Subject
title
Proclamation Declaring November 2025, as Pancreatic Cancer Awareness Month in Rockville, Maryland
end
Department
City Clerk/Director of Council Operations Office
Recommendation
Staff recommends the Mayor and Council read, approve, and present the proclamation to Carl Young, City of Rockville Fire Marshal.
November is Pancreatic Cancer Awareness Month.
Pancreatic Cancer Awareness Month was established to address the challenges associated with pancreatic cancer, including its low survival rates and limited treatment options. It was initiated by advocacy organizations, healthcare providers, and individuals impacted by pancreatic cancer.
Over time, Pancreatic Cancer Awareness Month has grown into a global movement that seeks to improve early detection, support patients and their families, and advance research to find more effective treatments for this challenging disease.
Pancreatic cancer is the fourth leading cause of cancer death in the United States. In 2025, more than 67,440 Americans are expected to be diagnosed with pancreatic cancer in the United States, and 51,980 will die from the disease, which accounts for 8.4% of all cancer deaths. Currently, there is no cure for pancreatic cancer, and there have been no significant improvements in survival rates in the last 50 years, remaining below 20% for major cancers. When symptoms of pancreatic cancer present themselves, it is usually too late for an optimistic prognosis.
What Is Pancreatic Cancer?
Pancreatic cancer is a type of cancer that starts in the pancreas. (Cancer starts when cells in the body begin to grow out of control. To learn more about how cancers start and spread, see What Is Cancer? <https://www.cancer.org/treatment/understanding-your-diagnosis/what-is-cancer.html>)
Pancreatic adenocarcinoma is the most common type of pancreatic cancer. Pancreatic neuroendocrine tumors (NETs) are a less common type and are discussed in Pancreatic Neuroendocrine Tumors <https://www.cancer.org/cancer/pancreatic-neuroendocrine-tumor.html>.
Where pancreatic cancer starts
The pancreas
The pancreas is an organ that sits behind the stomach. It's shaped a bit like a fish with a wide head, a tapering body, and a narrow, pointed tail. In adults, it's about 6 inches (15 centimeters) long but less than 2 inches (5 centimeters) wide.
• The head of the pancreas is on the right side of the abdomen (belly), behind where the stomach meets the duodenum (the first part of the small intestine).
• The body of the pancreas is behind the stomach.
• The tail of the pancreas is on the left side of the abdomen next to the spleen.
The most common type of pancreatic cancer, adenocarcinoma of the pancreas, starts when exocrine cells in the pancreas start to grow out of control. Most of the pancreas is made up of exocrine cells which form the exocrine glands and ducts. The exocrine glands make pancreatic enzymes that are released into the intestines to help you digest foods (especially fats). The enzymes are released into tiny tubes called ducts which eventually empty into the pancreatic duct. The pancreatic duct merges with the common bile duct (the duct that carries bile from the liver) and empties into the duodenum (the first part of the small intestine) at the ampulla of Vater.
Endocrine cells make up a smaller percentage of the cells in the pancreas. These cells make important hormones like insulin and glucagon (which help control blood sugar levels) and release them directly into the blood. Pancreatic neuroendocrine tumors start in the endocrine cells. See Pancreatic Neuroendocrine Tumor <https://www.cancer.org/cancer/pancreatic-neuroendocrine-tumor.html> for more about this type.
If you are diagnosed with pancreatic cancer, it’s very important to know if it's an endocrine cancer (see Pancreatic Neuroendocrine Tumor <https://www.cancer.org/cancer/pancreatic-neuroendocrine-tumor.html>) or exocrine cancer (discussed here). They have distinct risk factors and causes, have different signs and symptoms, are diagnosed with different tests, are treated in different ways, and have different outlooks.
Types of pancreatic cancer
Exocrine cancers are by far the most common type of pancreas cancer. If you are told you have pancreatic cancer, it's most likely an exocrine pancreatic cancer.
Pancreatic adenocarcinoma: About 95% of cancers of the exocrine pancreas are adenocarcinomas. These cancers usually start in the ducts of the pancreas. Less often, they develop from the cells that make the pancreatic enzymes, in which case they are called acinar cell carcinomas.
Less common types of exocrine cancer: Other, less common exocrine cancers include adenosquamous carcinomas, squamous cell carcinomas, signet ring cell carcinomas, undifferentiated carcinomas, and undifferentiated carcinomas with giant cells.
Ampullary cancer (carcinoma of the ampulla of Vater): This cancer starts in the ampulla of Vater, which is where the bile duct and pancreatic duct come together and empty into the small intestine. Ampullary cancers aren’t technically pancreatic cancers, but they are included here because they are treated much the same.
