Pancreatic Cancer Is Difficult To Diagnose, Treat

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Pancreatic cancer remains one of the most difficult cancers to diagnose and treat.

It was estimated in 2021, that about 60,430 people would be diagnosed with pancreatic cancer in the United States, according to the American Society of Clinical Oncology. “Unfortunately,” says Matthew Doepker, MD, “only about 9 percent will survive for five years.” Though the statistics don’t seem to inspire much hope, “we are learning more about the disease that can help people lower their risks and improve their overall health,” he adds.

Pancreatic cancer is a cancer of the pancreas, which is an organ that produces hormones that regulate blood sugars and enzymes that help digest food.

Most patients who are diagnosed with pancreatic cancer are a median age of 72. Often, they visit their primary care provider with complaints of abdominal pain, weight loss, lethargy, and other non-specific issues.

“Most frontline providers don’t think pancreatic cancer,” Dr. Doepker says. “Based on the rarity of its non-specific symptoms, sometimes it’s hard to diagnose.”

Landing on a pancreatic cancer diagnosis usually starts with a CT scan of the abdomen and pelvis, followed by an endoscopic ultrasound.

Treatment Options

During the last 10 to 15 years, treatments have advanced. Once you’ve been diagnosed with pancreatic cancer, specialists will determine whether radiation, chemotherapy, surgery, or a combination of these is best for you.

If the cancer is contained in a tumor and hasn’t spread any further, “we could actually give chemotherapy first, and potentially shrink the tumor, which increases the chances that we could surgically remove it,” Dr. Doepker says. “Sometimes we get patients who have an early-stage diagnosis, although that’s not as common. With these patients, sometimes we take them straight to surgery, and they actually do very well.”

In more advanced cases, however, the cancer has already spread to nearby organs, typically the liver, lungs, bones, and/or lymph nodes. “Once it has spread, we can’t go in and surgically remove all the disease. In these instances, chemotherapy is the best option,” Dr. Doepker explains.

As researchers learn more about pancreatic cancer, Dr. Doepker says, the use of immunotherapy and clinical trials are advancing treatment options and hope for future breakthroughs.

Unlike some other forms of cancer, pancreatic cancer is a type that it isn’t useful to screen for in most cases. Tumor markers can be evident in blood tests, but universal screening for pancreatic cancer remains somewhat unreliable.

“So, there’s no good data yet that says we should screen the general population,” he says.

Some risk factors for pancreatic cancer include:

“Obesity and uncontrolled diabetes are additional risk factors that patients can control or modify,” Dr. Doepker says. “It is also possible that some individuals may possess certain genetic mutations that make them more predisposed to the disease than others. So people who are closely related to someone who has had pancreatic cancer may want to consult with their physician.”

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