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Primary
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Cessation of cigarette smoking: The risk of pancreatic cancer falls with cessation of cigarette smoking, which is one of the most important modifiable risk factors.<ref name="pmid25276995">{{cite journal |vauthors=Bochatay L, Girardin M, Bichard P, Frossard JL |title=[Pancreatic cancer in 2014: screening and epidemiology] |language=French |journal=Rev Med Suisse |volume=10 |issue=440 |pages=1582–5 |year=2014 |pmid=25276995 |doi= |url=}}</ref><ref name="pmid16549324">{{cite journal |vauthors=Lowenfels AB, Maisonneuve P |title=Epidemiology and risk factors for pancreatic cancer |journal=Best Pract Res Clin Gastroenterol |volume=20 |issue=2 |pages=197–209 |year=2006 |pmid=16549324 |doi=10.1016/j.bpg.2005.10.001 |url=}}</ref><ref name="pmid23921790">{{cite journal |vauthors=Bosetti C, Bertuccio P, Malvezzi M, Levi F, Chatenoud L, Negri E, La Vecchia C |title=Cancer mortality in Europe, 2005-2009, and an overview of trends since 1980 |journal=Ann. Oncol. |volume=24 |issue=10 |pages=2657–71 |year=2013 |pmid=23921790 |doi=10.1093/annonc/mdt301 |url=}}</ref><ref name="pmid22162227">{{cite journal |vauthors=Bosetti C, Bertuccio P, Negri E, La Vecchia C, Zeegers MP, Boffetta P |title=Pancreatic cancer: overview of descriptive epidemiology |journal=Mol. Carcinog. |volume=51 |issue=1 |pages=3–13 |year=2012 |pmid=22162227 |doi=10.1002/mc.20785 |url=}}</ref><ref name="pmid10616684">{{cite journal |vauthors=Hart AR |title=Pancreatic cancer: any prospects for prevention? |journal=Postgrad Med J |volume=75 |issue=887 |pages=521–6 |year=1999 |pmid=10616684 |pmc=1741344 |doi= |url=}}</ref>  
Cessation of cigarette smoking: The risk of pancreatic cancer falls with cessation of cigarette smoking, which is one of the most important modifiable risk factors.<ref name="pmid25276995">{{cite journal |vauthors=Bochatay L, Girardin M, Bichard P, Frossard JL |title=[Pancreatic cancer in 2014: screening and epidemiology] |language=French |journal=Rev Med Suisse |volume=10 |issue=440 |pages=1582–5 |year=2014 |pmid=25276995 |doi= |url=}}</ref><ref name="pmid16549324">{{cite journal |vauthors=Lowenfels AB, Maisonneuve P |title=Epidemiology and risk factors for pancreatic cancer |journal=Best Pract Res Clin Gastroenterol |volume=20 |issue=2 |pages=197–209 |year=2006 |pmid=16549324 |doi=10.1016/j.bpg.2005.10.001 |url=}}</ref><ref name="pmid23921790">{{cite journal |vauthors=Bosetti C, Bertuccio P, Malvezzi M, Levi F, Chatenoud L, Negri E, La Vecchia C |title=Cancer mortality in Europe, 2005-2009, and an overview of trends since 1980 |journal=Ann. Oncol. |volume=24 |issue=10 |pages=2657–71 |year=2013 |pmid=23921790 |doi=10.1093/annonc/mdt301 |url=}}</ref><ref name="pmid22162227">{{cite journal |vauthors=Bosetti C, Bertuccio P, Negri E, La Vecchia C, Zeegers