Three Things People with Diabetes Should Know about Pancreatic Cancer Risk

By Bill Piersol,

Doctor pricks finger of patient with diabetes

People with diabetes can face an elevated risk of pancreatic cancer. Two MSK specialists discuss the relationship between diabetes and cancer, put the risk in perspective, and discuss how to manage it.

Pancreatic cancer and diabetes both involve the pancreas, which produces insulin. Your body needs insulin to use the sugar and fat from food. But what is the relationship between these two serious diseases? Should people with diabetes take their risk of pancreatic cancer into consideration when making complex decisions about their health and changes to their lifestyle?

The statistics are sobering: Pancreatic cancer accounts for just 3% of all cancers but is the fourth leading cause of cancer deaths in the United States. The disease often goes undiagnosed until it is advanced, when it is aggressive and hard to treat, and the number of new cases is on the rise, despite a fall in some major risk factors, like smoking.

The most important take-home lesson is for people to control their weight, says Azeez Farooki. That can lower your chances of developing diabetes and it may lower your risk of developing diabetes-related cancer.

By comparison, diabetes is distressingly common. Nearly 30 million people in America have diabetes. An estimated seven million of them are not aware they have it.

It’s long been known that diabetes is a risk factor for various cancers, including pancreatic cancer. Recent research suggests that the risk for people with diabetes may be even higher — although only slightly — when the disease comes on after age 50.

To find out more about what people with diabetes should know about pancreatic cancer, we spoke with MSK endocrinologists Azeez Farooki and James Flory

1. Diabetes does not significantly raise your risk of pancreatic cancer.

Dr. Flory advises people with diabetes to stay calm. He points out that more than a million people a year develop diabetes, while just 55,000 people are diagnosed with pancreatic cancer each year. “People over 50 who are diagnosed with diabetes should not start thinking about being screened for pancreatic cancer or spend a lot of time worrying about it,” he says. “The overwhelming majority of people with diabetes will never develop pancreatic cancer.” 

While research shows that there is a relationship between the two diseases, Dr. Flory says, “It’s not yet clear which disease causes the other or if they share a similar underlying cause. The bottom line for people with diabetes is that their increased risk of pancreatic cancer is very small.”

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2. A sudden change in diabetes could signal a problem. 

There are some situations, though, in which it pays to be extra vigilant.

Endocrinologists Azeez Farooki and James Flory

“If someone is lean, exercises, and develops diabetes out of nowhere, or if they have a history of well-controlled diabetes and suddenly it gets a lot worse, that should make a doctor wonder if there is an underlying problem, which could include pancreatic cancer,” says Dr. Farooki. “Your doctor should consider this in relation with other risk factors. These include a family history of pancreatic and other cancers, smoking, and damage to the pancreas from behaviors like heavy drinking. Also important to consider is that pancreatic cancer often causes unexplained and unintentional weight loss.”   

He cautions that “diabetes can worsen over time and require more medications to control it, so the vast majority of the time it’s simply a bad turn in diabetes.” However, it’s always important to be in touch with your care team if your condition changes dramatically.   

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3. Manage your weight, no matter what.

Both doctors say that the key for people who are concerned about these two diseases is diet and exercise. Dr. Farooki says, “The most important take-home lesson is for people to control their weight. That can lower your chances of developing diabetes. And if you already have the disease, it can mean fewer complications and may lower your risk of developing diabetes-related cancers, including pancreatic and endometrial cancer.” 

It’s important for people to be aware of their ideal body weight and understand that obesity, prediabetes, and diabetes are all cancer risk factors, says Dr. Farooki. “One thing we see over and over again with many patients is that they don’t recognize they are overweight and their doctor has never told them they need to lose weight,” he explains. “It’s become so normal in today’s world to be seriously overweight, and it has real consequences.”

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