November is Pancreatic Cancer Awareness Month, a time to recognize the impact of this disease and educate others about the search for a cure. Pancreatic cancer patients wage a tough fight, but more research may yield better treatment options and outcomes.
What Is Pancreatic Cancer?
The job of the 6-inch long pancreas involves secreting insulin and other hormones so that the body can process sugar. Along with hormones, the pancreas creates digestive juices to aid in nutrient absorption. Exocrine tumors make up the bulk of pancreatic cancers. They start out in the cells lining the pancreatic ducts. These tumors — also known as pancreatic adenocarcinomas — account for 95% of pancreatic cancers.
There’s another, much less common type of pancreatic cancer that develops in the hormone-producing cells. This is known as pancreatic endocrine cancer or islet cell tumors which often has a better outcome.
Pancreatic Cancer Awareness Month
This year, approximately 60,430 people in the United States will receive a pancreatic cancer diagnosis and roughly 48,220 people will succumb to the disease. While pancreatic cancer accounts for about 3% of all cancers in the U.S, it is responsible for 7% of all cancer deaths.
During Pancreatic Cancer Month, participants can join events, donate money or create fundraisers and share their own stories — or their loved ones’ stories — about this disease.
Pancreatic cancer overwhelmingly occurs in those aged 45 and older. More than two-thirds are diagnosed at 65 and older, with 70 the average age. Rates for males are slightly higher than for females. Black people have a slightly higher risk of pancreatic cancer than white people. Pancreatic cancer may have a genetic component, as the disease tends to run in some families.
As with many cancers, tobacco use is a major risk factor for pancreatic cancer. The American Cancer Society estimates 25% of pancreatic cancers result from cigarette smoking. Other risk factors include:
- Body weight — While obese people have a greater risk of developing pancreatic cancer, so do those who carry excess abdominal weight.
- Chronic pancreatitis — Issues with chronic inflammation of the pancreas may predispose patients to pancreatic cancer.
- Diabetes — Patients with Type 2 diabetes are more vulnerable to pancreatic cancer.
- Sedentary lifestyle — A lack of regular exercise combined with a sedentary lifestyle may increase the risk of pancreatic cancer development.
The most common symptoms of pancreatic cancer include:
- Abdominal pain that spreads to the back
- Appetite loss
- Light colored feces
- Dark urine
- Unintentional weight loss
Diabetics with pancreatic cancer may discover their condition is harder to control. Some patients newly diagnosed with diabetes may find it is related to pancreatic cancer.
If experiencing any of these symptoms, see a doctor as soon as possible. These symptoms are indicative of many health issues, but it is especially imperative to rule out pancreatic cancer right away.
Pancreatic Cancer Diagnosis
Because early signs of pancreatic cancer are so subtle, the disease is seldom detected in its initial stages. That is when a cure is most likely. By the time pancreatic cancer is usually diagnosed, it has already started to spread (metastasize).
When a doctor suspects pancreatic cancer, the patient may undergo the following tests:
- Blood tests: Blood tests may reveal pancreatic cancer cell tumor markers.
- Imaging tests: Diagnostic tests for pancreatic cancer include MRI, ultrasounds, CT scans and PET scans.
- Endoscopic ultrasound: In this test, a thin, flexible tube called an endoscope with a tiny ultrasound attached is passed through the esophagus to the stomach. Abdominal images are then taken.
- Biopsy: During the endoscopic ultrasound, a biopsy is performed via extremely small tools passed down the endoscope. A tissue sample is removed and sent to a pathologist for examination.
Once a diagnosis is made, the next step for the doctor is to determine the stage of the tumor. This plays a large role in planning a specific treatment.
Pancreatic Cancer Treatment
Pancreatic cancer patients generally undergo surgery. There are two types:
- If the cancer is found in an early stage, it is possible to remove all of it.
- If detected in later stages, palliative surgery may take place. This surgery is not aimed at curing the disease. It is done for symptom relief or to repair complications such as intestinal blockage.
Radiation and chemotherapy are common pancreatic cancer treatments, but used for different purposes depending on the stage of the tumor. Before surgery, radiation and chemotherapy may shrink tumors, making removal easier. For those whose cancers have spread beyond the pancreas, radiation and chemotherapy are often primary treatments. Radiation therapy is sometimes used for pain relief.
Targeted therapy includes drugs such as erlotinib, marketed under the brand name Tarceva. Patients with cell changes in their BRCA genes may benefit from the PARP inhibitor Olaparib, marketed as Lynparza. This drug makes it difficult for tumor cells with the mutated gene to repair damaged DNA. It has been shown to slow the growth of some pancreatic cancers.
Immunotherapy uses medications to stimulate the person’s immune system to combat cancer. In pancreatic cancer, these drugs are used for patients who cannot undergo surgery or who have seen the cancer return after chemotherapy.
The search for a cure and more effective treatments for pancreatic cancer continues. Yosemite Pathology and Precision Pathology has long played an important role. For more than 70 years, we have advanced anatomic pathology in the Western United States. Our current practice encompasses more than 20 board-certified anatomic pathology specialists offering a broad range of specialties. For more information about our services, contact us today.
Jane Meggitt’s work has appeared in dozens of publications including USA Today, Zack’s, Financial Advisor, nj.com, The Houston Chronicle and The Nest. She is a graduate of New York University.
American Cancer Society – What Is Pancreatic Cancer?
American Cancer Society – Key Statistics for Pancreatic Cancer
Mayo Clinic – Pancreatic cancer
Cancer.net – Pancreatic Cancer: Risk Factors
American Cancer Society – Pancreatic Cancer
National Cancer Institute – Pancreatic Cancer: Patient Version