MP, Boffetta P |title=Pancreatic cancer: overview of descriptive epidemiology |journal=Mol. Carcinog. |volume=51 |issue=1 |pages=3–13 |year=2012 |pmid=22162227 |doi=10.1002/mc.20785 |url=}}</ref><ref name="pmid10616684">{{cite journal |vauthors=Hart AR |title=Pancreatic cancer: any prospects for prevention? |journal=Postgrad Med J |volume=75 |issue=887 |pages=521–6 |year=1999 |pmid=10616684 |pmc=1741344 |doi= |url=}}</ref><ref name="pmid14749618">{{cite journal |vauthors=Vimalachandran D, Ghaneh P, Costello E, Neoptolemos JP |title=Genetics and prevention of pancreatic cancer |journal=Cancer Control |volume=11 |issue=1 |pages=6–14 |year=2004 |pmid=14749618 |doi= |url=}}</ref><ref name="pmid14749618">{{cite journal |vauthors=Vimalachandran D, Ghaneh P, Costello E, Neoptolemos JP |title=Genetics and prevention of pancreatic cancer |journal=Cancer Control |volume=11 |issue=1 |pages=6–14 |year=2004 |pmid=14749618 |doi= |url=}}</ref><ref name="pmid12670518">{{cite journal |vauthors=Ghadirian P, Lynch HT, Krewski D |title=Epidemiology of pancreatic cancer: an overview |journal=Cancer Detect. Prev. |volume=27 |issue=2 |pages=87–93 |year=2003 |pmid=12670518 |doi= |url=}}</ref><ref name="pmid19150414">{{cite journal |vauthors=Landi S |title=Genetic predisposition and environmental risk factors to pancreatic cancer: A review of the literature |journal=Mutat. Res. |volume=681 |issue=2-3 |pages=299–307 |year=2009 |pmid=19150414 |doi=10.1016/j.mrrev.2008.12.001 |url=}}</ref>  
Smoking accounts for the incidence of pancreatic cancer in one-fourth of all cases.<ref name="pmid25276995">{{cite journal |vauthors=Bochatay L, Girardin M, Bichard P, Frossard JL |title=[Pancreatic cancer in 2014: screening and epidemiology] |language=French |journal=Rev Med Suisse |volume=10 |issue=440 |pages=1582–5 |year=2014 |pmid=25276995 |doi= |url=}}</ref>  
Smoking accounts for the incidence of pancreatic cancer in one-fourth of all cases.<ref name="pmid25276995">{{cite journal |vauthors=Bochatay L, Girardin M, Bichard P, Frossard JL |title=[Pancreatic cancer in 2014: screening and epidemiology] |language=French |journal=Rev Med Suisse |volume=10 |issue=440 |pages=1582–5 |year=2014 |pmid=25276995 |doi= |url=}}</ref><ref name="pmid16127228">{{cite journal |vauthors=Qiu D, Kurosawa M, Lin Y, Inaba Y, Matsuba T, Kikuchi S, Yagyu K, Motohashi Y, Tamakoshi A |title=Overview of the epidemiology of pancreatic cancer focusing on the JACC Study |journal=J Epidemiol |volume=15 Suppl 2 |issue= |pages=S157–67 |year=2005 |pmid=16127228 |doi= |url=}}</ref>  
Nicotine in cigarettes stimulates tumorigenesis, increasing metastasis and resistance to treatment, hence impacting survival in patients.<ref name="pmid25076322">{{cite journal |vauthors=Toki MI, Syrigos KN, Saif MW |title=Risk determination for pancreatic cancer |journal=JOP |volume=15 |issue=4 |pages=289–91 |year=2014 |pmid=25076322 |doi= |url=}}</ref>
