The exact cause of pancreatic cancer is unknown. However, about 10% of cases are linked to genetic mutations or hereditary syndromes, including:

• BRCA1 and BRCA2 mutations
• PALB2 mutation
• Familial Atypical Multiple Mole Melanoma (FAMMM) Syndrome
• Familial pancreatitis (PRSS1 gene mutation)
• Lynch syndrome (HNPCC)
• Peutz-Jeghers Syndrome (STK11)
  (Source: American Cancer Society, www.cancer.org)

Symptoms often do not appear in the early stages and usually manifest when the disease has progressed. These may include:

• Severe abdominal pain, often radiating to the back, resembling a stabbing sensation.
• Jaundice (yellowing of the skin and eyes).
• Loss of appetite and significant weight loss.
• Enlarged liver.

Diagnosis involves various methods:

1. Blood Tests
   • Identifies markers or abnormalities related to pancreatic cancer.
2. CT Scan (Computerized Tomography Scan)
   • A Helical CT scan with contrast dye is highly effective for detecting small tumors. The advanced imaging provides high accuracy and detailed views of the tumor's location and spread.
3. CT-Guided Fine Needle Aspiration (FNA)
   • This technique helps confirm cancer cells but requires the expertise of an interventional radiologist.
4. Endoscopic Retrograde Cholangiopancreatography (ERCP)
   • This endoscopic procedure allows for biopsy collection and imaging of bile and pancreatic ducts to detect obstructions or abnormalities.

Surgical removal of the tumor is the most effective treatment but is only feasible if the cancer is detected early and has not metastasized.

In most cases, pancreatic cancer is diagnosed in advanced stages, where surgery is not an option, leading to lower survival rates. For this reason, individuals at risk are encouraged to undergo regular health screenings every six months to one year.

The American Joint Committee on Cancer (AJCC) 2002 classification is commonly used to determine cancer stages. Another system by Kawarada categorizes the disease into three groups for better treatment planning:

1. Operable Stage
   • No evidence of metastasis.
   • Tumor does not encircle the celiac artery or superior mesenteric artery.
   • Tumor does not encircle the superior mesenteric or portal veins.
2. Locally Advanced Stage
   • Cancer is confined to the local area but has grown beyond resectability.
3. Metastatic Stage
   • Cancer has spread to distant organs.