Pancreatic conditions

What is it?
Acute pancreatitis is when the pancreas suddenly becomes inflamed. This happens when digestive enzymes, which are normally inactive inside the pancreas, become active too early and start to damage the pancreas itself. Common causes include gallstones and heavy alcohol use.

Other rarer causes include medications, trauma, high fat levels in the bloodstream, high calcium levels. In about 10% of cases there is no identifiable cause. Severe pancreatitis can be a life-threatening condition.

Symptoms:

• Sudden, severe pain in the upper abdomen (which can spread to your back
• Nausea and vomiting
• Fever, a fast heartbeat
• A tender and swollen abdomen
• Feeling very unwell, especially after eating
   

Treatment:
Most people need hospital care. Treatment includes fluids through a drip, strong pain relief, and resting the pancreas by not eating for a few days. If the pancreatitis is severe, extra care like antibiotics, drainage of fluid, or even surgery may be needed. Treating the cause, like removing gallstones, is important to prevent future attacks.

What is it?
Chronic pancreatitis is ongoing inflammation of the pancreas that gets worse over time and can permanently damage the organ. It may affect your ability to digest food and control blood sugar. The most common cause is long-term alcohol use, but it can also happen after repeated bouts of acute pancreatitis.

Symptoms:

• Long-term upper abdominal pain, which may come and go or be constant
• Greasy, pale, or floating stools
• Weight loss, even if you're eating well
• Signs of diabetes like increased thirst, hunger, or needing to urinate more
   

Treatment:

• Pain relief and medications to replace digestive enzymes
• A strict no-alcohol and no-smoking lifestyle
• Treatment of complications like diabetes
• In some cases, surgery or endoscopic treatment may be needed if there are blockages or ongoing pain
   

See the dedicated Pancreatic Cancer page for more detailed information

What is it?
This is the most common type of pancreatic cancer. It starts in the cells that line the small tubes (ducts) of the pancreas. It is often not found until it is advanced because symptoms can be mild or vague early on.

Symptoms:

• Yellowing of the skin or eyes (jaundice)
• Unexplained weight loss
• Pain in the upper abdomen or back
• Loss of appetite, tiredness
• Pale stools and dark urine
• Some people develop diabetes suddenly, or their blood sugar control comes erratic
   

Treatment:

• If found early, surgery to remove the tumour may be possible, usually followed by chemotherapy
• If it’s not possible to remove the cancer, chemotherapy is used either prior to surgery to shrink the tumour or used to slow its growth and manage symptoms
• Pain relief and other supportive treatments (palliative care) are very important to improve quality of life
   

What are they?
These are rare types of pancreatic tumours that develop from hormone-producing cells. Some make excess hormones (called functioning tumours), while others do not (non-functioning tumours). Some grow slowly, while others may spread.

Symptoms:

• Functioning tumours: symptoms depend on the hormone involved, e.g. low blood sugar, diarrhoea, ulcers, or flushing
• Non-functioning tumours may not cause symptoms until they grow and press on other organs, causing pain or discomfort
   

Treatment:

• Surgery may be used to remove the tumour, especially if it hasn’t spread
• Medications may help control hormone levels and symptoms
• Some people may need chemotherapy or newer “targeted” therapies if the tumour spreads
• Long-term monitoring is important, especially for slow-growing types
   

What are they?
Pancreatic cysts are fluid-filled sacs in the pancreas. Many are harmless and don’t cause symptoms, but some can grow or have the potential to become cancerous. They’re often found accidentally during scans for other conditions.

Types and their management

PSEUDOCYSTS

What are they?
These are the most common type, usually caused by pancreatitis (inflammation of the pancreas). They don’t have a true cyst wall and are filled with fluid and sometimes damaged tissue.
 

Symptoms:
May cause pain, bloating, or nausea if large; often no symptoms.
 

Management:
Many go away on their own and only need monitoring with scans.
 

Large or painful pseudocysts may need to be drained using a camera (endoscopic drainage) or surgery.

SEROUS CYSTIC NEOPLASMS
What are they?
These are benign (non-cancerous) cysts, more common in older women. They have a “honeycomb” appearance on scans.
 

Symptoms:
Usually none, unless very large.
 

Management:
Do not turn into cancer.
 

Most are left alone and just monitored with scans.
 

Surgery is only considered if they cause symptoms or grow significantly.

MUCINOUS CYSTIC NEOPLASMS (MCNs)
What are they?
These are more common in middle-aged women and found in the body or tail of the pancreas. They contain mucus and can become cancerous if not treated.
 

Symptoms:
Usually no symptoms unless large.
 

Management:
Typically removed surgically due to cancer risk.
 

Regular scans may be used if the cyst is small and appears low-risk.

INTRADUCTAL PAPILLARY MUCINOUS NEOPLASMS (IPMNs)
What are they?
These involve the main pancreatic duct or side branches and produce mucus. They can sometimes turn into cancer, especially when they involve the main duct.
 

Symptoms:
May include vague abdominal pain, pancreatitis, or weight loss.
 

Management:
Main duct IPMNs or those with worrisome features (like nodules or size over 3cm) are often removed surgically.
 

Branch duct IPMNs without concerning features can be watched with regular imaging (MRI or CT scans) and follow-up.

SOLID PSEUDOPAPILLARY NEOPLASMS (SPNs)
What are they?
Rare tumours, usually in young women, that are mostly benign but have a small risk of turning cancerous.
 

Symptoms:
May cause abdominal pain or a feeling of fullness.
 

Management:
Surgery is usually recommended, even if they aren’t currently causing problems.
 

SUMMARY
While many pancreatic cysts are harmless and just need monitoring, some require surgery due to their risk of turning into cancer. The type of cyst, your symptoms, and findings on scans all help guide your treatment.