Nicotine in cigarettes stimulates tumorigenesis, increasing metastasis and resistance to treatment, hence impacting survival in patients.<ref name="pmid25076322">{{cite journal |vauthors=Toki MI, Syrigos KN, Saif MW |title=Risk determination for pancreatic cancer |journal=JOP |volume=15 |issue=4 |pages=289–91 |year=2014 |pmid=25076322 |doi= |url=}}</ref>
The risk of developing pancreatic cancer becomes almost equivalent to that of a nonsmoker after five years of cessation.<ref name="pmid16549324">{{cite journal |vauthors=Lowenfels AB, Maisonneuve P |title=Epidemiology and risk factors for pancreatic cancer |journal=Best Pract Res Clin Gastroenterol |volume=20 |issue=2 |pages=197–209 |year=2006 |pmid=16549324 |doi=10.1016/j.bpg.2005.10.001 |url=}}</ref><ref name="pmid15051286">{{cite journal |vauthors=Li D, Xie K, Wolff R, Abbruzzese JL |title=Pancreatic cancer |journal=Lancet |volume=363 |issue=9414 |pages=1049–57 |year=2004 |pmid=15051286 |doi=10.1016/S0140-6736(04)15841-8 |url=}}</ref><ref name="pmid22162227">{{cite journal |vauthors=Bosetti C, Bertuccio P, Negri E, La Vecchia C, Zeegers MP, Boffetta P |title=Pancreatic cancer: overview of descriptive epidemiology |journal=Mol. Carcinog. |volume=51 |issue=1 |pages=3–13 |year=2012 |pmid=22162227 |doi=10.1002/mc.20785 |url=}}</ref><ref name="pmid19150414">{{cite journal |vauthors=Landi S |title=Genetic predisposition and environmental risk factors to pancreatic cancer: A review of the literature |journal=Mutat. Res. |volume=681 |issue=2-3 |pages=299–307 |year=2009 |pmid=19150414 |doi=10.1016/j.mrrev.2008.12.001 |url=}}</ref>
The risk of developing pancreatic cancer becomes almost equivalent to that of a nonsmoker after five years of cessation.<ref name="pmid16549324">{{cite journal |vauthors=Lowenfels AB, Maisonneuve P |title=Epidemiology and risk factors for pancreatic cancer |journal=Best Pract Res Clin Gastroenterol |volume=20 |issue=2 |pages=197–209 |year=2006 |pmid=16549324 |doi=10.1016/j.bpg.2005.10.001 |url=}}</ref><ref name="pmid15051286">{{cite journal |vauthors=Li D, Xie K, Wolff R, Abbruzzese JL |title=Pancreatic cancer |journal=Lancet |volume=363 |issue=9414 |pages=1049–57 |year=2004 |pmid=15051286 |doi=10.1016/S0140-6736(04)15841-8 |url=}}</ref><ref name="pmid22162227">{{cite journal |vauthors=Bosetti C, Bertuccio P, Negri E, La Vecchia C, Zeegers MP, Boffetta P |title=Pancreatic cancer: overview of descriptive epidemiology |journal=Mol. Carcinog. |volume=51 |issue=1 |pages=3–13 |year=2012 |pmid=22162227 |doi=10.1002/mc.20785 |url=}}</ref><ref name="pmid19150414">{{cite journal |vauthors=Landi S |title=Genetic predisposition and environmental risk factors to pancreatic cancer: A review of the literature |journal=Mutat. Res. |volume=681 |issue=2-3 |pages=299–307 |year=2009 |pmid=19150414 |doi=10.1016/j.mrrev.2008.12.001 |url=}}</ref>