Ampullary cancers often block the bile duct while they're still small and have not spread far. This blockage causes bile to build up in the body, which leads to yellowing of the skin and eyes (jaundice). Because of this, these cancers are usually found earlier than most pancreatic cancers, and they usually have a better prognosis (outlook).
Benign and precancerous growths in the pancreas
Some growths in the pancreas are simply benign (not cancer), while others might become cancer over time if left untreated (known as precancers). Because people are getting imaging tests such as CT scans <https://www.cancer.org/treatment/understanding-your-diagnosis/tests/ct-scan-for-cancer.html> more often than in the past (for a number of reasons), these types of pancreatic growths are now being found more often.
Serous cystic neoplasms (SCNs) (also known as serous cystadenomas) are tumors that have sacs (cysts) filled with fluid. SCNs are almost always benign, and most don’t need to be treated unless they grow large or cause symptoms.
Mucinous cystic neoplasms (MCNs) (also known as mucinous cystadenomas) are slow-growing tumors that have cysts filled with a jelly-like substance called mucin. These tumors almost always occur in women. While they are not cancer, some of them can progress to cancer over time if not treated, so these tumors are typically removed with surgery.
What’s New in Pancreatic Cancer Research?
Research into the causes, diagnosis and treatment of pancreatic cancer is underway in many medical centers throughout the world.
Genetics and early detection
Scientists are learning more about some of the gene changes in pancreas cells that cause them to become cancer. Inherited changes <https://www.cancer.org/healthy/cancer-causes/genetics/family-cancer-syndromes.html> in genes such as BRCA2, p16, and the genes responsible for Lynch syndrome can increase a person’s risk of developing pancreatic cancer.
Researchers are now looking at how these and other genes may be altered in pancreatic cancers that are not inherited. Pancreatic cancer develops over many years in a series of steps known as pancreatic intraepithelial neoplasia or PanIN. In the early steps, such as PanIN 1, there are changes in a small number of genes, and the duct cells of the pancreas do not look very abnormal. In later steps such as PanIN 2 and PanIN 3, there are changes in several genes and the duct cells look more abnormal.
Researchers are using this information to develop tests for detecting acquired (not inherited) gene changes in pancreatic pre-cancerous conditions. One of the most common DNA changes in these conditions affects the KRAS oncogene, which affects regulation of cell growth. New diagnostic tests are often able to recognize this change in samples of pancreatic juice collected during an ERCP <https://www.cancer.org/cancer/pancreatic-cancer/detection-diagnosis-staging/how-diagnosed.html> (endoscopic retrograde cholangiopancreatography).
For now, imaging tests like endoscopic ultrasound (EUS), ERCP, and genetic tests for changes in certain genes (such as KRAS) are options for people with a strong family history of pancreatic cancer. But these tests are not recommended for widespread testing of people at average risk who do not have any symptoms <https://www.cancer.org/cancer/pancreatic-cancer/detection-diagnosis-staging/signs-and-symptoms.html>.
Other tests are looking to see if groups of proteins found in the blood might be used to find pancreatic cancer early, when it is likely to be treated easier. Some early results with this approach have been promising, but more research is needed to confirm its usefulness.
Treatment
A lot of research is focused on finding better treatments for pancreatic cancer. Improving surgery and radiation therapy are major goals, as is determining the best combination of treatments for people with certain stages <https://www.cancer.org/treatment/understanding-your-diagnosis/staging.html> of cancer.
Surgery
Surgery <https://www.cancer.org/cancer/pancreatic-cancer/treating/surgery.html> to remove pancreatic cancer (most often a Whipple procedure) is a long and complex operation that can be hard both for the surgeon and the patient. It often requires a long hospital stay, at least in part because of the long incision (cut) made in the belly.
A newer approach now used at some major medical centers is to do the operation laparoscopically. For this approach, the surgeon makes several small incisions in the belly instead of one large one. Long, thin surgical tools and a tiny video camera are then inserted through these cuts to do the operation. One advantage of this surgery is that people often recover from it more quickly. But this is still a difficult operation. Surgeons are looking to see how it compares to the standard operation, and which patients might be helped the most by it.
Radiation therapy
Some studies are looking at different ways to give radiation <https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/radiation.html> to treat pancreatic cancer. These include intraoperative radiation therapy (in which a single large dose of radiation is given to the area of the cancer in the operating room at the time of surgery) and proton beam radiation (which uses a special type of radiation that might do less damage to nearby normal cells).
Chemotherapy
Many clinical trials are testing new combinations of chemotherapy <https://www.cancer.org/cancer/pancreatic-cancer/treating/chemotherapy.html> drugs for pancreatic cancer. Many studies are seeing if combining gemcitabine with other drugs can help people live longer. Other newer chemo drugs are also being tested, as are combinations of chemo drugs with newer types of drugs.
