A nasty, stubborn killer: pancreatic cancer
Pancreatic cancer, a rare cancer that begins with no apparent symptoms, is fast becoming a leading cause of cancer-related deaths in the US; it currently accounts for about 3% of all cancers and 7% of cancer deaths. The grim outlook of pancreatic cancer is that only one in 10 diagnosed patients is lucky to survive the next five years. Successful treatment happens, perchance, when the cancer is detected at an early, symptom-free stage and the tumour can be surgically removed.
Despite this, there are certain risk factors for developing pancreatic cancer, some of which are amendable such as smoking and being overweight due to lifestyle choices. Type 2 diabetes, which is most often related to being overweight, is an important risk factor.
Other risks include chronic pancreatitis, a persistent inflammation of the pancreas often linked to heavy alcohol consumption and smoking, and workplace exposure to certain chemicals, like those used in dry cleaning and metalwork industries.
Age is also a risk factor for pancreatic cancer – nearly two-thirds of cases reportedly occur in those 65 and older. Family history, including inherited genetic conditions like mutations in the BRCA1 or BRCA2 genes often associated with breast and ovarian cancers, is thought to play a role as well.
Although the cancer often goes unnoticed unless the malignancy spreads beyond the confines of the pancreas, scientists are hard at work studying one possible early warning sign: a link between pancreatic cancer and newly developed Type 2 diabetes.
Diabetes arises in the pancreas, a small, carrot-shaped organ, about six inches long and less than two inches wide, that lies well-hidden between the ribs and the stomach. The pancreas contains specialised cells that produce the hormone insulin that regulates blood sugar levels – some research suggests thatrecent development of Type 2 diabetes may herald the existence of cancer hidden in this organ.
Among ongoing studies is one by Dr. Maxim S. Petrov, a professor of pancreatology at the University of Auckland School of Medicine, New Zealand. Dr. Petrov led a study of nearly 140,000 people with Type 2 diabetes or pancreatitis, or both, who were followed for up to 18 years. Recent findings revealed that those who developed diabetes after an attack of pancreatitis were seven times more likely to get pancreatic cancer than others with Type 2 diabetes.
Another such effort by the Pancreatic Cancer Action Network, called the Early Detection initiative for Pancreatic Cancer, beginning last summer will enrol more than 12,000 participants with elevated blood sugar levels and new-onset diabetes. Half the participants are expected to have periodic blood tests and undergo abdominal imaging based on their age, body weight and blood glucose levels to look for evidence of early pancreatic cancer, while the others will serve as controls.
The studies are hoped to identify biological markers, like certain genes or proteins excreted by the tumour, which could be used in screening tests to indicate the presence of cancer when it could still potentially benefit from surgery.
Doctors, too, should consider “a checklist” of warning signs that might alert them to the presence ofcancer, said Dr. Brian M. Wolpin, Director of the gastrointestinal cancer centre at the Dana-Farber Cancer Institute in Boston. The checklist should include sudden changes in a patient’s glucose level i.e., one that is rising rapidly and is difficult to control with diabetes medication; or whether a patientwith diabetes israpidly losing weight with no explanation.
Category: Features, Health alert
