For years, pancreatic cancer has been referred to as the “silent killer.” It is notoriously aggressive, resistant to treatment, and difficult to diagnose in the early stages when tumors are most treatable. Also, it’s location in the body, deep in the abdominal cavity right behind the stomach, makes it hard to detect. These are the primary reasons why it is the fourth deadliest cancer, and the five-year survival rate for those with stage IV pancreatic cancer is just 1 percent, according to the American Cancer Society. An estimated 41,000 Americans will die from pancreatic cancer this year alone. The disease claimed the life of Apple co-founder Steve Jobs, who had a rare form of pancreatic cancer called neuroendocrine. He lived for seven years, which is consistent with this type of cancer. Singer Luciano Pavarotti and actress Joan Crawford both had the more common form of pancreatic cancer called adenocarcinoma, a more aggressive type that can be treated with surgery – but only if caught early. Sadly, pancreatic cancer is most often diagnosed at a late stage when symptoms such as weight loss, jaundice, and back pain are more likely to occur. Only 10 to 15 percent of pancreatic cancers are diagnosed early enough to be considered for surgery. But even with surgery, the cancer returns in 50 to 90 percent of cases, and most patients die from the disease, according to the Centers for Disease Control. When surgery is not an option, patients undergo radiation and chemotherapy. However, pancreatic cancer cells are notoriously resistant to chemotherapy, especially in late stages when tumors have metastasized. Against this challenging backdrop, scientists and researchers have opened a new window into exactly how pancreatic tumors grow and spread, and hope it will lead to discovering more effective treatments. Much of the latest research centers on genetic changes in precancerous cells to determine the way damaged or abnormal genes are causing uncontrolled cell growth. Researchers believe if they can identify these damaged genes and proteins early, they can then begin repairing them or changing how they work. Studies show that pancreatic cancer develops in several different stages over a number of years.Scientists see the most significant abnormal changes in the genes in the late stages of the disease and are now analyzing the tumor cells and blood samples using a technique called DNA sequencing to look for genetic changes that give them clues to help formulate treatments. As we mark Pancreatic Cancer Awareness Month, I want to highlight recent research advancements centered on genetics and early detection so patients and families touched by this disease don’t lose hope. Since early detection is critical to a patient’s survival, researchers are zeroing in on special blood tests and diagnostic imaging tools to find cancer before it spreads. Cutting-edge imaging tests like the endoscopic ultrasound may be used to look for abnormalities like pre-cancerous lesions in people with risk factors for pancreatic cancer. Targeted therapies like EGFR inhibitors are being developed to attack the tumor itself and retard cancer cell growth. Another approach currently in clinical trials would starve the cancerous tumor by blocking the growth of blood vessels. Monoclonal antibody vaccines areanother form of treatment being tested that could strengthen the body’s immune system response to pancreatic cancer cells. As researchers make progress in understanding of the genetic basis of pancreatic cancer, it’s important for all Americans to know their risk factors. According the Mayo Clinic, the most common risk factors are smoking cigarettes, excess body weight, gender (men are at greater risk), age (90 percent of cases are diagnosed in people over 55), diabetes, chronic inflammation of the pancreas, family history of pancreatic cancer and family history of genetic conditions like Lynch syndrome, Familial Atypical Multiple Mole Melanoma (FAMMM) syndrome and the BRCA2 gene mutation. Because this disease has been so resistant to treatment, funding for research has been limited, which is reflected in the high mortality rates. At BIO, we hope that promoting a greater understanding of pancreatic cancer and highlighting promising avenues of diagnostic and therapeutic research will translate into increased investment and, one day, a cure.
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