The Medical Minute: Progress slow against pancreatic cancer

Pancreatic cancer is the third deadliest form of the disease after lung cancer and colorectal cancer.

There is no effective screening test, and its symptoms often mimic other maladies, making it difficult to diagnose. Once it develops, it’s very aggressive. Fewer than 10% of people who develop pancreatic cancer survive five years after they are diagnosed.

Dr. Niraj Gusani, director of the program for liver, pancreas and foregut tumors at Penn State Cancer Institute, said there isn’t a clear single cause for development of pancreatic cancer, but known risk factors include aging, smoking, obesity and certain types of cysts in the pancreas.

Some forms of pancreatic cancer are genetic, so those with a family history of gastrointestinal or breast cancers may want to consider genetic testing.

Pancreatic cancer develops when a tumor grows in the pancreas, an organ in the back of the abdomen that produces insulin and other hormones to control sugars and enzymes to help digest fatty foods. The most common type of pancreatic cancer starts in the gland cells that line the ducts of the pancreas.

Patients often complain of abdominal pain, colored urine or stool, nausea, vomiting, bloating, jaundice and weight loss. A biopsy can diagnose the disease while magnetic resonance imaging, positron emission tomography or computerized tomography scans and blood tests that look at tumor markers determine if it has spread beyond the pancreas.

“Unfortunately, by the time we find it, it has often already spread to other organs,” Gusani said.

Many cases are diagnosed at Stage 4 on the 1 to 4 scale and are not operable, so chemotherapy is the only option. Earlier diagnosis allows for the possibility of surgery combined with chemotherapy (and sometimes radiation) and offers a better chance of eliminating the cancer.

“Patients really need to make sure they have a team of doctors from different specialties treating them,” he said. “That way they can look at the problem from different angles.”

Despite the dismal prognosis, Gusani said more medications are coming out every year to treat the disease and control its symptoms. “There is always a good chance that even if we can’t cure you,” he said, “we can prolong your life or improve your quality of life.”

He said a recent study by a colleague examined how certain microorganisms and fungi in the gut might create an environment hospitable to the development of pancreatic cancer. Doctors hope that identifying and eradicating those fungi might prevent some cases of pancreatic cancer from developing.

“We’re still many steps away from that though,” he said.

Gusani said it’s important to focus attention on pancreatic cancer, because compared with the number of pancreatic cancer deaths, research is important and underfunded.

“It’s important that we advocate for more research funding,” he said. “It’s the only way to improve survival rates.”

The Medical Minute is a weekly health news feature produced by Penn State Health. Articles feature the expertise of faculty, physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.

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