Cessation of alcohol


Regular exercise:  
Regular exercise:  
Obesity is considered as a potential risk factor for pancreatic cancer.  
Obesity is considered as a potential risk factor for pancreatic cancer.<ref name="pmid22162231">{{cite journal |vauthors=Bracci PM |title=Obesity and pancreatic cancer: overview of epidemiologic evidence and biologic mechanisms |journal=Mol. Carcinog. |volume=51 |issue=1 |pages=53–63 |year=2012 |pmid=22162231 |pmc=3348117 |doi=10.1002/mc.20778 |url=}}</ref>
Regular exercise decreases the risk of pancreatic cancer as compared to people living a sedentary lifestyle.
Regular exercise decreases the risk of pancreatic cancer as compared to people living a sedentary lifestyle.<ref name="pmid22162227">{{cite journal |vauthors=Bosetti C, Bertuccio P, Negri E, La Vecchia C, Zeegers MP, Boffetta P |title=Pancreatic cancer: overview of descriptive epidemiology |journal=Mol. Carcinog. |volume=51 |issue=1 |pages=3–13 |year=2012 |pmid=22162227 |doi=10.1002/mc.20785 |url=}}</ref><ref name="pmid25246281">{{cite journal |vauthors=Kollarova H, Azeem K, Tomaskova H, Horakova D, Prochazka V, Martinek A, Shonova O, Sevcikova J, Sevcikova V, Janout V |title=Is physical activity a protective factor against pancreatic cancer? |journal=Bratisl Lek Listy |volume=115 |issue=8 |pages=474–8 |year=2014 |pmid=25246281 |doi= |url=}}</ref>


Healthy diet: A healthy balanced diet doesn't exceed 2000 calories daily and includes the following:
The American Cancer Society (ACS) has issued guidelines for diet and physical activity at individual and community levels.
Diet:
A healthy balanced diet doesn't exceed 2000 calories daily and includes the following:<ref name="pmid10616684">{{cite journal |vauthors=Hart AR |title=Pancreatic cancer: any prospects for prevention? |journal=Postgrad Med J |volume=75 |issue=887 |pages=521–6 |year=1999 |pmid=10616684 |pmc=1741344 |doi= |url=}}</ref><ref name="pmid12670518">{{cite journal |vauthors=Ghadirian P, Lynch HT, Krewski D |title=Epidemiology of pancreatic cancer: an overview |journal=Cancer Detect. Prev. |volume=27 |issue=2 |pages=87–93 |year=2003 |pmid=12670518 |doi= |url=}}</ref><ref name="pmid28435395">{{cite journal |vauthors=Kuroczycki-Saniutycz S, Grzeszczuk A, Zwierz ZW, Kołodziejczyk P, Szczesiul J, Zalewska-Szajda B, Ościłowicz K, Waszkiewicz N, Zwierz K, Szajda SD |title=Prevention of pancreatic cancer |journal=Contemp Oncol (Pozn) |volume=21 |issue=1 |pages=30–34 |year=2017 |pmid=28435395 |pmc=5385470 |doi=10.5114/wo.2016.63043 |url=}}</ref>
plenty of vegetables and fruits- blueberries, spinach, broccoli, tomatoes  
plenty of vegetables and fruits- blueberries, spinach, broccoli, tomatoes  
lean meat from fowl, fish and plant sources like nuts or whole grains  
lean meat from fowl, fish and plant sources like nuts or whole grains  
monounsaturated fats help control insulin levels in type 2 diabetics  
monounsaturated fats help control insulin levels in type 2 diabetics<ref name="pmid19150414">{{cite journal |vauthors=Landi S |title=Genetic predisposition and environmental risk factors to pancreatic cancer: A review of the literature |journal=Mutat. Res. |volume=681 |issue=2-3 |pages=299–307 |year=2009 |pmid=19150414 |doi=10.1016/j.mrrev.2008.12.001 |url=}}</ref>
Tuna, mackerel, salmon, and sardine are major sources of long-chain omega-3 fatty acids due to anticancer properties   
Tuna, mackerel, salmon, and sardine are major sources of long-chain omega-3 fatty acids due to anticancer properties   