Targeted therapies
Targeted drugs <https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/targeted-therapy.html> work differently from standard chemo drugs in that they attack only specific targets on cancer cells (or nearby cells). Targeted therapies may prove to be useful along with, or instead of, current treatments. In general, they seem to have different side effects than traditional chemo drugs. Looking for new targets to attack is an active area of cancer research.
Growth factor inhibitors: Many types of cancer cells, including pancreatic cancer cells, have certain proteins on their surface that help them grow. These proteins are called growth factor receptors. One example is epidermal growth factor receptor (EGFR). Several drugs that target EGFR are now being studied. One, known as erlotinib (Tarceva), is already approved for use along with gemcitabine.
Anti-angiogenesis factors: All cancers depend on new blood vessels to nourish their growth. To block the growth of these vessels and thereby starve the tumor, scientists have developed anti-angiogenesis drugs. These are being studied in clinical trials <https://www.cancer.org/treatment/treatments-and-side-effects/clinical-trials.html> for patients with pancreatic cancer.
Immune therapy
Immune therapies <https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/immunotherapy.html> attempt to boost a person’s immune system or give them ready-made components of an immune system to attack cancer cells. Some studies of these treatments have shown promising results.
Monoclonal antibodies:
One form of immune therapy uses injections of man-made monoclonal antibodies <https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/immunotherapy/monoclonal-antibodies.html>. These immune system proteins are made to home in on a specific molecule, such as carcinoembryonic antigen (CEA), which is sometimes found on the surface of pancreatic cancer cells. Toxins or radioactive atoms can be attached to these antibodies, which bring them directly to the tumor cells. The hope is that they will destroy cancer cells while leaving normal cells alone. For use in pancreatic cancer, these types of treatments are available only in clinical trials currently.
Cancer vaccines:
Several types of vaccines <https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/immunotherapy/cancer-vaccines.html> for boosting the body’s immune response to pancreatic cancer cells are being tested in clinical trials. Unlike vaccines against infections like measles or mumps, these vaccines are designed to help treat, not prevent, pancreatic cancer. One possible advantage of these types of treatments is that they tend to have very limited side effects. Currently, vaccines are available only in clinical trials.
Drugs that target immune system checkpoints:
The immune system normally keeps itself from attacking other normal cells in the body by using “checkpoints” - proteins on immune cells that need to be activated (or inactivated) to start an immune response. Cancer cells sometimes find ways to use these checkpoints to avoid being attacked by the immune system. Newer drugs that target these checkpoints have shown a lot of promise in treating some types of cancer. Some of these are now being studied for use in pancreatic cancer.
Individualization of therapy:
Some drugs seem to work better if certain types of mutations can be found in the patient’s tumor. For example, erlotinib may work better in patients whose tumors have a particular change in the EGFR gene. This concept is an area of intense study. There might also be some gene alterations that affect how well gemcitabine will work in a particular patient. Identifying markers that can predict how well a drug will work before it is given is an important area of research in many types of cancer.
Pancreatic Cancer Risk Factors
A risk factor is anything that increases your chance of getting a disease such as cancer. Different cancers have different risk factors. Some risk factors, like smoking, can be changed. Others, like a person’s age or family history, can’t be changed. In some cases, there might be a factor that may decrease your risk of developing cancer or has an unclear effect. That is not considered a risk factor, but you may see them noted clearly on this page as well.
Having a risk factor, or even many, does not mean that you will get cancer. And some people who get cancer may have few or no known risk factors.
Here are some of the risk factors known to increase your risk for pancreatic cancer:
Risk factors that can be changed
Tobacco use
Smoking <https://www.cancer.org/healthy/cancer-causes/tobacco-and-cancer.html> is one of the most important risk factors for pancreatic cancer. The risk of getting pancreatic cancer is about twice as high among people who smoke compared to those who have never smoked. About 25% of pancreatic cancers are thought to be caused by cigarette smoking. Cigar smoking and the use of smokeless tobacco products also increase the risk. However, the risk of pancreatic cancer starts to drop once a person stops smoking.
Can Pancreatic Cancer Be Prevented? <https://www.cancer.org/cancer/pancreatic-cancer/causes-risks-prevention/prevention.html>
Being overweight
Being very overweight (obese) <https://www.cancer.org/healthy/eat-healthy-get-active/acs-guidelines-nutrition-physical-activity-cancer-prevention.html> is a risk factor for pancreatic cancer. Obese people (body mass index [BMI] of 30 or more) are about 20% more likely to develop pancreatic cancer. Gaining weight as an adult can also increase risk.
Carrying extra weight around the waistline may be a risk factor even in people who are not very overweight.
