Kathy's Blog: Healing from the Loss of a Parent

According to the American Cancer Society, 43,920 new cases of pancreatic cancer will be diagnosed in 2012 and 37,390 people will die from this disease. Both of these statistics have decreased slightly from the 2011 statistics (44,030 new cases; 37,660 deaths). Pancreatic cancer remains the fourth leading cause of cancer-related death in the United States. Lung cancer is the leading cause of cancer-related death, followed by prostate (men)/breast (women) cancer and colorectal cancer. An article by Smith and colleagues published in the Journal of Clinical Oncology (June 10, 2009 issue) stated that the number of cases of pancreatic cancer is projected to increase by 55% by the year 2030.

Although there has been a slight decrease in the statistics for pancreatic cancer deaths over the past year, the survival rate remains low for all stages of this disease. Pancreatic cancer is usually not curable, and the overall survival rate for patients with this type of cancer is less than 4% according to the National Cancer Institute. The survival rate may increase up to 24% for patients in whom the cancer has not spread beyond the pancreas and their tumor can be completely removed. However, this is rare, and more than 75% of patients with pancreatic cancer are diagnosed at an advanced stage. Since the pancreas is located deep inside the body, tumors in the pancreas cannot be felt during a routine physical examination. It is very hard to detect pancreatic cancer early, and it has usually spread to surrounding lymph nodes and other organs by the time someone starts having symptoms.

The American Cancer Society states that the lifetime risk of having pancreatic cancer is about 1 in 71. There are certain things that can increase a person’s risk of developing pancreatic cancer. These include:

• Age: risk increases with age; about 90% of patients with pancreatic cancer are over age 55
• Gender: pancreatic cancer occurs slightly more often in men than women
• Family history: pancreatic cancer appears to “run” in some families and this may be related to the presence of specific genes
• Obesity and lack of exercise: people who are very overweight or who don’t get much exercise are more likely to develop pancreatic cancer
• Smoking: the risk of getting pancreatic cancer is 2-3 times higher in people who smoke
• Chronic pancreatitis (long-term inflammation of the pancreas): people with this condition have a slightly higher risk of developing pancreatic cancer, but most people with chronic pancreatitis do not get pancreatic cancer
• Stomach problems: too much stomach acid or having H. pylori bacteria in the stomach may increase the risk of pancreatic cancer
• Diabetes – pancreatic cancer is more common in diabetics, mainly those with type 2 diabetes, but the reason for this link is not known
• Cirrhosis (scarring) of the liver: there appears to be an increased risk of pancreatic cancer in people with cirrhosis
• Gene changes: inherited gene changes (mutations), or abnormal copies of certain genes that can be passed from parent to child, may cause pancreatic cancer. Some of these genes have been identified by scientists and recognized using genetic testing
• Work exposure: heavy work-related exposure to pesticides, dyes, and chemicals may increase a person’s risk of pancreatic cancer

Research by Johns Hopkins University shows that race is factor for the development of pancreatic cancer. It has been found that the incidence of pancreatic cancer is 50-90% higher in African-Americans compared with other races, with a poorer prognosis.

Although the survival rate associated with pancreatic cancer remains low, more research is being done to understand pancreatic cancer, detect the disease sooner, and identify new and more effective treatments for this type of cancer. Using a mathematical model to analyze data, NCI researchers now estimate that pancreatic cancer may take over 10 years to progress from the initial genetic mutation to formation of a tumor (for more information: http://www.cancer.gov/ncicancerbulletin/110210/page3). The Early Detection Research Network (EDRN) is identifying and testing new biomarkers to increase detection of pancreatic cancer and determine risks for this disease. A project supported by EDRN is studying stem cell biomarkers for early detection of pancreatic cancer (see http://edrn.nci.nih.gov for more information). Another study has identified a composite marker of two proteins, TIMP1 and ICAM1, that was able to distinguish people with pancreatic cancer from those without the disease. This may be a potential biomarker for detecting pancreatic cancer using a blood sample (for more information: http://www.ncbi.nlm.nih.gov/pubmed/21443201).

Pancreatic cancer remains a silent killer, and a diagnosis of pancreatic cancer is still referred to as a death sentence. Although the amount of research in the area of pancreatic cancer is increasing, more needs to be done to increase awareness of this disease, allow physicians to diagnosis it earlier, and treat this type of cancer more effectively, with greater survival rates. Unfortunately, not a lot of money is being spent on the treatment of pancreatic cancer. According to data on the National Cancer Institute website in regard to treatment each year, $13.9 billion is spent on breast cancer, $10.3 billion on lung cancer, $12.2 billion on colorectal cancer, and only $1.9 billion on pancreatic cancer.

So much more needs to be done to help people with this terrible disease. How many more people need to die before life-changing progress is made with finding a successful treatment to truly fight pancreatic cancer and win?

For more information on pancreatic cancer, you can go to:

• American Cancer Society (www.cancer.org)
• National Cancer Institute (www.cancer.gov)
• Pancreatic Cancer Action Network (www.pancan.org)
• Lustgarten Foundation (www.lustgarten.org)
• Johns Hopkins University (http://www.path.jhu.edu/pancreas/PartAfAm.php?area=pa)

If there is any information you would like me to add to this page, please leave me a comment. Thank you.