Pancreatic cancer explosion: As cases surge in young people, survivors reveal subtle early signs that are easily dismissed… and doctors share lifestyle tweaks that help PREVENT it

It is, without doubt, one of the most feared cancers.

Pancreatic cancer has earned that reputation not just for how many lives it claims, but for how swiftly it can advance before patients realize anything is seriously wrong. 

In its early stages, symptoms are vague and easily dismissed: a dull back ache, intermittent indigestion, unexplained fatigue, subtle yellowing of the eyes or skin that comes and goes. 

Doctors often describe it as a cancer that ‘whispers’ rather than shouts – and by the time it finally makes itself heard, it is frequently a death sentence. Its stealth is what makes pancreatic cancer uniquely dangerous.

Around 80 percent of cases are diagnosed only after the disease has spread beyond the pancreas, at which point surgery – currently the only potential cure – is no longer an option.

Overall, just 12 percent of patients survive for five years after diagnosis, and the majority do not live more than a year.

For decades, pancreatic cancer has largely been regarded as a disease of older age, most commonly affecting people over 65, particularly those with long-standing risk factors such as smoking, obesity or type 2 diabetes. Each year, it is diagnosed in around 67,000 Americans and kills more than 52,000.

But doctors on the front lines are now reporting something troubling: the type of patients they are seeing appears to be changing.

Dr Shanel Bhagwandin, a gastrointestinal surgeon who specializes in pancreatic and colon cancer, says he is increasingly treating patients who do not fit the traditional picture of who doctors once expected to develop the disease – namely, the elderly.

Medical director of the gastrointestinal surgical oncology program at Jupiter Medical Center in Florida, Bhagwandin told the Daily Mail that more of his pancreatic cancer patients are now in their forties and fifties – and, in some cases, even younger.

‘It’s one of the most concerning trends we’re seeing in clinic,’ he said. ‘These are patients who don’t fit the stereotypical profile.’

Historically, pancreatic cancer has been associated with decades of cumulative damage – smoking histories stretching back to adolescence, long-term obesity, poorly controlled diabetes. Increasingly, Bhagwandin says, that assumption no longer holds.

‘Patients are getting younger, and many of them look otherwise healthy,’ he said. ‘They exercise, they work full time. They don’t fit the picture we were taught to expect.’

Population-level data appear to support those observations. According to the American Cancer Society, the lifetime risk of developing pancreatic cancer is one in 56 for men and one in 60 for women. While the disease remains rare in younger adults, incidence rates are rising steadily.

Between 2000 and 2021, pancreatic cancer diagnoses increased by 4.3 percent per year among Americans aged 15 to 34, and by 1.5 percent annually among those aged 35 to 54, according to a 2025 analysis. Though the absolute numbers remain small, specialists say the trend is nonetheless concerning.

Dr Kim Reiss, a medical oncologist specializing in pancreatic cancer at the University of Pennsylvania Health System, says she has witnessed the same shift in her own practice.

‘When I started, most of my patients were in their sixties and seventies,’ she told the Daily Mail. ‘Now I’m seeing people in their thirties and forties – and occasionally even younger.’

‘I never thought I’d be treating people in their twenties,’ she added. ‘And it’s difficult, because you know how serious the disease is.’

One of the reasons pancreatic cancer is so often detected late, doctors say, is that its early warning signs are easy to rationalize away – particularly in younger patients, who may assume serious illness is unlikely.

‘Pancreas cancer whispers before it screams,’ Bhagwandin said. ‘You don’t get a lot of obvious red flags.’

Instead, patients often report a vague sense that something is ‘off’ long before they receive a diagnosis. Persistent abdominal or back pain, unexplained weight loss, changes in digestion, overwhelming fatigue or itching can all be early clues – but rarely trigger alarm on their own.

Dr Amar Rewari, chief of radiation oncology at Luminis Health, says many patients struggle to articulate what they felt in the months before diagnosis.

‘They’ll tell me they felt unwell, or not quite themselves, but they can’t point to a single symptom,’ he said. ‘It’s only in hindsight that the pattern becomes clear.’

That hindsight is often painful.

Ryan Dwars, a father of two from Iowa, previously told the Daily Mail that in the lead-up to his stage four pancreatic cancer diagnosis at 36, he experienced a lingering pain running down his left side and radiating into his chest. At the time, he assumed it was muscular or stress-related.

For Holly Shawyer, diagnosed with stage one pancreatic cancer at 35, the warning sign was sudden, intense stomach pain that she initially thought was an ulcer. 

Scans later revealed a grapefruit-sized tumor on the tail of her pancreas.

‘Getting diagnosed in my thirties felt like someone hit pause on my life,’ said the teacher from South Carolina. ‘I was healthy before this. I didn’t think cancer was even a possibility.’

