Pancreatic cancer is the third deadliest cancer in the United States, but it doesn’t have to be that way. While late-stage diagnoses are difficult to treat, five-year survival rates are highest when the disease is detected at its earliest stages.
According to Diane Simeone, MD, pancreatic surgeon and director of the UC San Diego Moores Cancer Center, identifying people at risk and prioritizing early detection could save thousands of lives. HealthyWomen spoke to Simeone to learn more about this secret illness.
Are the symptoms of pancreatic cancer different in women than in men?
There is no data that really shows a difference in symptoms depending on gender. The symptoms of pancreatic cancer are usually indefinable and vague to everyone, such as mild upper abdominal pain or bloating. The symptoms usually only appear when the disease has progressed: that is why it is so fatal. One of the warning signs of pancreatic cancer is a new diagnosis of diabetes and weight loss. Another warning sign is jaundice, which causes yellowing of the eyes or skin.
Does a history of diabetes or pancreatitis affect my risk of pancreatic cancer?
Diabetes is linked to pancreatic cancer in two ways. First, type 2 diabetes doubles your risk, and second, weight loss along with a new diabetes diagnosis is a warning sign of pancreatic cancer. When it comes to pancreatitis, every time chronic inflammation occurs, the risk of cancer increases twofold, and this also applies to pancreatitis, which is an inflammation of the pancreas.
What role does family history play in my risk of developing pancreatic cancer?
It has been found that there is a genetic link, meaning that in 10% of cases pancreatic cancer is caused by changes in your DNA. But if family history is taken into account, we believe this proportion could be as high as 20%.
In the pancreatic cancer community, we advocate for people to get germline testing, which are blood tests that can detect inherited genetic defects that are known to cause cancer.
What mutations are associated with pancreatic cancer and why should I care which mutations I have?
The BRCA genes, which are often linked to breast cancer, are also strongly linked to pancreatic cancer. Late detection leads to the worst outcomes, so we believe germline testing for cancer is critical. Today this does not happen consistently. A completely new strategy needs to be developed that includes routine germline testing, particularly for people at risk of pancreatic cancer.
What should high-risk people do to protect themselves from pancreatic cancer?
I recommend that people with risk factors contact a specialist center and work with a multidisciplinary team to assess their risk and create an individual plan to manage the risk. The plan will likely include the germline testing I mentioned and regular checkups. The pancreas is not easy to reach with an endoscope and there is no single blood test that can definitively detect pancreatic cancer. But there are markers that can be seen in the blood, and detection methods are improving as we study pancreatic tumors and their genetic makeup.
Are clinical trials a good option for people with pancreatic cancer?
Yes, clinical trials are always an important option to consider. There are studies testing the success of screening in early detection, and there are a growing number of clinical trials for new therapies. The Precede study is working to improve pancreatic cancer survival rates to 50% over the next 10 years through collaboration, funding and research in early detection, screening, risk modeling and prevention. These studies are not just aimed at patients: family members can also take part.
How does a healthcare provider decide which treatment options are appropriate for a particular patient?
While some cancers can be treated at your local cancer center, pancreatic cancer is a disease for which we recommend being evaluated at a National Cancer Institute Comprehensive Cancer Center. A multidisciplinary team is important so that patients can participate in studies, undergo germline testing, perform tumor sequencing, and gather as much information as possible to determine the best course of treatment.
Treatment will likely include a combination of surgery, radiation and chemotherapy. There have been promising breakthroughs in immunotherapy and vaccines that need to be validated in clinical trials. And new therapies could have an impact, such as those that target a gene called RAS that causes cancer when mutated. But any treatment will work best if the cancer is discovered at an earlier stage.
What role does diet play in pancreatic cancer?
The best nutrition data shows that a healthy, balanced diet low in processed foods reduces the risk of cancer. Exercise is also important. A study showed that people who completed 7,500 steps per day were able to extend their life expectancy by 10 years. There is a growing body of data showing that exercise can not only reduce the risk of cancer, but also help the body respond better to cancer treatments.
Are there relevant racial or socioeconomic disparities when it comes to pancreatic cancer?
A wealth of data shows that underrepresented populations are less likely to be offered germline testing and are not fully informed about their eligibility for cancer screening.
With 67,530 new cases of pancreatic cancer in the U.S. this year, most patients have no chance of dying from the disease. Late-stage diagnosis was and is the biggest problem. When I started as a pancreatic surgeon and scientist 30 years ago, the five-year survival rate was 5%. Now it’s 13%. It is poised to become the second leading cause of cancer death in our country.
I advise patients to stand up for themselves. It’s so important to listen to your body, get a second opinion, and work to be heard and seen. Your life is at stake. As these numbers and the devastating impact of this disease on patients and families change, it is important for all of us to advocate for a focus on early detection.
This educational resource was created with support from Merck.
From your website articles
Related articles on the Internet