17 November 2023
Check Up #20 - Pancreatic Cancer
What are the myths and the truths about this scary disease?
Pancreatic cancer is indeed a scary disease. This is because, when it becomes symptomatic enough to be detected and diagnosed, it has , in many cases, already disseminated, with metastatic tumor cells invading other organs.
Actually, it is among the most deadly forms of cancer, with an estimated five-year survival rate of around 3% once it has become metastatic, down from 44% when it is still localised, according to recent figures from the US National Cancer Institute.
Nonetheless, it is a relatively rare cancer. The estimated lifetime risk of contracting pancreatic cancer is relatively low: one in 73 for men and one in 74 for women.
But the big problem with pancreatic cancer is that reliable tests for its early diagnosis (in particular specific biomarkers), as well as screening strategies to detect it in its early stages – when it might be curable – are sorely lacking. In later stages, survival can be extended by different treatments, but the results are still modest. That is the hard truth about the current situation regarding pancreatic cancer.
There are, it’s true, signs and symptoms of pancreatic cancer, but they are often non-specific and can easily be linked to other diseases or conditions, like stomach pain, indigestion, mid-back pain, unexpected weight loss, loss of appetite, new-onset diabetes, or changes in bowel habits.
It is to address this big problem that the Champalimaud Foundation has built, equipped and staffed a unique pancreatic cancer centre that is bringing together the efforts of top basic researchers and medical oncologists committed to fast-tracking (“translating”) the recent and future research advances in understanding this cancer into the clinical practice. With funding from Spanish philanthropists Mauricio Botton Carasso and Charlotte Botton, the Botton-Champalimaud Pancreatic Cancer Centre now sits in close proximity to the main building of the Champalimaud Centre for the Unknown – and will begin operations in a few weeks’ time.
The hard truth about pancreatic cancer has generated some myths. One of them is that it is not treatable. In fact, as already mentioned, if it is detected early, when it is still localised, it can even be cured. And in later stages, it can be treated with chemotherapy, radiation and surgery to prolong the life and quality of life of the patient.
Another myth is that pancreatic cancer is purely inherited. Some of it it is, and for individuals with a close family history of the disease, close surveillance is highly recommended – once again, to catch it early. But most of the cases of pancreatic cancer are not due to genetic causes, but to risk factors, such as advanced age, smoking, diabetes and obesity, bad dietary habits, and chronic alcohol consumption (which can lead to chronic inflammation of the pancreas, or pancreatitis).
Still another myth: that there is only one type of pancreatic cancer or that all pancreatic cancers are equally deadly.. There are in fact two types of pancreatic cancers: pancreatic adenocarcinoma (the most common, accounting for around 90% of cases) and so-called neuroendocrine malignant tumours, which are cancers of the pancreatic cells (Langerhans cells) that produce insulin. And actually, neuroendocrine tumours tend to have a much better prognosis than pancreatic adenocarcinomas.
Another misconception is that pancreatic cancer only affects men; it affects men and women equally. And it does not only affect older people, in spite of the fact that advancing age is a risk factor for pancreatic cancer. The likelihood of having pancreatic cancer does increase with age, the average age of diagnosis of pancreatic cancer being 72. However, more than 30% of all patients diagnosed in the UK between 2005 and 2009, for instance, were under the age of 64.
Sources:
https://www.cancer.gov/
https://www.cancer.org/
https://www.cancerresearchuk.org/
https://columbiasurgery.org/
https://pancreaticcanceraction.org
https://www.gutcare.com.sg/
