Do People with Diabetes Have an Elevated Risk of Pancreatic Cancer?

Pancreatic cancer awareness has increased in recent years, in part because some high-profile people have died of it, including singer Aretha Franklin, Apple co-founder Steve Jobs, and actor Patrick Swayze. Although the Pancreatic Cancer Action Network released a finding that pancreatic cancer will likely move from the fourth to the second leading cause of cancer-related death in the United States around 2020, it remains one of the least discussed types of cancer and its research is underfunded. Moreover, pancreatic cancer isn’t often mentioned as a possible complication of diabetes, although people with diabetes do have an increased risk of pancreatic cancer. And since diabetes is becoming a more common diagnosis, it is possible that this is contributing to increased pancreatic cancer diagnoses.

Why People With Diabetes Have an Increased Risk of Pancreatic Cancer

 According to WebMD, “Researchers don’t know exactly why, but people who have had diabetes for several years are slightly more likely to get pancreatic cancer than those without diabetes.” However, this study says, “insulin resistance and associated hyperglycemia, hyperinsulinemia, and inflammation have been suggested to be the underlying mechanisms contributing to development of diabetes-associated pancreatic cancer. Signaling pathways that regulate the metabolic process also play important roles in cell proliferation and tumor growth.” 

While people with diabetes are at higher than average risk for getting pancreatic cancer, pancreatic cancer can also cause diabetes. About half of people with pancreatic cancer have high blood sugar. When the cancer is surgically removed, blood sugar levels often go back to normal.

Pancreatic cancer is hard to treat because many times, by the time people have symptoms, the pancreas is too overrun by cancer cells for effective treatment, and the cancer spreads quickly. It is difficult to detect pancreatic cancer before symptoms appear, but the sudden appearance of diabetes may be a reliable indicator in some people. This does not mean that everyone who develops diabetes actually has pancreatic cancer. According to recent scientific studies, about one percent of people with diabetes age fifty or older develops pancreatic cancer within three years of diabetes diagnosis.

What People With Diabetes Can Do to Reduce Their Risk of Pancreatic Cancer

While there are many unknowns about pancreatic cancer, there are, fortunately, a few things people with diabetes can do to decrease their risk, or get treatment quickly if needed.

Knowing the symptoms is important, although the symptoms of early pancreatic cancer can be relatively generic. People should consult their doctors if any symptoms persist for more than a week. Some of the less alarming potential symptoms are bloating, belching, heartburn, constipation, diarrhea, or itching. These could come from a variety of causes, but they’re always worth getting looked at if they last too long. More serious potential symptoms, which should be checked out promptly, are appetite loss, abdominal pain (which can radiate to the back), jaundice, weight loss, dark urine, fatigue, or an altered ability to sleep.

Some of the best things that people with diabetes can do to reduce their risk of cancer is avoid smoking, maintain a normal weight, and be aware of their own health and any changes that may occur..

The common diabetes drug metformin reduces the risk of pancreatic cancer in people with diabetes, while insulin may increase the risk. The benefits of metformin are increased when people follow a healthful diet and lifestyle. If a doctor recommends that someone take either of these medications, however, that means that the benefits of taking the medicine outweigh the risks.

Since type 2 diabetes is common, testing all people with type 2 diabetes for pancreatic cancer without symptoms is not feasible. It wouldn’t be possible to test everyone with diabetes routinely for pancreatic cancer, because the current ways to diagnose pancreatic cancer are expensive and difficult for many people to access. Without a simpler way to diagnose pancreatic cancer, like blood or saliva testing, and without a way to easily distinguish between causes of diabetes, it will likely remain difficult to determine when diabetes is a sign of pancreatic cancer.

Remember that even though people with diabetes have an increased risk for pancreatic cancer, it’s still rare. Following a knowledgeable doctor’s recommendations for diabetes management and maintaining a healthy lifestyle are the best things that people with diabetes can do to avoid complications.

Sources:

Chari, Suresh T., et al. “Probability of Pancreatic Cancer Following Diabetes: A Population-Based Study.” Gastroenterology, vol. 129, no. 2, Aug. 2005, pp. 504–511., doi:10.1053/j.gastro.2005.05.007.

Dankner, Rachel, et al. “Newly Diagnosed Type 2 Diabetes May Serve as a Potential Marker for Pancreatic Cancer.” Diabetes/Metabolism Research and Reviews, 19 Apr. 2018, doi:10.1002/dmrr.3018.

Diabetes Prevention Program Research Group. “Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin.” New England Journal of Medicine, vol. 346, no. 6, 7 Feb. 2002, pp. 393-403, doi:10.1056/NEJMoa012512.

Holly, Elizabeth A., et al. “Signs and Symptoms of Pancreatic Cancer: a Population-Based Case-Control Study in the San Francisco Bay Area.” Clinical Gastroenterology and Hepatology, vol. 2, no. 6, June 2004, pp. 510–517., doi:10.1016/s1542-3565(04)00171-5.

Li, Donghui, et al. “Antidiabetic Therapies Affect Risk of Pancreatic Cancer.” Gastroenterology, vol. 137, no. 2, Aug. 2009, pp. 482–488., doi:10.1053/j.gastro.2009.04.013.

Pannala, Rahul, et al. “New-Onset Diabetes: a Potential Clue to the Early Diagnosis of Pancreatic Cancer.” The Lancet Oncology, vol. 10, no. 1, 1 Jan. 2009, pp. 88–95., doi:10.1016/s1470-2045(08)70337-1.

Jessica Reuter Castrogiovanni

Jessica Reuter Castrogiovanni is a scientific writer and scientist. She is passionate about education and learning, and hopes to help people understand their own health. She spends her spare time raising a scientist-in-training, and finding as many interesting projects as possible.