Rates of pancreatic cancer are on the rise around the world, a troublesome trend for a disease that often has no symptoms until it becomes lethal.
“Pancreatic cancer is responsible for 7% to 10% of cancer-related deaths in the U.S.,” says Muhammad Baig, MD, a gastroenterologist on the medical staff at Methodist Dallas Medical Center. “Unfortunately, one of the grim truths about this disease is its extremely high mortality rate.”
With a five-year survival rate of just 13%, pancreatic cancer is among the deadliest forms of cancer. This is because common symptoms — fatigue, jaundice, and unexplained weight loss — often don’t appear until the disease is in an advanced stage.
“Early-stage pancreatic cancer can be entirely symptom-free,” Dr. Baig says. “Most patients don’t experience any noticeable issues until it’s already quite advanced.”
Still, there is hope. For those at risk, advancements in high-quality radiologic and endoscopic imaging technologies have made it possible to detect early pancreatic lesions more effectively.
PANCAN EXPLAINED
The pancreas is a large tadpole-shaped gland that rests behind the stomach. It plays a dual role by producing digestive enzymes and hormones that help regulate blood sugar levels.
Insulin and other essential hormones are made by the endocrine cells of the pancreas, while digestive juices are secreted by the exocrine cells — where most pancreatic cancers originate.
Symptoms of pancreatic cancer often appear in the later stages and may include jaundice (yellowing of the skin and eyes), abdominal or back pain, and unexplained weight loss.
“Anyone experiencing significant abdominal pain or unintentional weight loss should be evaluated for pancreatic cancer,” Dr. Baig advises.
Several risk factors may contribute to the development of pancreatic cancer beyond family history:
- Smoking: Approximately 25% of pancreatic cancer cases are linked to cigarette use.
- Obesity and diabetes: People with obesity have a 20% higher risk, and the disease is more common in those with type 2 diabetes.
- Chronic pancreatitis: Long-term inflammation of the pancreas, often associated with smoking and heavy alcohol consumption, also increases risk.
HOW SCREENING WORKS
Unlike some other types of cancers, pancreatic cancer doesn’t have a standard screening test.
While tools like mammograms and colonoscopies help detect breast and colorectal cancers early, no such routine test exists for pancreatic cancer. However, physicians such as Dr. Baig use a combination of blood tests, imaging scans, and endoscopic ultrasound (EUS) with pancreatic tissue biopsies to assess the condition.
“Endoscopic ultrasound allows us to detect cancer in its early stages and even identify pre-cancerous pancreatic cysts, which can develop into cancer over time,” Dr. Baig explains.
When detected early, pancreatic cancer can often be surgically removed with positive outcomes. If pre-cancerous cysts are detected, they can be closely monitored with imaging to help prevent cancer from forming.
TREATMENT OPTIONS
Surgery remains the most effective treatment for pancreatic cancer; however, it’s only an option for approximately 20% of patients, as the disease is typically advanced at the time of diagnosis.
“Gastroenterologists play a crucial role in supporting oncologists and surgeons by managing complications of pancreatic cancer, such as pain, jaundice, and intestinal obstruction,” Dr. Baig says.
When surgery isn’t an option, doctors will turn to chemotherapy, radiation, and targeted therapies. For some patients with neuroendocrine tumors, peptide receptor radionuclide therapy (PRRT) may be an option.
PRRT is a relatively new outpatient procedure that combines a drug made up of a cell-targeting protein with a radioactive substance called lutetium. When injected into a patient’s bloodstream, the drug attaches to the tumor, killing the cancer cell.
“Unlike traditional forms of radiation therapy,” says Alexandru Bageac, MD, chair of the radiology department at Methodist Dallas, “this approach radiates the tumor from within with little effect on the surrounding normal tissues.”
However, the best medicine is screening and prevention for patients at highest risk for pancreatic cancer.
“If you’re at high risk, it’s important to speak with your primary care doctor and a gastroenterologist, as pancreatic cancer is not a condition to delay addressing,” Dr. Baig says.
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