Poor diet: A poor diet includes the presence of the following:
Poor diet: A poor diet includes the presence of the following:<ref name="pmid22162231">{{cite journal |vauthors=Bracci PM |title=Obesity and pancreatic cancer: overview of epidemiologic evidence and biologic mechanisms |journal=Mol. Carcinog. |volume=51 |issue=1 |pages=53–63 |year=2012 |pmid=22162231 |pmc=3348117 |doi=10.1002/mc.20778 |url=}}</ref><ref name="pmid16549324">{{cite journal |vauthors=Lowenfels AB, Maisonneuve P |title=Epidemiology and risk factors for pancreatic cancer |journal=Best Pract Res Clin Gastroenterol |volume=20 |issue=2 |pages=197–209 |year=2006 |pmid=16549324 |doi=10.1016/j.bpg.2005.10.001 |url=}}</ref><ref name="pmid28435395">{{cite journal |vauthors=Kuroczycki-Saniutycz S, Grzeszczuk A, Zwierz ZW, Kołodziejczyk P, Szczesiul J, Zalewska-Szajda B, Ościłowicz K, Waszkiewicz N, Zwierz K, Szajda SD |title=Prevention of pancreatic cancer |journal=Contemp Oncol (Pozn) |volume=21 |issue=1 |pages=30–34 |year=2017 |pmid=28435395 |pmc=5385470 |doi=10.5114/wo.2016.63043 |url=}}</ref>
Food preservatives and additives
Food preservatives and additives
Smoked meat
Smoked meat
Line 59: Line 60:
Chemicals known as heterocyclic amines, nitrates, and heme iron, found in foods, are capable of damaging cells and DNA, influencing cancerogenic processes
Chemicals known as heterocyclic amines, nitrates, and heme iron, found in foods, are capable of damaging cells and DNA, influencing cancerogenic processes


Aging: Aging is associated with the development of pancreatic cancer.  
Aging: Aging is associated with the development of pancreatic cancer.<ref name="pmid15051286">{{cite journal |vauthors=Li D, Xie K, Wolff R, Abbruzzese JL |title=Pancreatic cancer |journal=Lancet |volume=363 |issue=9414 |pages=1049–57 |year=2004 |pmid=15051286 |doi=10.1016/S0140-6736(04)15841-8 |url=}}</ref><ref name="pmid15051286">{{cite journal |vauthors=Li D, Xie K, Wolff R, Abbruzzese JL |title=Pancreatic cancer |journal=Lancet |volume=363 |issue=9414 |pages=1049–57 |year=2004 |pmid=15051286 |doi=10.1016/S0140-6736(04)15841-8 |url=}}</ref><ref name="pmid22162227">{{cite journal |vauthors=Bosetti C, Bertuccio P, Negri E, La Vecchia C, Zeegers MP, Boffetta P |title=Pancreatic cancer: overview of descriptive epidemiology |journal=Mol. Carcinog. |volume=51 |issue=1 |pages=3–13 |year=2012 |pmid=22162227 |doi=10.1002/mc.20785 |url=}}</ref>
Regular exercise, healthy lifestyle and diet can slow down aging and decrease the risk of development of cancer.




Line 66: Line 66:
Diet: Exocrine pancreatic insufficiency due to pancreatic duct obstruction by the tumor may lead to malabsorption.
Diet: Exocrine pancreatic insufficiency due to pancreatic duct obstruction by the tumor may lead to malabsorption.
Malabsorption in patients presents with anorexia, weight loss, and diarrhea.  
Malabsorption in patients presents with anorexia, weight loss, and diarrhea.  
Pancreatic enzyme supplementation and avoidance of high-protein/high-fat diets improve symptoms in patients.
Treatment: based on American Cancer Society(ACS) guidelines<ref name="pmid22237782">{{cite journal |vauthors=Kushi LH, Doyle C, McCullough M, Rock CL, Demark-Wahnefried W, Bandera EV, Gapstur S, Patel AV, Andrews K, Gansler T |title=American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity |journal=CA Cancer J Clin |volume=62 |issue=1 |pages=30–67 |year=2012 |pmid=22237782 |doi=10.3322/caac.20140 |url=}}</ref>
Pancreatic enzyme replacement therapy
avoidance of high-protein/high-fat diets  
Individualized dietary prescriptions from a registered dietitian
Supplementation with omega-3 fatty acids

Revision as of 17:49, 14 November 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sudarshana Datta, MD [2]

Treatment Options by Stage

Stages I and II Pancreatic Cancer

Treatment of stage I and stage II pancreatic cancer may include the following:

  • Surgery alone.
  • Surgery with chemotherapy and radiation therapy.

