PurpleStride Chicago 2012: Research on Pancreatic Cancer

Tomorrow, we’re walking in PurpleStride Chicago 2012 to raise money for the Pancreatic Cancer Action Network. Click HERE for our team page. That’s an opportunity for us to focus this post on a health sciences topic and consider some of the science related to our own bodies.

Image from National Institutes of Health (NIH)

If you remember back to high school anatomy class, the pancreas, an organ about six inches long, sits horizontally behind the stomach. The head of the pancreas connects to the small intestine, where its secretions do their work on the food you eat. The job of the pancreas is to produce enzymes for the digestion process and hormones used for metabolism.

Pancreatic cancer has been in the news in recent years because Apple founder Steve Jobs, actor Patrick Swayze, and professor and author of The Last Lecture Randy Pausch died from this cancer. (Watch Jobs’s 2005 speech at the end of a previous post HERE. Watch Pausch’s CMU “Last Lecture” HERE.) Jobs was 56, Swayze was 57, and Pausch was just 48, which might lead a person to believe that successful white men in their late forties and fifties are particularly at risk. But one of the things we’ve learned from talking with nurses these past few weeks is that pancreatic cancer can strike at almost any age—one nurse knew a 30-year-old nurse and the 89-year-old grandfather of another friend who’d been diagnosed in the last couple of weeks—and that the risk factors are poorly understood. Smokers, diabetics, and those with chronic pancreatitis are at greater risk, and more women than men contract this cancer.

Image by Department of Health and Human Services

As cancers go, pancreatic cancer is relatively rare, with a lifetime risk of about 1.4%, meaning that fewer than 3 in 200 people are ever diagnosed with this type of cancer. Compare that with the commonly cited lifetime risk of breast cancer: 1 in 8 women, or 12.5%. Or consider the overall lifetime risk of being diagnosed with any cancer: 45% for men, 38% for women, according to the American Cancer Society (click HERE for more info). The overall risk of dying from cancer, though, is better: 23% (1 in 4) for men, and 19.5% (1 in 5) for women. Statistics are tricky, of course, and tell us nothing about a particular individual and only some things about everybody else. Those numbers indicate many things, including that we are living long enough to develop cancer, which is more likely as we age, and that we are, in many cases, surviving cancer long enough to die of something else.

What’s especially disconcerting about pancreatic cancer, though, is that more than half of pancreatic cancers are diagnosed after they’ve metastasized, when there exists no cure. The NIH reports even worse numbers than most resources, stating, “in more than 80% of patients the tumor has already spread and cannot be completely removed at the time of diagnosis.” Often, the first symptom is jaundice, which occurs after the cancer has spread to the liver. That late diagnosis contributes to a very discouraging survival rate, with roughly 6% of patients hitting that magical five-year goal, according to the American Cancer Society (click HERE for Cancer Facts & Figures 2011). Even if the tumor is localized and operable, the five-year surrvial rate is just 23%. In fact, just 26%—one in four—of patients are alive a mere one year after diagnosis. The numbers vary slightly from resource to resource, and these statistics capture information about the past (the 2011 report is based on numbers no later than 2007).

Mary Lee & Anna Leahy

Statistically, several patients out of every hundred do stick around for years to come. If caught before the cancer spreads, the tumor is sometimes operable, which is the key to a potential cure. Research shows that surgery is much more successful if done at a hospital where the Whipple procedure—abdominal surgery almost as complicated as organ transplant—is performed regularly and if the surgeon is very experienced with the Whipple. Jobs, who had the slower-growing, more treatable of the two kinds of pancreatic cancer, waited nine months after diagnosis to have the Whipple surgery and still survived eight years. Even those who aren’t candidates for surgery can live several years; Swayze held out 20 months. For inoperable tumors, chemotherapy, radiation, and newer NanoKnife technology can sometimes shrink the tumor and, thereby, improve quality of life. In some cases, these treatments make the tumor operable and the cancer possibly curable.

Pancreatic cancer is relatively slow growing, with tumors taking years to develop and even longer to metastasize. That long timeframe—before deadly metastasis—during which pancreatic cancer could be diagnosed and cured is excellent reason for research because a screening test or even a better understanding of risk factors that leads to early detection could drastically improve survival rates. Immunotherapy treatment is another area of worthwhile investigation for pancreatic cancer and for cancers more generally. In other words, pancreatic cancer seems an especially good target for medical research because answers could make big differences in outcomes and possibly could be adapted for screening techniques and treatment options for other cancers.

In addition, the American Cancer Society reports, “Since 1998, incidence rates of pancreatic cancer have been increasing by 0.8% per year in men and by 1.0% per year in women.” Pancreatic cancer is on the rise, as are death rates from this disease, and research needs to catch up. So tomorrow, we’re walking in PurpleStride Chicago 2012 because scientific research matters can make big differences in our health and quality of life.