pdq/treatment/pancreatic/Patient/page1/AllPages|website=National Cancer Institute|accessdate=8 June 2014|date=2014-04-17}}</ref>。當確診癌症時，通常已[[遠端轉移|轉移]]到其他臟器<ref name="Bond-Smith">{{cite journal|last1=Bond-Smith|first1=G|last2=Banga|first2=N|last3=Hammond|first3=TM|last4=Imber|first4=CJ|title=Pancreatic adenocarcinoma.|journal=BMJ (Clinical research ed.)|date=16 May 2012|volume=344|pages=e2476|pmid=22592847|doi=10.1136/bmj.e2476}}</ref><ref name="WCR2014">{{cite book|title=World Cancer Report 2014.|date=2014|publisher=World Health Organization|isbn=9283204298|pages=Chapter 5.7}}</ref>。
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Risk factors include: smoking, obesity, diabetes, and certain genetic conditions including: multiple endocrine neoplasia type 1 and hereditary nonpolyposis colon cancer among others.[1] Smoking is the cause of about 20% of cases while 10% of cases are inherited from a person’s parents. Infiltrating ductal adenocarcinoma is the most common type of pancreatic cancer, making up 90% of cases. It arises within the part of the pancreas that makes digestive enzymes, known as the exocrine pancreas. One to two percent arise from islet cells, and are classified asneuroendocrine tumors. There are also a number of other types of pancreatic cancer.[2] Diagnosis is usually based on a combination of imaging tests such as ultrasound and computer tomography, blood tests such as CEA and CA 19-9 and biopsy. This allows the disease to be divided into five stages.[1]
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危險因子包括：抽菸、[[肥胖症|肥胖]]、[[糖尿病]]、和一些特殊基因問題如第一型多發性{{link-en|內分泌腫瘤症候群|Multiple endocrine neoplasia type 1}}或{{link-en|遺傳性非瘜肉結直腸癌|Hereditary nonpolyposis colorectal cancer}}等<ref name=PDQ2014/>。大約20%胰臟癌和抽菸有關，約10%胰臟癌則和遺傳因素有關。依產生癌變的組織和細胞類型不同，病理學上有不同分類。由執行外分泌功能、產生消化液和酵素的胰管細胞產生的腺管{{link-en|腺癌|Adenocarcinoma}}，約佔所有胰臟癌90%；由執行內分泌功能的[[胰島|胰島細胞]]產生的[[神經內分泌腫瘤|神經內分泌瘤]]，約佔1-2%。另外仍有其他種類的胰臟癌<ref name=WCR2014/><ref>{{cite web| url=http://www.ntuhpan.com/FAQDisplay.aspx?FileName=002-(%E5%BC%B5%E6%AF%93%E5%BB%B7%E9%86%AB%E5%B8%AB)%E8%83%B0%E8%87%9F%E8%85%AB%E7%98%A4%E6%9C%89%E9%82%A3%E4%BA%9B.txt |title=胰臟腫瘤有那些？胰臟腫瘤的分類？ |author=張毓廷 |date=2014-02-22 |accessdate=2014-11-26}}</ref>。胰臟癌通常藉由合併[[超音波]]和[[X射線電腦斷層掃描|電腦斷層]]、血液檢查包含{{link-en|癌症胚胎抗原|Carcinoembryonic antigen}}(CEA)和{{link-en|癌症抗原19-9|CA19-9}}(CA 19-9)、以及[[活體組織切片|切片]]。藉此再將疾病分成五期<ref name=PDQ2014/>。
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Prevention is by stopping smoking with risk returning to normal after 20 years.[2] Other recommendations include limiting alcohol intake and eating a healthy diet.[3] Screening the general population has not been found to be effective.[3] In those with the disease treatments may include: surgery, radiation therapy, chemotherapy, or a combination of treatments. Recommendations are partly based on the cancer stage. Surgery may be done in an effort to cure the disease or to try to improve quality of life without trying to cure. Pain management and medications to improve digestion are sometimes needed.[1] Early palliative care is recommended even in those who are receiving active treatment.[4][5]
