Pancreatic Cancer Is On the Rise. So Is Hope for Earlier Detection.

by Stanley J. Pietrak, MD, Gastroenterology
March 12, 2020

Over the past decade, we’ve made incredible strides in the fight against many types of cancer. But pancreatic cancer is one type that continues to elude a cure. This year, cases are predicted to increase worldwide. And within the U.S., this lethal cancer is now the third leading cause of cancer death, just behind colorectal and lung cancers.

What is happening here? Pancreatic cancer has not yet experienced the caliber of breakthrough treatments that are driving down other cancer deaths. And as certain high-profile cases—such as TV host Alex Trebek and Congressman John Lewis—illustrate, it is still notoriously difficult to detect in its early stages, when available treatments can be most successful.

On a positive note, the attention that celebrity patients like these have brought to the disease is spurring hope that more people will understand the risk factors, take steps to prevent or catch it early, and get to their doctors sooner when unusual symptoms arise.

What Is Pancreatic Cancer?

The pancreas is a narrow gland, about six inches long, that sits deep within your abdomen. It produces enzymes that help with digestion and insulin that regulates your blood sugar. The location of the pancreas, sandwiched between your stomach and spine, makes it tough to discover small growths that might be felt elsewhere. So cancerous tumors that grow in or around the pancreas tend to be larger, and even invasive, before they’re discovered.

Thankfully, this type of cancer is not that common, accounting for only about 3% of all cancers. But because it’s typically diagnosed in late stages, currently fewer than 10% of patients survive longer than five years.

Pancreatic cancer is uncommon, accounting for about 3% of all cancers. But because it’s typically diagnosed in late stages, currently fewer than 10% of patients survive longer than 5 years. https://bit.ly/335KIzW via @MedStarWHC

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What Can You Do To Help Prevent It?

So far, screening tools that help us early-detect and successfully treat other kinds of cancer haven’t worked for pancreatic cancer. But some preventive steps may help. Avoiding smoking is a big one, since researchers estimate that it accounts for about 25% of cases. Limiting alcohol and consumption of red meat, processed foods, and added sugars should also offer some protection. These habits contribute to other important risk factors for this cancer, including chronic pancreatitis (a painful inflammation of the pancreas) as well as obesity and type 2 diabetes. You’ve heard it before, but it’s worth repeating: eating a healthy diet, staying active, and skipping alcohol and smoking are smart moves toward preventing all kinds of cancer.

Some risk factors, however, are unavoidable, such as advancing age and race (African-American and Ashkenazi Jewish people are at higher risk). But some can make you eligible for special monitoring. For instance, about 10% of cases are associated with a family history of the disease. If you have two or more first-degree relatives (a parent, sibling, or child) who have had this cancer, or one who was diagnosed before age 50, you should strongly consider meeting with a genetic counselor to determine your own risk and to see if you qualify for a close surveillance program. That typically includes regular MRIs or endoscopic ultrasound tests of your pancreas that are not routinely available to everyone.

I also recommend these close surveillance measures for people with chronic pancreatitis or pancreatic cysts. These are conditions that are typically benign when they cause symptoms you’ll notice. But they may evolve into cancer over time. By monitoring them closely with these imaging tests, we can detect pre-cancerous or cancerous changes early, when they’re most treatable and even curable.

What Symptoms Should You Act On?

The important message is that it’s critically important not to wait when you notice any changes in your body that could be signs of pancreatic cancer.

The two most noticeable symptoms may be pain in your upper middle abdomen, just below the rib cage, that may even radiate through to your back, and yellowing of your skin or the whites of your eyes.

Others symptoms include:

  • Light, clay-colored stools and/or dark urine
  • Itchy skin
  • A sudden diagnosis of diabetes over age 50
  • Digestion trouble or bloating
  • Unexplained weight loss

The biggest mistake people make is noticing these odd changes in their body or health and ignoring them. If something unusual like that persists for more than two days, call your doctor. Don’t wait and see, especially if you have other risk factors. In addition, stay on track with all your recommended screenings for other cancers.

What’s on the Horizon?

Research toward new diagnosis and treatment options is underway in medical centers around the world.

For instance, scientists are learning more about genetic changes, either inherited or acquired during a person’s lifetime, that could fuel this cancer. These insights could be used to develop new genetic tests or targeted treatments for patients with these mutations. Other studies are focusing on the ability of blood tests to identify certain proteins that could indicate the cancer in its very early stages. At MedStar Health, we’re involved in research on high-risk patients to help us identify specific factors that might eventually allow us to more accurately predict who is most likely to develop this cancer, so we can act earlier.

As for treatment, research is focused on improving surgery and radiation therapies and on finding new types of treatment. Some medical centers, including MedStar Health, are now using minimally invasive techniques, such as robotics, that help make pancreatic surgery more tolerable, reduce recovery time, and still achieve good outcomes for our patients.

Many clinical trials are also underway to test new combinations of chemotherapy drugs, new approaches to radiation therapy, and novel treatments like targeted therapies that could attack specific targets on pancreatic cells, as well as immunotherapies that boost the body’s own ability to destroy cancerous cells in the pancreas.

While the fight for better pancreatic cancer outcomes continues, the future holds tremendous promise that we will get there.

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Category: Healthy Living     Tags: chronic pancreatitisgastroenterologyPancreatic cancerpancreatic cancer detectionscreening tools for pancreatic cancer