Stage III Pancreatic Cancer

Treatment of stage III pancreatic cancer may include the following:

  • Palliative surgery or stent placement to bypass blocked areas in ducts or the small intestine.
  • Chemotherapy with gemcitabine.

Stage IV Pancreatic Cancer

Treatment of stage IV pancreatic cancer may include the following:

  • Chemotherapy with gemcitabine with or without erlotinib.
  • Palliative treatments for pain, such as nerve blocks, and other supportive care.
  • Palliative surgery or stent placement to bypass blocked areas in ducts or the small intestine.

Treatment Options for Recurrent Pancreatic Cancer

Treatment of recurrent pancreatic cancer may include the following:

  • Chemotherapy.
  • Palliative surgery or stent placement to bypass blocked areas in ducts or the small intestine.
  • Palliative radiation therapy.
  • Other palliative medical care to reduce symptoms, such as nerve blocks to relieve pain.

prevention

Primary Cessation of cigarette smoking: The risk of pancreatic cancer falls with cessation of cigarette smoking, which is one of the most important modifiable risk factors.[1][2][3][4][5][6][6][7][8] Smoking accounts for the incidence of pancreatic cancer in one-fourth of all cases.[1][9] Nicotine in cigarettes stimulates tumorigenesis, increasing metastasis and resistance to treatment, hence impacting survival in patients.[10] The risk of developing pancreatic cancer becomes almost equivalent to that of a nonsmoker after five years of cessation.[2][11][4][8]


Regular exercise: Obesity is considered as a potential risk factor for pancreatic cancer.[12] Regular exercise decreases the risk of pancreatic cancer as compared to people living a sedentary lifestyle.[4][13]

The American Cancer Society (ACS) has issued guidelines for diet and physical activity at individual and community levels. Diet: A healthy balanced diet doesn't exceed 2000 calories daily and includes the following:[5][7][14] plenty of vegetables and fruits- blueberries, spinach, broccoli, tomatoes lean meat from fowl, fish and plant sources like nuts or whole grains monounsaturated fats help control insulin levels in type 2 diabetics[8] Tuna, mackerel, salmon, and sardine are major sources of long-chain omega-3 fatty acids due to anticancer properties

Poor diet: A poor diet includes the presence of the following:[12][2][14] Food preservatives and additives Smoked meat Heavy alcohol use High cholesterol Red meat Low consumption of fruits and vegetables Saturated fatty acids Processed foods high-fat, high-protein diet Chemicals known as heterocyclic amines, nitrates, and heme iron, found in foods, are capable of damaging cells and DNA, influencing cancerogenic processes

Aging: Aging is associated with the development of pancreatic cancer.[11][11][4]


Secondary Diet: Exocrine pancreatic insufficiency due to pancreatic duct obstruction by the tumor may lead to malabsorption. Malabsorption in patients presents with anorexia, weight loss, and diarrhea. Treatment: based on American Cancer Society(ACS) guidelines[15] Pancreatic enzyme replacement therapy avoidance of high-protein/high-fat diets Individualized dietary prescriptions from a registered dietitian Supplementation with omega-3 fatty acids