Digestive changes are another common but often overlooked signal. Pale or loose stools, bloating after meals, and unexplained weight loss can occur when a tumor interferes with the pancreas’ ability to release digestive enzymes.

Matthew Rosenblum, diagnosed with stage four pancreatic cancer at 32, recalled noticing his stools turning ‘bone-white’ and his weight dropping rapidly.

‘At first, I thought I was hungover,’ he told The Patient Story. ‘I’d had a few beers the night before, so I drank some Gatorade and lay in bed – but the urine didn’t get lighter.’

The social scientist and geographer originally from Michigan also developed intense itching on his palms and the soles of his feet. According to MD Anderson Cancer Center, this can occur when a tumor blocks the bile duct, causing bile salts and bilirubin to back up into the bloodstream – the same process that leads to jaundice.

Doctors believe that rising rates of obesity, insulin resistance and early metabolic disease among younger adults may be playing a role in pancreatic cancer’s shifting demographics.

‘We’re seeing increasing rates of obesity and prediabetes even in younger age groups,’ Bhagwandin said. ‘Those metabolic changes create an inflammatory environment that’s not good for the pancreas.’

‘I do think this trend will continue,’ he added.

Smoking remains the single most powerful modifiable risk factor. Tobacco use has been shown to nearly double pancreatic cancer risk, largely due to carcinogens such as nitrosamines and benzene, which damage DNA in pancreatic cells and promote tumor-forming mutations.

‘It’s something we should never do,’ Bhagwandin said. ‘That’s my biggest non-negotiable.’

Rewari agrees, adding that heavy alcohol use also raises risk by increasing rates of pancreatitis, a known precursor to pancreatic cancer.

‘People underestimate alcohol’s long-term effects,’ he said. ‘Chronic inflammation matters.’

Genetics also play a role. Inherited mutations in genes such as BRCA and ATM increase pancreatic cancer risk, and around 25 to 30 percent of early-onset cases occur in people with germline mutations, according to Dana-Farber Cancer Institute.

Meanwhile, a new study from researchers at Johns Hopkins University found that shifts in a gene called Krueppel-like factor 5 (KLF5) can also fuel the growth of the cancer.

In a lab study, researchers used gene-editing technology to cut certain genes out of pancreatic cancer cells and then monitored their growth, finding that removing KLF5 led to the greatest reduction. 

Further testing showed, however, that KLF5 fueled cancer growth not because it had certain mutations, but because chemical changes altered its programming, in a system called epigenetics, leading it to drive the spread of the cancer. 

The results did not show whether KLF5 raised the risk of developing the cancer, but they did suggest that it could fuel the disease once it appeared. 

Dr Andrew Feinberg, an epigenetic researcher at the university who led the study, said: ‘Epigenetic alterations are underappreciated as a major route to developing and fueling the growth of cancer metastasis.’ 

Beyond smoking and genetics, doctors say emerging research is increasingly examining the role of diet and environmental exposure.

Red and processed meats have been linked to higher rates of pancreatic and colorectal cancer, particularly in younger populations. According to the American Cancer Society, preservatives such as nitrates and nitrites used in processed meats can form nitrosamines – compounds known to damage DNA.

‘I avoid processed meats like bacon, sausage and deli meats,’ Bhagwandin said. ‘They increase inflammation and cancer risk overall.’

Ultra-processed foods, including some breads and baked goods, contain emulsifiers that research suggests may trigger inflammatory responses in the gut and pancreas.

Reiss says her family limits ultra-processed foods by cooking at home, eating fish and lean meats, and growing vegetables herself. She also makes sourdough bread to avoid commercial additives.

‘If you have the ability to do that, it’s something I’d encourage,’ she said.

Pesticide exposure is another area of active research. Used on roughly 70 percent of the US food supply, pesticides are thought to disrupt cellular signaling pathways and gene expression in major organs, including the pancreas.

‘There’s likely something environmental contributing to this,’ Reiss said, stressing that the evidence is still emerging.

Despite the grim statistics, specialists say there are reasons for cautious optimism.

Only 15 to 20 percent of pancreatic cancer patients are eligible for surgery, traditionally a complex and invasive Whipple procedure that can last up to seven hours and requires lengthy recovery.

However, some centers – including Jupiter Medical Center – are increasingly performing robotic Whipple surgeries, using smaller incisions that reduce complications and shorten hospital stays.

At the same time, targeted drugs are beginning to change treatment for a small but important group of patients. PARP inhibitors, which block cancer cells’ ability to repair damaged DNA, are now used in pancreatic cancers driven by inherited BRCA mutations, helping delay progression in some cases. 

Other experimental drugs aimed at interrupting cancer-driving pathways are also moving through early trials, though most remain years away from routine use. 

‘Survival is improving, but only when patients are treated early,’ Bhagwandin said. ‘That’s the key.’

‘Pancreatic cancer demands awareness, speed and specialist care.’