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預防方面，戒菸後20年可將風險降至與正常人相當<ref name=WCR2014/>。其他建議包含限制[[酒精]]攝取與健康飲食<ref name=Bus2010/>。針對大眾的{{link-en|篩檢|Screening (medicine)}}尚未被證實有效<ref name=Bus2010>{{cite journal|last1=Bussom|first1=S|last2=Saif|first2=MW|title=Methods and rationale for the early detection of pancreatic cancer. Highlights from the "2010 ASCO Gastrointestinal Cancers Symposium". Orlando, FL, USA. January 22-24, 2010.|journal=JOP : Journal of the pancreas|date=Mar 5, 2010|volume=11|issue=2|pages=128-30|pmid=20208319}}</ref>。疾病的治療包含手術、[[放射線療法|放射治療]]、[[化學療法|化學治療]]或合併上述治療。治療依{{link-en|癌症分期|Cancer staging|分期}}不同而異。手術可治癒疾病或嘗試提升[[生活品質]]。有時更需要{{link-en|疼痛控制|Pain management}}與改善消化的藥物<ref name=PDQ2014/>。因整體預後較差，即使正接受積極治療者，也建議早期[[安寧緩和醫療]]<ref>{{cite journal|last1=Shahrokni|first1=A|last2=Saif|first2=MW|title=Metastatic pancreatic cancer: the dilemma of quality vs. quantity of life.|journal=JOP : Journal of the pancreas|date=Jul 10, 2013|volume=14|issue=4|pages=391-4|pmid=23846935}}</ref><ref>{{cite journal|last1=Bardou|first1=M|last2=Le Ray|first2=I|title=Treatment of pancreatic cancer: A narrative review of cost-effectiveness studies.|journal=Best practice & research. Clinical gastroenterology|date=Dec 2013|volume=27|issue=6|pages=881-92|pmid=24182608}}</ref>。
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In 2012 pancreatic cancer caused 330,000 deaths globally, the seventh most common cause of deaths due to cancer.[2] In the United States it is the fourth most common cause of deaths due to cancer.[6] The disease occurs more often in the developed world, where 68% of new cases occur in 2012.[2] It often has poor outcomes with the average one and five year survival ratebeing 25% and 5% respectively.[7][2] In localized disease where the cancer is small (< 2 cm) the 5-year survival is approximately 20%.[8] For those with neuroendocrine cancer the survival at five years is better at 65%.[2] In the United States, as of 2006, the economic costs of pancreatic cancer are estimated at $8.6 billion.[9]
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2012年，胰臟癌在全球有33萬人因此而死亡，在全球因癌症死亡的排名中為第七名<ref name=WCR2014/>。在美國，則是排名第四名<ref name="PMC2504856">{{cite journal | author = Hariharan D, Saied A, Kocher HM | title = Analysis of mortality rates for pancreatic cancer across the world | journal = HPB | volume = 10 | issue = 1 | pages = 58–62 | year = 2008 | pmid = 18695761 | pmc = 2504856 | doi = 10.1080/13651820701883148 }}</ref>。該疾病常發生於已開發國家，2012年在這些地區有68%的新病例<ref name=WCR2014/>。預後方面，其平均一年及{{link-en|五年存活率|Five-year survival rate}}較差，分別為25%與5%<ref name="ACS-CFF-2010">{{cite web | title=American Cancer Society: Cancer Facts & Figures 2010: see page 4 for incidence estimates, and page 19 for survival percentages|url=http://www.cancer.org/acs/groups/content/@nho/documents/document/acspc-024113.pdf}}</ref><ref name=WCR2014/>。在部分病例當中，小於2公分的癌細胞，其五年存活率約為20%<ref name=PDQ2014P>{{cite web|title=Pancreatic Cancer Treatment (PDQ®) Health Professional Version|url=http://www.cancer.gov/cancertopics/pdq/treatment/pancreatic/HealthProfessional/page1/AllPages|website=NCI|accessdate=8 June 2014|date=2014-02-21}}</ref>。如果為胰臟的神經內分泌癌症，五年存活率大於65%<ref name=WCR2014/>。在美國，2006年針對胰臟癌的經濟支出將近86億美元<ref>{{cite web|last1=Hardison|first1=Brooke Layne|title=The Financial Burden of Cancer|url=http://benchmarks.cancer.gov/2010/04/the-financial-burden-of-cancer/|website=NCI|accessdate=8 June 2014|date=April 23, 2010}}</ref>。