Pancreatic cancer is the fourth leading cause of cancer-related death among Americans, accounting for over 47,000 deaths in 2020.

Like any other type of cancer, pancreatic cancer develops when the cells in an organ start to grow abnormally. The majority of pancreatic cancer cases originate in the head of the pancreas. The most common type of pancreatic cancer is pancreatic ductal adenocarcinoma. This cancer is made up of the cells that create pancreatic ducts, which channel digestive enzymes from the pancreas tissue to the intestine.

There is no specific cause of pancreatic cancer, but experts agree that smoking is the main risk factor. A diet excessively high in dietary fat and protein, a sedentary lifestyle, and having a high body mass index can also increase one’s risk of developing pancreatic cancer.

Although many cases of pancreatic cancer occur after the age of 45 (about two-thirds develop over the age of 65), it can affect anyone at any age.

Signs and Symptoms

Dr. David Roife
Surgical Oncologist

Surgical Oncologist Dr. David Roife with Premier Surgical at Fort Sanders Regional explains that the early stages of pancreatic cancer often do not cause any signs or symptoms. “A typical presentation is painless jaundice. It’s usually people going about their day, and all of a sudden, their friends or family say ‘hey why do you look yellow?’ They go to an emergency room and get a scan, and that’s the way it first turns up.”

Having any of the following signs and symptoms listed below does not automatically mean you have pancreatic cancer, but they are symptoms that warrant immediate medical attention:

• Belly or back pain
This is the most common symptom of pancreatic cancer.

As the tumor grows, it can start pressing on the nearby organs, causing pain. It may also spread to the surrounding nerves, causing the back pain.

• Weight loss
Unexplained or unintended weight loss is very common in people with pancreatic cancer. They may have very little to no appetite at all.

• Nausea and vomiting
The tumor can press on the far end of the stomach, making food harder to get through. This causes nausea, vomiting, and pain that can get worse after eating.

• Large lump under the rib cage
Pancreatic cancer can cause blockage of the bile duct. This causes the bile to build up in the gallbladder, causing it to enlarge. This can be felt through a physical exam as a large lump just right under the rib cage.

•Early Detection
Dr. David Roife urges early detection when it comes to pancreatic cancer. He says, “Pancreatic cancer is one of the hardest cancers to diagnose early because of the location of where it grows. It typically does not cause any symptoms until it’s already advanced or spread to spread to other organs, which means surgery is not an option for many patients unfortunately.”

“Early detection is one of the most sought after areas of research right now. Once you have it detected, it is important to get treated at a high volume center where the physicians are experienced in dealing with pancreatic cancer, as it involves a team of many kinds of different doctors and specialists to treat you properly including chemotherapy, radiation, and surgery.”

If you are diagnosed with pancreatic cancer, surgical consultation should be a part of your workup to assess if the tumor is capable of being removed. Surgical removal of pancreas cancer is the only chance of a durable cure.

The surgeons of Premier Surgical Associates of Knoxville and Cleveland, TN, like surgical oncologist Dr. Roife, are experienced in diagnosing and treating pancreatic cancer. To request an appointment with Dr. David Roife at Premier Surgical Fort Sanders call (865) 524-3695 or visit