Diabetes
Pancreatic cancer is more common in people with diabetes. The reason for this is not known. Most of the risk is found in people with type 2 diabetes. This type of diabetes is increasing in children and adolescents as obesity in these age groups also rises. Type 2 diabetes in adults is also often related to being overweight or obese. It’s not clear if people with type 1 (juvenile) diabetes have a higher risk.
Chronic pancreatitis
Chronic pancreatitis, a long-term inflammation of the pancreas, is linked with an increased risk of pancreatic cancer. Chronic pancreatitis is often seen with heavy alcohol use and smoking.
Workplace exposure to certain chemicals
Heavy exposure at work to certain chemicals used in the dry cleaning and metalworking industries may raise a person’s risk of pancreatic cancer.
Risk factors that can’t be changed
Age
The risk of developing pancreatic cancer goes up as people age. Almost all patients are older than 45. About two-thirds are at least 65 years old. The average age of diagnosis is 70.
Gender
Men are slightly more likely to develop pancreatic cancer than women. This may be due, at least in part, to higher tobacco use in men, which raises pancreatic cancer risk (see above).
Race
African Americans are slightly more likely to develop pancreatic cancer than whites. The reasons for this aren’t clear, but it may be due in part to having higher rates of some other risk factors for pancreatic cancer, such as diabetes, smoking, and being overweight.
Family history
Pancreatic cancer seems to run in some families. In some of these families, the high risk is due to an inherited syndrome (explained below). In other families, the gene causing the increased risk is not known. Although family history is a risk factor, most people who get pancreatic cancer do not have a family history of it.
Inherited genetic syndromes
Inherited gene changes (mutations) can be passed from parent to child. These gene changes may cause as many as 10% of pancreatic cancers. Sometimes these changes result in syndromes that include increased risks of other cancers (or other health problems). Examples of genetic syndromes <https://www.cancer.org/healthy/cancer-causes/genetics/family-cancer-syndromes.html> that can cause pancreatic cancer include:
• Hereditary breast and ovarian cancer syndrome, caused by mutations in the BRCA1 or BRCA2 genes
• Hereditary breast cancer, caused by mutations in the PALB2 gene
• Familial atypical multiple mole melanoma (FAMMM) syndrome, caused by mutations in the p16/CDKN2A gene and associated with skin and eye melanomas
• Familial pancreatitis, usually caused by mutations in the PRSS1 gene
• Lynch syndrome, also known as hereditary non-polyposis colorectal cancer (HNPCC), most often caused by a defect in the MLH1 or MSH2 genes
• Peutz-Jeghers syndrome, caused by defects in the STK11 gene. This syndrome is also linked with polyps in the digestive tract and several other cancers.
Changes in the genes that cause some of these syndromes can be found by genetic testing. For more information on genetic testing, see Can Pancreatic Cancer Be Found Early? <https://www.cancer.org/cancer/pancreatic-cancer/detection-diagnosis-staging/detection.html>
Chronic pancreatitis (due to a gene change)
Chronic pancreatitis is sometimes due to an inherited gene mutation <https://www.cancer.org/healthy/cancer-causes/genetics.html>. People with this inherited (familial) form of pancreatitis have a high lifetime risk of pancreatic cancer.
Factors with an unclear effect on risk
Diet
Diets <https://www.cancer.org/healthy/cancer-causes/diet-physical-activity.html>with red and processed meats (such as sausage and bacon) and saturated fats may increase the risk of pancreatic cancer. Sugary drinks may also increase this risk. More research is needed in this area.
Physical inactivity
Some research has suggested that lack of physical activity <https://www.cancer.org/healthy/cancer-causes/diet-physical-activity/diet-and-physical-activity.html> might increase pancreatic cancer risk. But not all studies have found this. Regular physical activity may help reduce the risk of pancreatic cancer.
Coffee
Some older studies have suggested that drinking coffee might increase the risk of pancreatic cancer, but more recent studies have not confirmed this.
Alcohol
Some studies have shown a link between heavy alcohol use <https://www.cancer.org/healthy/cancer-causes/diet-physical-activity/alcohol-use-and-cancer.html> and pancreatic cancer. Heavy alcohol use can also lead to conditions such as chronic pancreatitis, which is known to increase pancreatic cancer risk.
Infections
Some research suggests that infection of the stomach with the ulcer-causing bacteria Helicobacter pylori (H. pylori) or infection with Hepatitis B may increase the risk of getting pancreatic cancer. More studies are needed.
Source: American Cancer Society - <https://www.cancer.org/cancer/pancreatic-cancer/causes-risks-prevention/risk-factors.html>
Mayor and Council History
The Mayor and Council present this proclamation annually.
Public Notification and Engagement
For more information, visit www.pancan.org <http://www.pancan.org> or call 877.435.8650