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A Look at Pancreatic CancerGeneral The pancreas is a small spongy organ that lies just under the curvature of the stomach and deep within the abdomen. The pancreas is complicated but it does two main things: produces enzymes that are useful for the digestion of food AND secretes hormones (like insulin and glucagon) that, among other actions, help maintain and regulate body sugar levels. When cancer develops in the pancreas it is almost always lethal. Pancreatic cancer is the most virulent of all of the major cancers. The median duration from diagnosis to demise in advanced pancreatic cancer (the most common stage at diagnosis) is 5 to 6 months with good treatment. The reasons for this late diagnosis are primarily related to the tumor’s stealth nature. The most common symptoms are vague — and include malaise, fatigue, loss-of-appetite, weight loss, abdominal discomfort and nausea. Also, the most common presenting physical sign of pancreatic cancer, that of jaundice (due to obstruction of the bile duct), is typically shown late in the disease progression. Pancreatic cancer is the least funded cancer in terms of research. It receives (on a per mortality basis): 10% of the funding of breast cancer (but causes 78% of the mortality), 29% of the funding of colorectal cancer (but causes 55% of the mortality) and 35% of the funding of prostate cancer (but causes more mortality). This is further accentuated by the lack of funding for studies oriented to the earlier diagnosis of pancreatic cancer. Less than 5% of published medical articles about pancreatic cancer are about finding a method to aid in the earlier diagnosis of this disease.
Epidemiology Pancreatic cancer will cause more than
30,000 deaths in the In the developed world, cancer is the second most common cause of mortality (behind cardiovascular heart disease). And pancreatic cancer is the fourth most common cause of cancer death (behind lung, colorectal and breast, respectively). Pancreatic cancer is more common in African-Americans; it is strongly associated with smoking. And likely associated with diets rich in saturated fats. There appears to be a mild correlation between the onset of diabetes and pancreatic cancer, but it is not entirely clear if this is a cause or an effect of the cancer. There does not appear to be a strong correlation between pancreatic cancer and the drinking of alcohol or of coffee (though these have been past issues of some controversy). In a small percentage of cases, pancreatic cancer stems from a familial genetic predisposition.
Earlier Diagnosis There currently exists no molecular marker or genetic screening tool to aid in the earlier diagnosis and screening of pancreatic cancer (such as now exists, for example, with prostate cancer). Earlier diagnosis would give access to potential curative surgery for a much greater number of people. Such surgery, typically the Whipple Procedure, is considered the most likely treatment to offer a cure to an individual patient. But due to the aggressiveness and stealth of the tumor it is now applicable to only about 15% of patients by the time of diagnosis. The natural history of pancreatic cancer would be significantly altered for the better if it could be diagnosed at an earlier stage. Treatment options would radically open up — and its mortality profile would improve. |
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