  1. ↑ 1.0 1.1 Bochatay L, Girardin M, Bichard P, Frossard JL (2014). "[Pancreatic cancer in 2014: screening and epidemiology]". Rev Med Suisse (in French). 10 (440): 1582–5. PMID 25276995.
  2. ↑ 2.0 2.1 2.2 Lowenfels AB, Maisonneuve P (2006). "Epidemiology and risk factors for pancreatic cancer". Best Pract Res Clin Gastroenterol. 20 (2): 197–209. doi:10.1016/j.bpg.2005.10.001. PMID 16549324.
  3. ↑ Bosetti C, Bertuccio P, Malvezzi M, Levi F, Chatenoud L, Negri E, La Vecchia C (2013). "Cancer mortality in Europe, 2005-2009, and an overview of trends since 1980". Ann. Oncol. 24 (10): 2657–71. doi:10.1093/annonc/mdt301. PMID 23921790.
  4. ↑ 4.0 4.1 4.2 4.3 Bosetti C, Bertuccio P, Negri E, La Vecchia C, Zeegers MP, Boffetta P (2012). "Pancreatic cancer: overview of descriptive epidemiology". Mol. Carcinog. 51 (1): 3–13. doi:10.1002/mc.20785. PMID 22162227.
  5. ↑ 5.0 5.1 Hart AR (1999). "Pancreatic cancer: any prospects for prevention?". Postgrad Med J. 75 (887): 521–6. PMC 1741344. PMID 10616684.
  6. ↑ 6.0 6.1 Vimalachandran D, Ghaneh P, Costello E, Neoptolemos JP (2004). "Genetics and prevention of pancreatic cancer". Cancer Control. 11 (1): 6–14. PMID 14749618.
  7. ↑ 7.0 7.1 Ghadirian P, Lynch HT, Krewski D (2003). "Epidemiology of pancreatic cancer: an overview". Cancer Detect. Prev. 27 (2): 87–93. PMID 12670518.
  8. ↑ 8.0 8.1 8.2 Landi S (2009). "Genetic predisposition and environmental risk factors to pancreatic cancer: A review of the literature". Mutat. Res. 681 (2–3): 299–307. doi:10.1016/j.mrrev.2008.12.001. PMID 19150414.
  9. ↑ Qiu D, Kurosawa M, Lin Y, Inaba Y, Matsuba T, Kikuchi S, Yagyu K, Motohashi Y, Tamakoshi A (2005). "Overview of the epidemiology of pancreatic cancer focusing on the JACC Study". J Epidemiol. 15 Suppl 2: S157–67. PMID 16127228.
  10. ↑ Toki MI, Syrigos KN, Saif MW (2014). "Risk determination for pancreatic cancer". JOP. 15 (4): 289–91. PMID 25076322.
  11. ↑ 11.0 11.1 11.2 Li D, Xie K, Wolff R, Abbruzzese JL (2004). "Pancreatic cancer". Lancet. 363 (9414): 1049–57. doi:10.1016/S0140-6736(04)15841-8. PMID 15051286.
  12. ↑ 12.0 12.1 Bracci PM (2012). "Obesity and pancreatic cancer: overview of epidemiologic evidence and biologic mechanisms". Mol. Carcinog. 51 (1): 53–63. doi:10.1002/mc.20778. PMC 3348117. PMID 22162231.
  13. ↑ Kollarova H, Azeem K, Tomaskova H, Horakova D, Prochazka V, Martinek A, Shonova O, Sevcikova J, Sevcikova V, Janout V (2014). "Is physical activity a protective factor against pancreatic cancer?". Bratisl Lek Listy. 115 (8): 474–8. PMID 25246281.
  14. ↑ 14.0 14.1 Kuroczycki-Saniutycz S, Grzeszczuk A, Zwierz ZW, Kołodziejczyk P, Szczesiul J, Zalewska-Szajda B, Ościłowicz K, Waszkiewicz N, Zwierz K, Szajda SD (2017). "Prevention of pancreatic cancer". Contemp Oncol (Pozn). 21 (1): 30–34. doi:10.5114/wo.2016.63043. PMC 5385470. PMID 28435395.
  15. ↑ Kushi LH, Doyle C, McCullough M, Rock CL, Demark-Wahnefried W, Bandera EV, Gapstur S, Patel AV, Andrews K, Gansler T (2012). "American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity". CA Cancer J Clin. 62 (1): 30–67. doi:10.3322/caac.20140. PMID 22237782.
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