How does a person get pancreatic cancer?
Scientists don’t know exactly what causes most pancreatic cancers, but they have found several risk factors that can make a person more likely to get this disease. Some of these risk factors affect the DNA of cells in the pancreas, which can result in abnormal cell growth and may cause tumors to form.
DNA is the chemical in our cells that carries our genes, which control how our cells function. We look like our parents because they are the source of our DNA. But DNA affects more than just how we look.
Some genes control when our cells grow, divide into new cells, and die:
- Genes that help cells grow, divide, and stay alive are called oncogenes.
- Genes that help keep cell division under control, repair mistakes in DNA, or cause cells to die at the right time are calledtumor suppressor genes.
Cancers can be caused by DNA changes (gene mutations) that turn on oncogenes or turn off tumor suppressor genes.
Inherited gene mutations
Some people inherit gene changes from their parents that raise their risk of pancreatic cancer. Sometimes these gene changes are part of syndromes that include increased risks of other health problems .
Acquired gene mutations
Most gene mutations related to cancers of the pancreas occur after a person is born, rather than having been inherited. Theseacquired gene mutations sometimes result from exposure to cancer-causing chemicals (like those found in tobacco smoke). But often what causes these changes is not known. Many gene changes are probably just random events that sometimes happen inside a cell, without having an outside cause.
Some of the DNA changes often seen in sporadic (non-inherited) cases of pancreatic cancer are the same as those seen in inherited cases, while others are different. For example, many sporadic cases of exocrine pancreatic cancer have changes in the p16 and TP53 genes, which can also be seen in some genetic syndromes. But many pancreatic cancers also have changes in genes such as KRAS, BRAF, and DPC4(SMAD4), which are not part of inherited syndromes. Other gene changes can also be found in pancreatic cancers, although often it’s not clear what has caused these changes.
The way to answer the question about what causes pancreatic cancer is to ask what are the risk factors for pancreatic cancer? Some of the risk factors include:
- Cigarette smoking:Cigarette smoking doubles the risk of pancreatic cancer. In fact, some scientists have estimated that one in four, or one in five cases of pancreatic cancer are caused by smoking cigarettes. Smoking is also associated with early age at diagnosis. Very importantly, the risk of pancreatic cancer drops close to normal in people who quit smoking. Simply put, cigarette smoking is the leading preventable cause of pancreatic cancer.
- Age: The risk of developing pancreatic cancer increases with age. Over 80% of pancreatic cancers develop between the ages of 60 and 80 years.
- Race: Studies in the United States have shown that pancreatic cancer is more common in the African American population than it is in the white population. Some of this increased risk may be due to socioeconomic factors and to cigarette smoking.
- Gender: Cancer of the pancreas is more common in men than in women. Men are more likely to smoke than women.
- Religious background: Pancreatic cancer is proportionally more common in Ashkenazi Jews than the rest of the population. This may be because of a particular inherited mutation in the breast cancer gene (BRCA2)which runs in some Ashkenazi Jewish families.
- Chronic pancreatitis: Long-term (chronic) inflammation of the pancreas (pancreatitis) has been linked to cancer of the pancreas.
- Diabetes mellitus: Diabetes mellitus (sugar diabetes) can be a symptom of pancreatic cancer, and long-standing adult-onset diabetes also increases the risk of pancreatic cancer.
- Obesity: Obesity significantly increases the risk of pancreatic cancer. Believe it or not, it has been estimated that 8% of cancers are related to obesity.
- Diet: Diets high in meats, cholesterol, fried foods and nitrosamines may increase risk, while diets high in fruits and vegetables reduce risk. The vitamin folate may be protective.
There are risk factor that can make a person more likely to get this disease. Some risk affect DNA of cells in the pancreas. Some people inherit genes from their parents that raise their risk of pancreatic cancer. Smoking is number factor for pancreatic disease/cancer. Other gene changes can also be found in pancreatic cancers, although often it’s not clear what has caused these changes.
No one knows what the major causes for pancreatic cancer is but they do know some of the various factors that can make you more prone to getting pancreatic cancer. There are three catagories of risk factors, General, Lifestyle, and Genetic.
- Age (almost 90% of all pancreatic cancers are found in people age 55 and older)
- Gender: For an unknown reason, men are somewhat more likely to develop pancreatic cancer than are women.
- Chronic pancreatitis
- Cirrhosis of the liver
- Helicobacter pylori (H. pylori) infection
- Smoking cigarettes: Almost a third (20-30 percent) of all pancreatic cancers are linked to smoking cigarettes. Carcinogens (cancer-causing chemicals) found in tobacco products may damage the pancreas, and smoking may add to the risks associated with other conditions, like long-term inflammation of the pancreas (chronic pancreatitis). Likewise, the risk of diabetes and obesity may also be greater if an individual smokes.
About 10 percent of pancreatic cancers are thought to be related to genetic factors, meaning an inherited gene mutation is passed on from parents to their children. Although these genetic conditions do not directly cause pancreatic cancer, they may increase your risks for developing the disease.
The following genetic mutations are considered risk factors for pancreatic cancer:
- Mutations in the gene BRCA2 (hereditary breast and ovarian cancer syndrome)
- Mutations in the gene p16 (familial melanoma)
- Mutations in the gene PRSS1 (familial pancreatitis)
- Mutations in the gene NF1 (neurofibromatosis, type 1)
Other inherited syndromes that may be linked to pancreatic cancer include:
- Lynch Syndrome
- Peutz-Jeghers Syndrome (PJS)
- Von Hippel-Lindau Syndrome (VHL)
- MEN1 (multiple endocrine neoplasia type 1) syndrome: A rare genetic disorder that may be a risk factor for malignant islet cell tumors
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