NCCN Guidelines for Patients
Pancreatic Cancer, Version 1.2017
About pancreatic cancer
The pancreas | Cancer basics
Learning that you or a loved one has
cancer can be overwhelming. Part 1
reviews some basics about pancreatic
cancer that may help you better
understand this disease. This information
may also help you start planning for
The pancreas is a gland found behind the stomach.
A gland is an organ that makes fluids or chemicals
the body needs. The pancreas is about 6 inches long
and has 3 main parts:
The widest part is called the head.
The middle part is called the body.
The narrow end is called the tail.
The pancreas makes hormones, such as insulin. It
also makes proteins, called enzymes, that help to
digest food. Endocrine cells of the pancreas make
hormones. Enzymes are made by exocrine cells in
the small ducts of the pancreas. Ducts are tiny tubes
or vessels that fluids pass through. The small ducts
connect to the main pancreatic duct that extends
from the tail to the head of the pancreas.
The liver is near the pancreas, above the gallbladder.
The liver removes waste from blood and makes
bile. Bile is a fluid that helps to digest food. The
gallbladder stores bile from the liver. The common
bile duct carries bile from the liver into the main
pancreatic duct. From the main pancreatic duct,
bile and enzymes empty into the duodenum. The
duodenum is the first part of the small intestine,
which absorbs nutrients from eaten food.
Cancer is a disease of cells—the building blocks that
form tissue in the body. Normal cells grow and then
divide to make new cells. New cells are made as
the body needs them. When normal cells grow old
or get damaged, they die. Cancer cells don’t do this.
Cancer cells make new cells that aren’t needed and
don’t die quickly when old or damaged.
Over time, cancer cells grow and divide enough to
form a primary tumor. Primary tumors can grow large
and invade nearby tissues. Primary tumors can also
send cancer cells to other areas in the body to form
Genes are the codes within the cell that carry the
instructions for making new cells. They also control
how cells behave. Changes in genes turn normal
cells into cancer cells. Within the pancreas, exocrine
or endocrine cells can become cancer cells. About
90 out of 100 pancreatic cancers start in exocrine
cells that line the ducts of the pancreas. This type of
pancreatic cancer is called ductal adenocarcinoma
and is the focus of this patient book.
Anything that increases your chances of cancer
is called a risk factor. Certain risk factors can be
seen with this cancer type. Risk factors can be
activities that people do, things you have contact
with in the environment, or traits passed down from
parents to children through genes. Genes are coded
instructions for your cells.
A process called mutation is when something goes
wrong in the genetic code. Mutations can be passed
on from a parent and may be present before you
are born (inherited), or may be caused later in life
by genetic damage (acquired). People with inherited
genetic mutations have a higher risk for certain
cancers, but that doesn’t mean they will definitely
develop cancer. Only a small number of cancers are
a result of inherited mutations.