Pancreatic Cancer: We all die from something

The funding for research on pancreatic cancer has skyrocketed since the founder of Apple, Steve Jobs, died from it on October 11, 2011.(1) Only $17 million was spent on research in this disease in 1999, climbing to more than $182 million in 2018.(2)

The lack of funding is due to the relative rarity of the disease. There are roughly 13 cases per 100,000 people, although that rate is gradually increasing, reaching close to 19 cases per 100,000 by mid-century.

That doesn’t mean much if you’re unlucky enough to get it. The 5-year survival rate with pancreatic cancer was 4.2% when Steve Jobs died, and remains a low 10% today. Statistically, new treatments have produced a 100% improvement, but 90% of people with this cancer don’t stay with us very long. The cancer can be cured if caught at an early stage when it is surgically treatable (more below), but that’s not what happens with most people who get it.

This raises a valid concern: how much are you willing to endure to get maybe one extra year of life?

This cancer is an issue because the pancreas is hidden behind the stomach, making direct observation and early detection of tumors difficult. By ignoring symptoms and weighting to see a doctor, people give the cancer time to develop. And that assumes the doctor recognizes the symptoms on initial examination.

As with any disease, early detection is better for the prognosis. Patients are divided into four categories: resectable, borderline resectable, locally advanced, and metastatic.(3) Those whose disease can be treated with surgical resection are the ones with the best chance for a full remission or cure today.

Source: Hu et. al. (4)

The AARP (among others) has published a list of early symptoms of pancreatic cancer, and it’s worth keeping these in mind. The problem, as with most other diseases, is that the symptoms overlap with other less serious diseases. However, one or two of the symptoms are less common, and symptoms that linger are worth a consultation with a doctor.

  • Abdominal and back pain. The pain is above the belly button and radiates toward the back. The pain stays and gets worse over time.
  • Diabetes with weight loss. This combination is unusual. Typically, weight loss diabetes can be put into remission. However, if cancer interferes with the function of the pancreas, everything changes.
  • Darkening of urine, lightening of stools and jaundice. Pancreatic cancer can block the bile duct causing these changes. Of course, darkening of urine can also signal dehydration, but if drinking more water doesn’t help, see a doctor.
  • Nausea and vomiting. Of course these are also early warning signs for Covid.
  • Fatigue. Unfortunately, this is an issue with a lot of diseases.
  • Loss of appetite and unintentional weight loss. If you lose weight without effort, you need to know why.

The review article (4) by Jian Xiong Hu and colleagues of Putian University (China) identifies some potentially controllable risk factors for pancreatic cancer as including:

  • Smoking
  • Alcohol consumption
  • Obesity
  • Oral bacteria (Listerine, anyone?)

There are a large number of uncontrollable factors that include gender (male), ethnicity (African-American, Japanese-American and native tribal), family history, history of pancreatitis (infections and inflammation). These all serve to increase the risk of this disease.

If you’re interested in this, the article by Hu et al is worth reading, and the NIH has a full reprint on it’s website.

Sources:

  1. https://abcnews.go.com/Health/CancerPreventionAndTreatment/steve-jobs-pancreatic-cancer-timeline/story?id=14681812
  2. https://www.aarp.org/health/conditions-treatments/info-2020/advances-in-pancreatic-cancer-treatment.html?cmp=EMC-DSO-NLC-WBLTR—BAU-021122-F1-6145759&ET_CID=6145759&ET_RID=116391553&encparam=ymgS3OZtsk3nhMrPdd27t30dvjeCy77bx69gILTX0JE%3d
  3. https://pubmed.ncbi.nlm.nih.gov/32593337/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8316912/

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