Pancreatic cancer is a disease in which malignant cells grow in the pancreas, a gland located behind the stomach and in front of the spine. Because of the gland's location deep inside the abdomen, pancreatic cancer is often diagnosed at an advanced stage. Pancreatic cancer is the fourth most common cause of cancer death in men and women in the United States. Risk Factors Most pancreatic cancer occurs in people older than age 45. More men than women are diagnosed with it. African-Americans are also more likely than Asians, Hispanics, or Caucasians to develop the disease. Other risk factors for pancreatic cancer include: smoking, having diabetes or chronic pancreatitis, and having a family history of the disease. The risk for developing pancreatic cancer triples if a person's mother, father, or a sibling had the disease. Types There are several types of pancreatic cancers, including the following: adenocarcinoma of the pancreas (the most common pancreatic cancer, which occurs in the lining of the pancreatic duct), cystadenocarcinoma, and acinar cell carcinoma. Diagnostic Procedures To diagnose pancreatic cancer, a doctor starts by performing a complete medical history and physical examination and ordering special blood tests. Other procedures used to diagnose pancreatic cancer may include the following: Ultrasound (also called sonography)—a diagnostic imaging technique that uses high-frequency sound waves to view internal organs of the abdomen such as the liver, pancreas, spleen, and kidneys and to assess blood flow through various vessels Computed tomography scan (also called a CT or CAT scan)—a diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce cross-sectional images (often called slices) of the body Magnetic resonance imaging (MRI)—a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body Endoscopic retrograde cholangiopancreatography (ERCP)—a procedure that combines X-ray and an endoscope (a long, flexible, lighted tube) to help the doctor diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas Percutaneous transhepatic cholangiography (PTC)—a procedure in which a needle is introduced through the skin and into the liver where a dye (contrast) is deposited, and the bile duct structures can be viewed by X-ray Pancreas biopsy—a procedure in which a sample of pancreatic tissue is removed (with a needle or during surgery) for examination under a microscope Positron emission tomography (PET)—a procedure that evaluates the function and structure of a particular organ or tissue, allowing the doctor to identify the onset of a disease before anatomical changes related to the disease can be seen with other imaging procedures, such as a CT Treatment Depending upon the type and stage, pancreatic cancer may be treated with medication to relieve or reduce pain, external radiation, conventional chemotherapy, targeted molecular therapy, or surgery to remove the tumor. The type of surgery depends on the stage of the cancer, the location and size of the tumor, and the person's overall health.